The development of a measure of participation in adults with hearing loss: a qualitative study of expert views

Background The International Classification of Functioning, Disability and Health (ICF) proposes that there are three primary healthcare outcomes: body functions/structure, activity and participation [1]. The ICF has recently been applied to hearing loss [2]. This is an important development, as it recognises that hearing loss can substantially affect both physical functioning and participation [3]. However, despite the importance of participation, this construct has proven difficult to measure [4]. This is primarily because participation is highly individual and because the current conceptualisation of participation is weak. The ultimate aim of this research is to develop a measure of participation in adults with hearing loss that addresses these difficulties, as presently there is no gold standard measure available [5]. The first step was to conduct a qualitative study to further develop the conceptualisation of participation in adults with hearing loss, thereby providing a foundation for its measurement.