Effects of Children With Hearing Loss on Parents' Work and Social Adjustment: The Mediating Role of Psychological Inflexibility and Psychological Distress.

Purpose: Our study aimed to validate the reliability and validity of the Chinese version of the Work and Social Adjustment Scale (WSAS) in a group of parents of children with hearing loss (CHL), to explore the factors influencing the work and social adjustment (WSA) of parents of CHL, and to verify whether the association between CHL and parents' WSA was mediated by psychological inflexibility and psychological distress.

Method: Two hundred sixty-three CHL and their parents were involved in the study. Cronbach's alpha coefficient, intraclass correlation coefficient, exploratory factor analysis, and Spearman's correlation coefficient were used to verify the reliability and validity of the Chinese version of the WSAS. Multivariable binary logistic regression identified factors associated with parents' WSA. A structural equation model was utilized to clarify the relationship among CHL, parents' psychological inflexibility and distress, and the WSA of the parents.

Results: The Chinese version of WSAS had good reliability and validity, which provided an indicator for assessing the WSA of families of CHL in China. Fitting hearing-assistive devices on both ears for CHL was a protective factor for parents' WSA, while being a male with hearing loss was a risk factor for parents' WSA. Furthermore, older parents, higher education levels, psychological inflexibility, and psychological distress for family members were associated with poorer WSA. Most importantly, the structural equation model showed that psychological inflexibility and psychological distress played a mediating role between CHL and parents' WSA.

Conclusions: The psychological inflexibility and psychological distress of family members of CHL deserve close attention from medical workers during the rehabilitation of CHL. Our findings provide the theoretical basis for reducing CHL parents' psychological inflexibility and psychological distress and improving the WSA of parents.