Parental knowledge and attitude towards permanent childhood hearing loss in Rawalpindi City, Pakistan: cultural adaptation and validation of a questionnaire

Abstract

Childhood hearing loss is a significant public health issue in Pakistan, where prevalence rates exceed the global average. Parental knowledge and attitudes play a pivotal role in early detection and intervention, yet limited research explores these aspects within this country. This study assessed parental understanding and perceptions of permanent childhood hearing loss (PCHL) in Rawalpindi city, Pakistan, focusing on knowledge and attitudes, demographic influences, and psychometric evaluation of the survey tool. A cross-sectional survey was conducted with 430 parents (215 fathers and 215 mothers) of children aged 0–12 years, recruited through multi-site convenience sampling at public locations, including schools, malls, and hospitals. Data were collected through face-to-face interviews. Results showed that 52.6% of parents demonstrated good knowledge of PCHL, with 84% recognizing the need for help when a child is unresponsive to a call. However, significant gaps were evident regarding prenatal and neonatal risk factors, with less than 50% aware of these risks. Gender disparities were found, with mothers showing greater awareness than fathers across several areas, including congenital causes (84.7% vs. 74.9%), Down syndrome (57.5% vs. 47%), oxygen deprivation (40.9% vs. 30.7%), early identification (60.9% vs. 50.7%), treatment availability (79.5% vs. 69.3%), and educational inclusion (55.3% vs. 44.2%). Despite knowledge gaps, attitudes were overwhelmingly positive, with over 80% agreement across all items. Educational level emerged as the only factor impacting both knowledge (p < 0.001) and attitudes (p < 0.001). Additionally, chi-square tests confirmed a significant association between knowledge and attitudes (p < 0.001). The questionnaire demonstrated good reliability (Cronbach’s alpha = 0.7), and factor analysis revealed multidimensional parental knowledge, except for beliefs about non-medical causes. These findings highlight the need for targeted educational programs to address parental knowledge gaps and enhance positive attitudes, thereby promoting early detection and intervention for PCHL in Pakistan