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Loughlin J, Das V, Manchaiah V, Beukes E, Andersson G, Shekhawat GS. The positive side of living with tinnitus: a cross-sectional study. Int J Audiol 2024; 63:358-365. [PMID: 37004170 DOI: 10.1080/14992027.2023.2185756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/22/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE The aim of the current study was to examine the presence of positive experiences reported by individuals with tinnitus in the United States. DESIGN The study used a cross-sectional survey design. The data were analysed using qualitative (content analysis) and quantitative (t-test or Chi-square test) analyses. STUDY SAMPLE Study participants were individuals participating in clinical trials involving Internet-based cognitive behavioural therapy (ICBT) for tinnitus. A total of 439 respondents, 211 (48.1%) male and 228 (51.9%) female responded, and data were collected via an online questionnaire. RESULTS Of the 439 participants, 164 (i.e. 37.4%) reported at least one positive experience. Younger participants and those with lower hearing disability were more likely to report positive experiences. The responses were categorised into six categories: Outlook (n = 139), Personal development (n = 42), Treatment-related (n = 42), Coping (n = 29), Support (n = 19), and Disease-specific (n = 19). CONCLUSIONS The ability of individuals with chronic tinnitus to identify positive experiences may give insights regarding acceptance and coping with tinnitus as well as the temperament of individuals reporting positive experiences. Considering these variables may help when planning individualised rehabilitation programs.
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Affiliation(s)
- Jeremy Loughlin
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Vedas Das
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO, USA
- Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, CO, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Eldre Beukes
- Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, CO, USA
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Stockholm, Sweden
| | - Giriraj Singh Shekhawat
- College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
- Ear Institute, University College London, London, UK
- Tinnitus Research Initiative, Regensburg, Germany
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Clark KD, Coco L, Zaugg T, DeFrancesco S, Kaelin C, Henry JA, Carlson KF. A Qualitative Study of Veterans' Perspectives on Tinnitus: An Invisible Wound. Am J Audiol 2023:1-14. [PMID: 37983172 DOI: 10.1044/2023_aja-23-00040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
PURPOSE Tinnitus is highly prevalent among U.S. military Veterans, yet referral to, and use of, tinnitus rehabilitation services to improve quality of life and functional status with tinnitus is low. Veterans with tinnitus often have other health issues that overlap or exacerbate the impact of tinnitus, potentially complicating referral and rehabilitative pathways. This qualitative study explores views on the daily impacts of tinnitus and experiences with tinnitus-related health care among Veterans. The goal of this research is to amplify the voices of Veterans regarding their experiences with tinnitus to illuminate the physiological and socioemotional sequelae associated with the condition and to increase clinician awareness of the complex, interdisciplinary rehabilitative needs among Veterans with bothersome tinnitus. METHOD This qualitative study was part of a larger study about tinnitus and traumatic brain injury (TBI). Veterans were sampled to represent national Department of Veterans Affairs (VA) users with and without comorbid TBI, and who were or were not interested in tinnitus rehabilitation services. Forty Veterans with tinnitus were interviewed (32 men, eight women). Data were analyzed using a modified grounded theory approach. RESULTS Major themes across the Veteran interviews included (a) functional effects of tinnitus on daily life, (b) tinnitus and other health conditions, (c) reactions to the lack of a cure for tinnitus, (d) strategies to improve quality of life and function, and (e) use of VA services for tinnitus. CONCLUSIONS Our findings highlight that bothersome tinnitus negatively impacted various aspects of daily functioning, including communication, sleep, concentration, and mood, suggesting a need for audiologists to work closely with mental health services to improve quality of life and functional status for those negatively impacted by the condition. Future work is needed to obtain the viewpoints of clinicians and other health care partners to better understand the barriers and facilitators to providing evidence-based tinnitus treatment in VA and non-VA settings.
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Affiliation(s)
- Khaya D Clark
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland
- VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care, VA Portland Health Care System, OR
| | - Laura Coco
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care, VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Oregon Health and Science University, Portland
- School of Speech, Language, and Hearing Sciences, San Diego State University, CA
| | - Tara Zaugg
- School of Speech, Language, and Hearing Sciences, San Diego State University, CA
| | - Susan DeFrancesco
- VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care, VA Portland Health Care System, OR
- Oregon Health and Science University-Portland State University School of Public Health
| | - Christine Kaelin
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
| | - James A Henry
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, School of Medicine, Oregon Health and Science University, Portland
| | - Kathleen F Carlson
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care, VA Portland Health Care System, OR
- Oregon Health and Science University-Portland State University School of Public Health
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Baniotopoulou C, Boecking B, Mazurek B. Do you Hear what I Hear? A Qualitative Study Examining Psychological Associations Underlying Evaluations of Everyday Sounds in Patients with Chronic Tinnitus. J Pers Med 2023; 13:jpm13040690. [PMID: 37109076 PMCID: PMC10145674 DOI: 10.3390/jpm13040690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/12/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Tinnitus is a multifactorial phenomenon and psychological, audiological, or medical factors can facilitate its onset or maintenance. A growing body of research investigates individuals' perceptions, associations, and experiences of living with tinnitus. This body of research examines tinnitus as a condition rather than a symptom. We examine a sample of chronic tinnitus patients in terms of associations that are induced by neutral sounds. In particular, we investigate how patients with chronic tinnitus ascribe meaning to those neutral sounds. The present study uses Mayring's content analysis to explore the content of psychological associations underlying valence ratings of everyday neutral sounds. Nine tinnitus patients completed a hearing exercise, during which they listened to seven neutral sounds, following which we examined their sound-induced associations using semi-structured interviews. Three groups of factors influenced patients' associations and valence ratings of neutral sounds: affect, episodic memory, and 'other'. The former two factors further comprised two subcategories. In line with previous psychoaudiological research designs, our findings suggest that neutral, everyday auditory stimuli evoke strong affective reactions-possibly through serving as retrieval cues for episodic memories. Based on these findings, we discuss our results in the context of previous psychoaudiological findings and propose further research concerning psychological associations that may specifically underlie the tinnitus sound.
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Affiliation(s)
| | - Benjamin Boecking
- Tinnitus Center, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
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Carmody N, Eikelboom RH, Tegg-Quinn S. Seeking Help for Tinnitus and Satisfaction With Healthcare Providers Including Diagnosis, Clinical Services, and Treatment: A Scoping Review. Eval Health Prof 2023; 46:170-193. [PMID: 36853910 DOI: 10.1177/01632787231158402] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The objective of this scoping review was to describe the extent and type of evidence related to seeking help for tinnitus and satisfaction with healthcare providers including diagnosis, services and treatments along the clinical pathway. The selection criteria were adults aged 18 and over with tinnitus who sought help and where patient satisfaction with healthcare providers was reported. Online databases MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP) and CINAHL plus (EBSCO) were searched for original studies in English. The search had no date limit. Twenty-one records were eligible for data extraction. Studies reported that the most common healthcare providers seen were general practitioners, ear, nose and throat specialists and audiologists. Depression and tinnitus severity were related to an increase in the number of times help was sought and the type of healthcare provider seen may also impact patient satisfaction. The majority of participants were unlikely to receive a referral to a specialist at the initial GP consultation. Although there is limited research in this area, help-seekers for tinnitus were generally dissatisfied and reported negative interactions with healthcare providers. However, once in a specialised tinnitus clinical setting, studies reported that most help-seekers were satisfied and had positive interactions with healthcare providers.
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Affiliation(s)
- Natalie Carmody
- 104182Ear Science Institute Australia, Subiaco, WA, Australia.,Ear Sciences Centre, Medical School, 2720The University of Western Australia, Nedlands, WA, Australia
| | - Robert H Eikelboom
- 104182Ear Science Institute Australia, Subiaco, WA, Australia.,Ear Sciences Centre, Medical School, 2720The University of Western Australia, Nedlands, WA, Australia.,Department of Speech Language Pathology and Audiology, 56410University of Pretoria, Pretoria, South Africa.,Curtin Medical School, 1649Curtin University, Bentley, WA, Australia
| | - Susan Tegg-Quinn
- 104182Ear Science Institute Australia, Subiaco, WA, Australia.,Ear Sciences Centre, Medical School, 2720The University of Western Australia, Nedlands, WA, Australia
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5
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Pryce H, Dauman N, Burns-O’Connell G. What is the burden of tinnitus? Front Psychol 2023; 13:981776. [PMID: 36710784 PMCID: PMC9879209 DOI: 10.3389/fpsyg.2022.981776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 12/05/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Tinnitus is a complex experience that often occurs alongside other health conditions, including hearing loss. In the UK, as in other western countries, patterns of health are changing with a rise in multi-morbidity and complexity of health conditions. As we age, we can expect to live with multiple health conditions. Burden of illness has long been recognised. Less well recognised is the burden that accumulates from the treatment of health conditions. Methods This qualitative thematic analysis of patient accounts described the cumulative burdens of tinnitus, both the experience of hearing the tinnitus and from the treatments undertaken. Between 2017-8 we conducted interviews with 38 participants who were help-seekers in a range of contrasting UK clinical services (Physician led, Audiology led and Hearing Therapy led). We examined these interview data using reflexive thematic analysis methods to identify and explore the cumulative burdens for those who live with and seek help for their tinnitus. Specifically, we used six phased approach to determine and group themes. Results The themes provide a coherent description of the nature of the burden that people with tinnitus experience. Discussion In tinnitus, as with most chronic health conditions, the largest treatment workload is devolved to the patient. Patients are required to implement treatments, learn about tinnitus and find new ways of coping. Yet this work happens invisibly, without recognition from clinicians who measure outcomes but not the efforts made to achieve outcomes. Patient-centred care depends upon the recognition of the cumulative burdens that patients experience.
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Affiliation(s)
- Helen Pryce
- Department of Audiology, Aston University, Birmingham, United Kingdom
| | - Nicolas Dauman
- Université de Poitiers, Univ Rennes, Univ Angers, Univ Brest, RPPSY, Poitiers, France
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Dauman N. Towards a psychological framework on time perception in patients with chronic tinnitus. Front Aging Neurosci 2023; 15:1141903. [PMID: 37139090 PMCID: PMC10149727 DOI: 10.3389/fnagi.2023.1141903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/13/2023] [Indexed: 05/05/2023] Open
Abstract
Although disabling tinnitus is a chronic auditory phantom sensation, current knowledge on time perception (i.e., subjective time) in sufferers is limited and unsystematic. This theoretical analysis provides a first approach to this topic, highlighting the heterogeneity of time perception in humans as shown in various research areas. This heterogeneity is inherently related to goal attainment. Our immediate perception of time is restricted to present moment and recent past, whereas our sense of time is mostly future-oriented and represented as our past in a mental time line. The heterogeneity of time translates into a tension between anticipated changes one wants to see happen and full commitment that is required to goal attainment. Tinnitus sufferers are intensely aware of this tension in their self-perception. Their most compelling desire is that they no longer perceive tinnitus, but they get closer to this goal only by avoiding to put all their thoughts into it. Our analysis provides new perspectives on acceptance of tinnitus in relation to this time paradox. Building on the Tolerance model and the role of self-awareness in time perception, we contend that the main way for patients to gain long-term self-confidence is to engage in the present moment. Attention to this attitude is obscured in chronic sufferers by worries and ruminations associated with the ongoing presence of tinnitus. We provide arguments that time perception is a social perception, emphasizing the role of rewarding interactions in helping sufferers to overcome the feeling of being prevented from living in the moment. In the course of improvement towards acceptance, different changes in time perception are hypothesized that promote individuals' disengagement from unattainable goal (i.e., tinnitus suppression). A framework for future research is proposed, which distinguishes individuals' behaviors and associated emotions in relation to the time paradox.
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Affiliation(s)
- Nicolas Dauman
- Université de Poitiers, Univ Rennes, Univ Angers, Univ Brest, RPPSY, Poitiers, France
- Maison des Sciences de l’Homme et de la Société, Université de Poitiers – CNRS, Poitiers, France
- *Correspondence: Nicolas Dauman,
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Web-based discussion forums reveal the person-centered relevance and importance of tinnitus. PROGRESS IN BRAIN RESEARCH 2021; 260:205-221. [PMID: 33637218 DOI: 10.1016/bs.pbr.2020.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
An increasing number of health researchers are recognizing the benefits of crowdsourcing. Web-based discussion forums are well suited for collecting qualitative research data with tinnitus participants and forum posts can be evaluated using thematic analysis. The present study reports an innovative use of such qualitative data contributed by a group of 148 people with tinnitus and tinnitus professionals through the crowdsourcing platform Tinnitus Talk. While the primary research question was focused on defining symptom concepts, discussions were broad-ranging and extended far beyond this topic. Thematic analysis of the discussion conducted by two analysts identified three novel emerging themes and these were not pre-planned according to the moderator's script. These were (i) the lived experience of tinnitus, (ii) perspectives on interventions for tinnitus, and (iii) the experience of participating in a web discussion forum. These unexpected themes contribute to a richer and more in-depth understanding of tinnitus seen through the eyes of those who experience it on a daily basis. Findings are important since spontaneous themes presumably reflect issues that are of personal relevance and importance to the participants. They therefore give insights into future research directions and have implications for patient-centered counseling strategies that could be effective in clinic.
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8
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Abstract
OBJECTIVE This qualitative study sought to construct a model of empowerment for clinical implementation, based on the first-hand experience of a sample of individuals with chronic tinnitus. DESIGN The study was conducted in accordance with the inductive approach to data in classic grounded theory (GT). GT aims to build a model of behavior that accounts for the main concern of individuals and how they strive to resolve it. Twenty-one participants with chronic tinnitus (10 females, 11 males, age 31-85, mean: 57.6 years, mean duration of tinnitus: 12 years) were recruited through the patient association France Acouphènes and ENT consultations. Open-ended, tape-recorded interviews addressed the variation in the intrusiveness of tinnitus in daily life. A constant comparison analysis was undertaken to identify a core category and to distinguish stages in behavioral changes toward the tolerance of tinnitus. RESULTS Participants' main concern was to limit the intrusiveness of tinnitus day in, day out. They continuously had to handle tinnitus-induced frustration, which was found to be the core category of the analysis accounting for how all the participants tried to deal with the condition. The more they managed to handle their frustration, the better they coped with the condition. Three behavior patterns were identified as facilitating the ongoing management of tinnitus-induced frustration: (1) searching for perspective upon tinnitus; (2) maintaining order in perception despite its interference; and (3) alleviating conflict arising from social interactions. A model of empowerment is presented that is based on four stages toward tolerance of tinnitus. They are dominated by lack of perspective upon tinnitus (circuit 1), preservation of energy through attempts to control its intrusiveness (circuit 2), attempts to detach oneself from the interference of tinnitus through constant activities (circuit 3), and self-induced relief through the fulfillment of meaningful goals (circuit 4). CONCLUSION Tolerance of tinnitus requires finding balance between limiting one's social participation and spontaneity in carrying out meaningful activities. Tolerance can be enhanced by the preservation of one's energy and the mediating role of enjoyment through the fulfillment of gratifying goals. In patient counseling, it is essential to address the individual's desire for direct relief from tinnitus through its elimination. Individuals should be made aware that such a desire will likely be thwarted, resulting in the worsening of intrusiveness. Improvement in tolerance is accompanied by the attenuation of niggling self-awareness, a change that is typical of full commitment with valued goals and that helps in alleviating the interference of tinnitus. By understanding the role of frustration, individuals may develop a sense of responsibility in dealing with disabling tinnitus.
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Erlandsson SIM, Lundin L, Dauman N. The Experience of Tinnitus and Its Interaction With Unique Life Histories-Life Events, Trauma and Inner Resources Narrated by Patients With Tinnitus. Front Psychiatry 2020; 11:136. [PMID: 32256394 PMCID: PMC7093576 DOI: 10.3389/fpsyt.2020.00136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/14/2020] [Indexed: 12/18/2022] Open
Abstract
Background: The challenges facing people with chronic tinnitus include finding relief and rebuilding quality of life. However, previous traumatic episodes may influence adjustment and prolong suffering. Recovery implies reducing aggravating reactions and improving social roles, relationships and interests. Self-narratives about living with tinnitus have not yet received the attention they deserve in the research literature. Thus, the main goal of the present study was to illustrate how tinnitus suffering interacts with the participants' unique life histories. Method: Four women and one man (ages 52-58) took part in the study after consulting a special hearing clinic for annoying tinnitus. Criteria for inclusion were that tinnitus was regarded as a problem with negative consequences for quality of life. The participants should be willing to share how the experience of tinnitus suffering interacts with their previous life story. Narrative methodology was employed in order to achieve the goals of the study. We used unstructured interviews with free conversation, which allowed for rich narratives with full contextual meaning. Results: The findings, based on the narrative analysis, revealed that three out of five participants presented a regressive form of narrative indicating ongoing struggles beyond tinnitus itself, which they were unable to bring to closure. For them, valued goals were continuously thwarted by frustrating circumstances in their lives, either past events or current unresolved issues. Progressive and stable narratives, as identified in the other two participants, demonstrated values that rely on others' attitude and understanding toward their suffering, in sharp contrast to the regressive narratives. We suggest that a central issue in tinnitus rehabilitation should be to help suffering patients to overcome unresolved conflicts and thereby extend their ability for a fuller commitment in life. Conclusion: Considering enduring tinnitus as a chronic condition, whose course is likely to vary depending on the patient's general health status, an alteration of progressive and stable narratives is likely to occur during the lifespan. A progressive narrative shows similarities to the core construct of the salutogenesis model of health promotion (1). In conclusion, a narrative approach in tinnitus rehabilitation can be health promoting by offering the patient the opportunity to engage in storytelling, which in turn can increase comprehensibility and a sense of coherence.
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Affiliation(s)
| | - Linda Lundin
- Department of Social and Behavioral Science, University West, Trollhättan, Sweden
| | - Nicolas Dauman
- Department of Psychology, CAPS-EA4050, University of Poitiers, Poitiers, France
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10
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Abstract
Lifeworld-led care provides a route through which research and practice can navigate the 'biopsychosocial' allowing us to overcome the shortfalls of the medical model and enabling us to prioritise humanity in the care of people living with tinnitus. In this article, we sought to explore qualitative descriptions of life with tinnitus. We aimed to address the question 'what it is like to live with tinnitus?' In doing so we examined qualitative studies and provide suggestions about key themes that seem consistent. This is a narrative, thematic overview of the way lifeworld has been conceptualised and explored in tinnitus research.
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Affiliation(s)
- Helen Pryce
- Audiology Department, Aston University, Birmingham, UK
| | - Rachel Shaw
- Psychology Department, Aston University, Birmingham, UK
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The Fear of Tinnitus Questionnaire: Toward a Reliable and Valid Means of Assessing Fear in Adults with Tinnitus. Ear Hear 2019; 40:1467-1477. [DOI: 10.1097/aud.0000000000000728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Watts EJ, Fackrell K, Smith S, Sheldrake J, Haider H, Hoare DJ. Why Is Tinnitus a Problem? A Qualitative Analysis of Problems Reported by Tinnitus Patients. Trends Hear 2019; 22:2331216518812250. [PMID: 30482102 PMCID: PMC6277754 DOI: 10.1177/2331216518812250] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Tinnitus is a prevalent complaint, and people with bothersome tinnitus can report any number of associated problems. Yet, to date, only a few studies, with different populations and relatively modest sample sizes, have qualitatively evaluated what those problems are. Our primary objective was to determine domains of tinnitus problem according to a large clinical data set. This was a retrospective analysis of anonymized clinical data from patients who attended a U.K. Tinnitus Treatment Center between 1989 and 2014. Content analysis was used to code and collate the responses of 678 patients to the clinical interview question "Why is tinnitus a problem?" into categories of problems (domains). We identified 18 distinct domains of tinnitus-associated problems. Reduced quality of life, tinnitus-related fear, and constant awareness were notably common problems. Clinicians need to be mindful of the numerous problem domains that might affect their tinnitus patients. Current questionnaires, as well as being measures of severity, are useful clinical tools for identifying problem domains that need further discussion and possibly measurement with additional questionnaires. The domains identified in this work should inform clinical assessment and the development of future clinical tinnitus questionnaire.
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Affiliation(s)
| | - Kathryn Fackrell
- 2 NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, UK
| | - Sandra Smith
- 2 NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, UK
| | | | - Haúla Haider
- 4 ENT Department, Hospital Cuf Infante Santo, Nova Medical School, Lisbon, Portugal
| | - Derek J Hoare
- 2 NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, UK
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Marks E, Smith P, McKenna L. Living with tinnitus and the health care journey: An interpretative phenomenological analysis. Br J Health Psychol 2019; 24:250-264. [DOI: 10.1111/bjhp.12351] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 12/02/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Elizabeth Marks
- Department of Psychology University of Bath UK
- Royal National Throat Nose and Ear Hospital London UK
| | - Paula Smith
- Department of Psychology University of Bath UK
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15
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Pryce H, Chilvers K. Losing silence, gaining acceptance: a qualitative exploration of the role of thoughts in adult patients with subjective tinnitus. Int J Audiol 2018; 57:801-808. [DOI: 10.1080/14992027.2018.1500041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Helen Pryce
- Aston University School of Life and Health Sciences, Aston Triangle, Birmingham, UK
| | - Katie Chilvers
- Department of Audiology, Great Western Hospital, Swindon, UK
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Hall DA, Fackrell K, Li AB, Thavayogan R, Smith S, Kennedy V, Tinoco C, Rodrigues ED, Campelo P, Martins TD, Lourenço VM, Ribeiro D, Haider HF. A narrative synthesis of research evidence for tinnitus-related complaints as reported by patients and their significant others. Health Qual Life Outcomes 2018; 16:61. [PMID: 29642913 PMCID: PMC5896078 DOI: 10.1186/s12955-018-0888-9] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 04/02/2018] [Indexed: 12/26/2022] Open
Abstract
Background There are a large number of assessment tools for tinnitus, with little consensus on what it is important to measure and no preference for a minimum reporting standard. The item content of tinnitus assessment tools should seek to capture relevant impacts of tinnitus on everyday life, but no-one has yet synthesised information about the range of tinnitus complaints. This review is thus the first comprehensive and authoritative collection and synthesis of what adults with tinnitus and their significant others report as problems in their everyday lives caused by tinnitus. Methods Electronic searches were conducted in PubMed, Embase, CINAHL, as well as grey literature sources to identify publications from January 1980 to June 2015 in which participants were enrolled because tinnitus was their primary complaint. A manual search of seven relevant journals updated the search to December 2017. Of the 3699 titles identified overall, 84 records (reporting 86 studies) met our inclusion criteria and were taken through to data collection. Coders collated generic and tinnitus-specific complaints reported by people with tinnitus. All relevant data items were then analyzed using an iterative approach to narrative synthesis to form domain groupings representing complaints of tinnitus, which were compared patients and significant others. Results From the 86 studies analyzed using data collected from 16,381 patients, 42 discrete complaints were identified spanning physical and psychological health, quality of life and negative attributes of the tinnitus sound. This diversity was not captured by any individual study alone. There was good convergence between complaints collected using open- and closed-format questions, with the exception of general moods and perceptual attributes of tinnitus (location, loudness, pitch and unpleasantness); reported only using closed questions. Just two studies addressed data from the perspective of significant others (n = 79), but there was substantial correspondence with the patient framework, especially regarding relationships and social life. Conclusions Our findings contribute fundamental new knowledge and a unique resource that enables investigators to appreciate the broad impacts of tinnitus on an individual. Our findings can also be used to guide questions during diagnostic assessment, to evaluate existing tinnitus-specific HR-QoL questionnaires and develop new ones, where necessary. Trial Registration PROSPERO registration number: CRD42015020629. Protocol published in BMJ Open. 2016;6e009171. Electronic supplementary material The online version of this article (10.1186/s12955-018-0888-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Deborah Ann Hall
- Otology and hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK. .,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, NG1 5DU, UK.
| | - Kathryn Fackrell
- Otology and hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, NG1 5DU, UK
| | - Anne Beatrice Li
- School of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Rachel Thavayogan
- School of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK
| | - Sandra Smith
- Otology and hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2RD, UK.,National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, NG1 5DU, UK
| | - Veronica Kennedy
- Department of Audiovestibular Medicine, Halliwell Health and Children's Centre, Bolton NHS Foundation Trust, Farnworth, UK
| | - Catarina Tinoco
- ENT Department, Hospital Cuf Infante Santo - Nova Medical School, Travessa do Castro, 3, 1350-070, Lisbon, Portugal
| | - Evelina D Rodrigues
- WJCR - William James Center for Research, ISPA-Instituto Universitário, Rua Jardim do Tabaco, n°34, 1149-041, Lisbon, Portugal
| | - Paula Campelo
- ENT Department, Hospital Cuf Infante Santo - Nova Medical School, Travessa do Castro, 3, 1350-070, Lisbon, Portugal
| | - Tânia D Martins
- ENT Department, Hospital Cuf Infante Santo - Nova Medical School, Travessa do Castro, 3, 1350-070, Lisbon, Portugal
| | - Vera Martins Lourenço
- ENT Department, Hospital Cuf Infante Santo - Nova Medical School, Travessa do Castro, 3, 1350-070, Lisbon, Portugal
| | - Diogo Ribeiro
- ENT Department, Hospital Cuf Infante Santo - Nova Medical School, Travessa do Castro, 3, 1350-070, Lisbon, Portugal
| | - Haúla F Haider
- ENT Department, Hospital Cuf Infante Santo - Nova Medical School, Travessa do Castro, 3, 1350-070, Lisbon, Portugal
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17
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Greenwell K, Sereda M, Coulson N, El Refaie A, Hoare DJ. A systematic review of techniques and effects of self-help interventions for tinnitus: Application of taxonomies from health psychology. Int J Audiol 2016; 55 Suppl 3:S79-89. [DOI: 10.3109/14992027.2015.1137363] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Kate Greenwell
- National Institute for Health Research - Nottingham Hearing Biomedical Research Unit, Nottingham, UK,
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK,
| | - Magdalena Sereda
- National Institute for Health Research - Nottingham Hearing Biomedical Research Unit, Nottingham, UK,
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK,
| | - Neil Coulson
- Division of Rehabilitation and Aging, School of Medicine, University of Nottingham, Nottingham, UK and
| | - Amr El Refaie
- Speech and Hearing Department, School of Clinical Therapies, University College, Cork, Ireland
| | - Derek J. Hoare
- National Institute for Health Research - Nottingham Hearing Biomedical Research Unit, Nottingham, UK,
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK,
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18
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Greenwell K, Sereda M, Coulson N, Hoare DJ. Understanding User Reactions and Interactions With an Internet-Based Intervention for Tinnitus Self-Management: Mixed-Methods Process Evaluation Protocol. JMIR Res Protoc 2016; 5:e49. [PMID: 27009548 PMCID: PMC4823589 DOI: 10.2196/resprot.5008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 11/10/2015] [Accepted: 11/22/2015] [Indexed: 12/03/2022] Open
Abstract
Background Tinnitus is a common medical symptom that can affect an individual’s emotional and functional quality of life. Psychological therapies are acknowledged as beneficial to people with tinnitus; however, such therapies are not always readily accessible. With their global reach, automated Internet-based interventions have the potential to reduce the disparity in access to psychological support that people with tinnitus currently experience. However, the evidence on the acceptability and efficacy of these interventions is lacking. Process evaluations that develop an in-depth understanding of how users experience these interventions provide an essential first step when evaluating complex psychological interventions. Objective To describe the protocol for a study that will explore past, current, and new users’ reactions to and interactions with the Tinnitus E-Programme, an Internet-based intervention for the self-management of tinnitus. Methods Two parallel mixed-methods studies will be carried out with 2 different populations. Study 1 will use an online survey to gather past and current users’ views of the program. Study 2 will recruit new program users to take part in an interview and complete a relaxation log to explore how well they were able to implement the skills they learned during the program in their everyday lives. The findings from both studies will be triangulated to develop an in-depth understanding of the program’s mechanisms of impact and identify any implementation or contextual factors that strengthen or impede its delivery and functioning. Results Study 1 is open for recruitment with a projected completion in June 2016 and Study 2 was completed November 2015. At the time of submission, 36 participants have been recruited to Study 1 and 12 participants have taken part in Study 2. Conclusions Findings will inform the optimization of the Tinnitus E-Programme and guide future evaluation work to assess the program’s effectiveness as a therapy for people with tinnitus.
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Affiliation(s)
- Kate Greenwell
- National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom.
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