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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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Mui B, Leong N, Keil B, Domingo D, Dafny HA, Manchaiah V, Gopinath B, Muzaffar J, Chen J, Bidargaddi N, Timmer BHB, Vitkovic J, Esterman A, Shekhawat GS. COVID-19 and tinnitus: an initiative to improve tinnitus care. Int J Audiol 2023; 62:826-834. [PMID: 35916637 DOI: 10.1080/14992027.2022.2104175] [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: 03/15/2022] [Revised: 07/09/2022] [Accepted: 07/13/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the effects of COVID-19 on individuals with tinnitus and their views to guide future tinnitus care. DESIGN A mixed-methods cross-sectional research design. STUDY SAMPLE An online survey was completed by 365 individuals with tinnitus from Australia and other countries. RESULTS Tinnitus was reported to be more bothersome during the pandemic by 36% of respondents, whereas 59% reported no change and 5% reported less bothersome tinnitus. Nearly half of the respondents had received COVID-19 vaccination(s) and 12% of them reported more bothersome tinnitus while 2% developed tinnitus post-vaccination. Australian respondents spent less time in self-isolation or quarantine and saw fewer change in in-person social contact than respondents from other countries. More than 70% of respondents thought that tinnitus care services were insufficient both before and during the pandemic. Regarding their opinions on how to improve tinnitus care in the future, five themes including alleviation of condition, government policies, reduced barriers, self- and public-awareness, and hearing devices were identified. CONCLUSIONS A majority of respondents did not perceive any change in tinnitus perception and one-third of respondents had worsened tinnitus during the pandemic. To improve tinnitus care, better awareness and more accessible resources and management are crucial.
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Affiliation(s)
- Boaz Mui
- Department of Audiology, College of Nursing and Health Sciences, Flinders University, Flinders, Australia
| | - Natalie Leong
- Department of Audiology, College of Nursing and Health Sciences, Flinders University, Flinders, Australia
| | - Brenton Keil
- Department of Audiology, College of Nursing and Health Sciences, Flinders University, Flinders, Australia
| | - Deepti Domingo
- Department of Audiology, College of Nursing and Health Sciences, Flinders University, Flinders, Australia
| | - Hila A Dafny
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Flinders, Australia
- Centre for Remote Health: A JBI Affiliated Group
| | - 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
| | - Bamini Gopinath
- Department of Linguistics, Macquarie University Hearing, Macquarie University, Macquarie, Australia
| | - Jameel Muzaffar
- Department of Clinical Neurosciences, TWJ Foundation Fellow in Otology & Auditory Implantation, University of Cambridge, Cambridge, UK
- Department of Ear, Nose and Throat Surgery, Cambridge University Hospitals NHS Foundation Trust
- Oto Health Ltd
| | - Jinsong Chen
- The Clinician Ltd
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Niranjan Bidargaddi
- Flinders Digital Health Research Centre, College of Medicine and Public Health, Flinders University, Flinders, Australia
| | - Barbra H B Timmer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Sonova AG, Staefa, Switzerland
| | | | | | - Giriraj Singh Shekhawat
- Department of Audiology, College of Nursing and Health Sciences, Flinders University, Flinders, Australia
- Ear Institute, University College London, UK
- Tinnitus Research Initiative, Germany
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Leung T, Chalimourdas A, Timmermans A, Van Rompaey V, Vanderveken OM, Jacquemin L, Schlee W, Marneffe W, Luyten J, Gilles A, Michiels S. Effectiveness of Telerehabilitation Interventions for Self-management of Tinnitus: Systematic Review. J Med Internet Res 2023; 25:e39076. [PMID: 36757768 PMCID: PMC9951082 DOI: 10.2196/39076] [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: 04/28/2022] [Revised: 12/16/2022] [Accepted: 12/31/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Tinnitus is a highly prevalent symptom affecting 10%-20% of the adult population. Most patients with tinnitus have chronic tinnitus, which can directly or indirectly disrupt their daily life and negatively affect the health-related quality of life. Therefore, patients with tinnitus are frequently in need of costly and time-consuming treatments. As an answer, telerehabilitation interventions are on a rise to promote self-management in patients with tinnitus and reduce their dependency on in-person care. OBJECTIVE This systematic review aimed to provide an overview of the research concerning the effectiveness of telerehabilitation interventions for self-management of tinnitus. METHODS This systematic review adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were eligible for inclusion if study participants were adult patients with complaints of primary subjective tinnitus and the study intervention comprised any possible telerehabilitation form for the self-management of tinnitus complaints. A search for eligible studies was conducted on PubMed, ScienceDirect, Scopus, Web of Science, and Cochrane Library. The Cochrane Risk of Bias 2 tool was used to the assess risk of bias. RESULTS In total, 29 articles were found eligible, and of these, 5 (17%) studied multiple telerehabilitation forms. Internet-based cognitive behavioral treatment with guidance by a psychologist or audiologist was examined in 17 studies (n=1767), internet-based cognitive behavioral treatment without guidance was examined in 4 studies (n=940), self-help manuals were examined in 1 study (n=72), technological self-help devices were examined in 2 studies (n=82), smartphone apps were examined in 8 studies (n=284), and other internet-based interventions were examined in 2 studies (n=130). These rehabilitation categories were proven to be effective in decreasing tinnitus severity and relieving tinnitus distress as measured by tinnitus questionnaires such as Tinnitus Functional Index, Tinnitus Handicap Inventory, or Tinnitus Reactions Questionnaire. However, dropout rates were often high (range 4%-71.4%). All studies reported between some concerns and high concerns of risk of bias, resulting in low to moderate certainty levels. CONCLUSIONS Overall, there is low to moderate quality evidence that telerehabilitation interventions effectively reduce tinnitus severity and distress. These interventions form a possible tool to improve the self-management capacities of the patient and the accessibility of tinnitus care as a replacement or an addition to in-person care. Nevertheless, barriers such as lack of time, engagement, motivation, and openness of the patient causing high dropout should be considered. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42021285450; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=285450.
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Affiliation(s)
| | - Antonios Chalimourdas
- Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Annick Timmermans
- Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.,Department of translational neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Olivier M Vanderveken
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.,Department of translational neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Laure Jacquemin
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.,Department of translational neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Wim Marneffe
- Faculty of Business Economics, Hasselt University, Hasselt, Belgium
| | - Janis Luyten
- Faculty of Business Economics, Hasselt University, Hasselt, Belgium
| | - Annick Gilles
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.,Department of translational neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
| | - Sarah Michiels
- Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
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Standardized Clinical Profiling in Spanish Patients with Chronic Tinnitus. J Clin Med 2022; 11:jcm11040978. [PMID: 35207250 PMCID: PMC8875075 DOI: 10.3390/jcm11040978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 02/07/2023] Open
Abstract
Background: Tinnitus is a heterogeneous condition. The aim of this study as to compare the online and hospital responses to the Spanish version of European School for Interdisciplinary Tinnitus Research screening-questionnaire (ESIT-SQ) in tinnitus individuals by an unsupervised age clustering. Methods: A cross-sectional study was performed including 434 white Spanish patients with chronic tinnitus to assess the demographic and clinical profile through the ESIT-SQ, with 204 outpatients and 230 individuals from an online survey; a K-means clustering algorithm was used to classify both responses according to age. Results: Online survey showed a high proportion of Meniere’s disease (MD) patients compared to both the general population and the outpatient cohort. The responses showed statistically significant differences between groups regarding education level, tinnitus-related hearing disorders (MD, hyperacusis), sleep difficulties, dyslipidemia, and other tinnitus characteristics, including duration, type of onset, the report of mitigating factors and the use of treatments. However, these differences were partially confirmed after adjusting for age. Conclusions: Self-reported tinnitus surveys are a low confidence source for tinnitus phenotyping. Additional clinical evaluation is needed for tinnitus research to reach the diagnosis. Age-based cluster analysis might help to better define clinical profiles and to compare responses in ESIT-SQ among subgroups of patients with tinnitus.
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Andersson G. Tinnitus in 2021. Time to consider evidence-based digital interventions. THE LANCET REGIONAL HEALTH. EUROPE 2022; 12:100263. [PMID: 34950921 PMCID: PMC8671109 DOI: 10.1016/j.lanepe.2021.100263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Campus Valla, SE-58183, Linköping, Sweden
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Beukes E, Ulep AJ, Eubank T, Manchaiah V. The Impact of COVID-19 and the Pandemic on Tinnitus: A Systematic Review. J Clin Med 2021; 10:2763. [PMID: 34201831 PMCID: PMC8268057 DOI: 10.3390/jcm10132763] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 01/08/2023] Open
Abstract
This review aimed to systematically review what has been published regarding tinnitus during the coronavirus disease 2019 (COVID-19) pandemic up to March 2021 by performing both narrative and quantitative meta-analyses. Of the 181 records identified, 33 met the inclusion criteria, which generally had a fair risk of overall bias. In the included, 28 studies focused on the impact of the COVID-19 virus on tinnitus and 5 studies focused on the impact of the pandemic on tinnitus. From the studies identifying the impact of COVID-19 on tinnitus, there were 17 cross-sectional studies (n = 8913) and 11 case series or case report studies (n = 35). There were 2 cross-sectional studies (n = 3232) and 3 pre-post-test design studies (n = 326) focusing on the impact of the pandemic on tinnitus. No consistent patterns were found regarding the presentation of the tinnitus or additional factors that could have tinnitus developing in the disease impact studies. For the pandemic impact studies, the associated stress and anxiety of the pandemic were consistently suggested to contribute to tinnitus experiences. The pooled estimated prevalence of tinnitus post COVID-19 was 8% (CI: 5 to 13%). Medical professionals should be aware that tinnitus might be more problematic following the pandemic or after having COVID-19.
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Affiliation(s)
- Eldre Beukes
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX 77710, USA
- Vision and Hearing Sciences Research Centre, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1TP, UK
| | - Alyssa Jade Ulep
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX 77710, USA
| | - Taylor Eubank
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX 77710, USA
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX 77710, USA
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka 576104, India
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