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Quality of life in patients with tinnitus and sensorineural hearing loss
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
2014 (English)In: B-ENT, ISSN 1781-782X, Vol. 10, no 1, 41-51 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of this study was to evaluate the quality of life in patients with tinnitus and SNHL, to investigate patients’ mental and physical health and to measure the level of satisfaction concerning the care experienced by the patients.

Methods: Three questionnaires related to patients` physical and psychological health, were mailed to 714 Swedish patients with tinnitus and sensorineural hearing loss.

Results: Female patients had significantly higher Tinnitus Handicap Inventory scores than male patients. Patients who were satisfied with the care they obtained had significantly higher PTA. It was found that the satisfied group had significantly lower THI-scores. In the dissatisfied group, 61% of patients had no hearing aids compared to 42% in the satisfied group.

Conclusion: Our cohort of patients estimated their life quality and general health at a good level almost 4.5 years after their first report of tinnitus. Another finding was that 47% of patients were not satisfied with the treatment they obtained. In the dissatisfied group, 61% of patients had no hearing aids. Further research is required to find an approach that could motivate patients with both tinnitus and hearing impairment to use hearing aids.

Place, publisher, year, edition, pages
ROYAL BELGIAN SOC EAR, NOSE, THROAT, HEAD & NECK SURGERY , 2014. Vol. 10, no 1, 41-51 p.
Keyword [en]
Tinnitus, Sensorineural hearing loss, Questionnaire, Quality of life
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-81412ISI: 000334566200007PubMedID: 24765828OAI: oai:DiVA.org:liu-81412DiVA: diva2:552289
Available from: 2012-09-13 Created: 2012-09-13 Last updated: 2017-02-20Bibliographically approved
In thesis
1. Tinnitus in Patients with Sensorineural Hearing Loss: Management and Quality of Life
Open this publication in new window or tab >>Tinnitus in Patients with Sensorineural Hearing Loss: Management and Quality of Life
2012 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Approximately 15 % of Swedish people experience tinnitus, but only 2.4 % of them experience severe problems. Treatment modalities for tinnitus are varied, but the most common treatment model is counselling. The majority of patients with tinnitus report some degree of hearing loss, and in addition, hearing aids have been used for many years in patients who suffer from both tinnitus and hearing impairment.

The aim of the present thesis was to investigate the disease management and identify the quality of life in patients with tinnitus and sensorineural hearing loss.

Both studies described here are retrospective, descriptive studies of patients who sought care for tinnitus and hearing loss at the two ENT clinics in Östergötland County, Sweden, during 2004 - 2007 and who also received a diagnosis code. A medical record review of all patients (study I contained 1672 subjects) revealed that 714 patients were diagnosed with both tinnitus and SNHL between 2004 and 2007 and could be included in study II.

The results showed that 70% of our cohort had tinnitus, but many of the patients initially did not receive a diagnosis for their tinnitus. Information about the patients’ vertigo, heredity for hearing loss and tinnitus, diabetes history, cardiovascular disease history and other factors related to their health was often missing from the medical records. Our findings showed that the Stepped Care Model, which however was only used in a minority of the cases, could be effective in patients with tinnitus and could provide a better care process for these patients. Of the cohort, 56% of the patients received a diagnosis of bilateral hearing loss. The pure tone average (PTA) of the left ear was significantly higher than that of the right ear. There were 314 patients (44%) who had hearing aids out of the total of 714, even though it is likely that hearing aids could be beneficial for these patients. We found that the overall scores for the Tinnitus Handicap Inventory (THI) were higher in female patients than male patients. All patients who participated in study II estimated their life quality and general health at a good level. This could be due to the fact that they were investigated 4.5 years after they first reported their tinnitus and that tinnitus annoyance decrease over time. Further, the outcomes of study II demonstrated that the majority of patients, who were dissatisfied with the care they obtained, had no hearing aids. This could indicate a support the use of hearing aids fitting as main treatment model in patients with both tinnitus and hearing loss.

Future research is needed to investigate how hearing aid professionals could motivate patients who suffer from both tinnitus and hearing loss to use hearing aids.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. 56 p.
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 123
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-81413 (URN)978-91-7519-830-9 (ISBN)
Presentation
2012-10-05, Flemingsalen, plan 10, Södra entren, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2012-09-14 Created: 2012-09-13 Last updated: 2012-09-14Bibliographically approved
2. Tinnitus in Patients with Sensorineural Hearing Loss: Management, Quality of Life and Treatment Strategies
Open this publication in new window or tab >>Tinnitus in Patients with Sensorineural Hearing Loss: Management, Quality of Life and Treatment Strategies
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Approximately 15% of Swedish people experience tinnitus, but only 2.4% experience severe problems. Treatment modalities for tinnitus vary, but the most common treatment is counseling. The majority of patients with tinnitus report some degree of hearing loss, and hearing aids have been used for many years in patients who suffer from both tinnitus and hearing impairment. The aim of the present thesis was to investigate disease management, determine quality of life and identify treatment strategies for patients with tinnitus and sensorineural hearing loss.

The first two studies described here are retrospective, descriptive studies of patients who sought care for tinnitus and hearing loss at two Ear-Nose-Throat (ENT) clinics in Östergötland County, Sweden, during the years 2004 - 2007. Study I showed that 70% of the cohort had tinnitus; however, many did not initially receive a diagnosis of tinnitus. Information about vertigo, heredity for hearing loss and tinnitus, diabetes history, cardiovascular disease history and other factors related to health was often missing from the patients’ medical records. The results could show that the overall scores using the Tinnitus Handicap Inventory (THI) were higher in female patients than in male patients. Although it is likely that hearing aids would be beneficial for the majority of these patients, 314 (44%) of the 714 total patients had hearing aids. Furthermore, the outcomes from study II demonstrated that a majority of the patients (61%) who were dissatisfied with the care they had obtained had no hearing aids. This finding may indicate that the fitting of hearing aids is an important treatment for patients with both tinnitus and hearing loss.

Studies III and IV were prospective studies. Data collection was based on patients who sought care for tinnitus and/or hearing loss at the ENT clinic in Linköping during 2012-2013. In study III, 92 patients were divided into two groups: one group contained individuals with both tinnitus and hearing loss, and the other group contained patients with only hearing loss. The patients were assessed using the Reading Span test, the Hearing in Noise Test (HINT) and three questionnaires (the THI, the Hearing Handicap Inventory for Elderly and the Pittsburg Sleep Quality Index) at baseline and follow-up. The results from the age-matched subgroups (n=30+30) generated from the full clinical groups (46+46) showed significantly improved Reading Span test performance and sleep quality in patients with both tinnitus and hearing loss. Similar results were observed in our full clinical population (n=46+46). However, the interpretation of this finding is difficult due to age differences between the groups. In conclusion, hearing aid fitting had a significantly positive impact on working memory capacity and sleep quality in patients with both tinnitus and hearing loss compared with patients with only hearing loss.

In study IV, a brief Motivational Interviewing (MI) guide was integrated into the hearing rehabilitation process for 23 patients with both tinnitus and hearing loss, and they were compared against a control group (n=23) of patients with both tinnitus and hearing loss who underwent traditional hearing rehabilitation. The results showed that the patients who received the brief MI guide required fewer visits to complete their hearing rehabilitation compared with the patients in the control group. In addition, there was a significant difference in THI scores between the groups, which indicated that the intervention reduced tinnitus annoyance more in the MI group. Furthermore, both groups showed higher scores at follow-up compared with baseline on the International Outcome Inventory for Hearing Aids (IOI-HA) scale, which indicated that both approaches showed a positive effect on hearing aid satisfaction.

Study V was a retrospective, descriptive study that focused on a part of a Stepped Care model and included patients who participated in half-day tinnitus information meetings from 2004 to 2011 in the audiology clinic at Linköping University Hospital. A total of 426 tinnitus patients with complete questionnaires (the THI and the Hospital Anxiety and Depression Scale, HADS) were included in the study. The results showed significant decreases in scores on the THI and the anxiety module of the HADS before and after the information session. However, there were no statistically significant changes in the depression module of the HADS.

In conclusion, this thesis underscores the importance of hearing impairment, cognitive variables and motivational procedures in the management of tinnitus. Multidisciplinary group information needs to be further validated.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. 73 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1536
National Category
Otorhinolaryngology Neurology Public Health, Global Health, Social Medicine and Epidemiology Psychology
Identifiers
urn:nbn:se:liu:diva-132163 (URN)10.3384/diss.diva-132163 (DOI)9789176856970 (ISBN)
Public defence
2016-11-17, Graniten, Campus US, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2016-10-19 Created: 2016-10-19 Last updated: 2016-10-19Bibliographically approved

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Zarenoe, RezaLedin, Torbjörn

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