Factors related to tinnitus and hyperacusis handicap in older people.

OBJECTIVE: The aim was to assess factors related to tinnitus and hyperacusis handicap in older people. DESIGN: Retrospective cross-sectional. STUDY SAMPLE: Data were gathered for 184 patients with an average age of 69 years. RESULTS: Tinnitus handicap as measured via the Tinnitus Handicap Inventory (THI) was significantly predicted by tinnitus annoyance as measured via the visual analogue scale (VAS) (regression coefficient, b = 2.9, p < 0.001) and the effect of tinnitus on the patient's life as measured via the VAS (b = 3.9, p < 0.001). Hyperacusis handicap as measured via the Hyperacusis Questionnaire (HQ) was significantly predicted by the score on the depression subscale of the Hospital Anxiety and Depression Scale (HADS) (b = 0.8, p < 0.001) and to a small extent by the THI score (b = 0.07, p = 0.048). Insomnia scores as measured via the Insomnia Severity Index (ISI) were significantly predicted by scores on the depression subscale of the HADS (b = 0.46, p = 0.007). CONCLUSIONS: Since tinnitus annoyance significantly predicts tinnitus handicap, it is important to explore factors associated with annoyance that may be useful in designing appropriate rehabilitative interventions aimed at reducing tinnitus handicap in older people. Future studies should explore whether hyperacusis and insomnia in older people with tinnitus need to be managed in conjunction with treatment for depression.

Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: Patients' evaluations of the effectiveness of treatments.

OBJECTIVE: To assess patients' judgements of the effectiveness of the tinnitus and hyperacusis therapies offered in a specialist UK National Health Service audiology department. DESIGN: Cross-sectional service evaluation questionnaire survey. Patients were asked to rank the effectiveness of the treatment they received on a scale from 1 to 5 (1 = no effect, 5 = very effective). STUDY SAMPLE: The questionnaire was sent to all patients who received treatment between January and March 2014 (n = 200) and 92 questionnaires were returned. RESULTS: The mean score was greatest for counselling (Mean = 4.7, SD = 0.6), followed by education (Mean = 4.5, SD = 0.8), cognitive behavioural therapy - CBT (Mean = 4.4, SD = 0.7), and hearing tests (Mean = 4.4, SD = 0.9). Only 6% of responders rated counselling as 3 or below. In contrast, bedside sound generators, hearing aids, and wideband noise generators were rated as 3 or below by 25%, 36%, and 47% of participants, respectively. CONCLUSION: The most effective components of the tinnitus and hyperacusis therapy interventions were judged by the patients to be counselling, education, and CBT.

Psychometric Evaluation of a Patient Experience Questionnaire (PEQ) for Outpatient Appointments: Analysis Using Data from a U.K. National Health Service Audiology Department.

BACKGROUND: The Audiology Department at the Royal Surrey NHS Foundation Trust (RSFT), United Kingdom, developed a patient experience questionnaire (PEQ) to assess and compare patients' experiences of attending a wide range of appointments (e.g., hearing assessment, hearing aid fitting, hearing aid review, tinnitus therapy, balance assessment, and balance rehabilitation). PURPOSE: The aim of this study was to assess the psychometric properties of the PEQ. The PEQ is a unidimensional instrument with four items that assess a patient's experience of an outpatient appointment. RESEARCH DESIGN: Retrospective cross-sectional study. STUDY SAMPLE: Patients attending appointments for audiology services at RSFT between January and March 2020. DATA COLLECTION AND ANALYSIS: All patients (n = 656) attending appointments for audiology services at RSFT during randomly selected days between January and March 2020 were given the questionnaire to complete themselves (PEQ-self) or to complete on their child's behalf (PEQ-parent). The factor structures for the PEQ-self and PEQ-parent were assessed separately, using confirmatory factor analysis. A multiple-causes, multiple-indicators (MIMIC) model was fitted to explore potential bias due to gender and age. Internal consistency was assessed using Cronbach's α. The bivariate correlations between PEQ scores and other variables were evaluated using the nonparametric Spearman correlation coefficient. Floor and ceiling effects were assessed using the distribution of total scores. RESULTS: Confirmatory factor analysis revealed that a one-factor model gave a close fit to the data for both the self and parent versions. Cronbach's α for the total score was 0.77 for the PEQ-self and 0.86 for the PEQ-parent. The MIMIC model showed no significant direct effects of age or gender for either version. CONCLUSIONS: Both the PEQ-self and PEQ-parent questionnaire can be reliably used to measure patients' experiences of outpatient audiology appointments. Future studies should aim to assess the psychometric properties of the PEQ-self and PEQ-parent for a range of outpatient appointments other than audiology.