Adequacy of the Simplified Version of the Tinnitus Handicap Inventory (THI-S) to Measure Tinnitus Handicap and Relevant Distress

다국어 초록 (Multilingual Abstract)

Background and Objectives: The Tinnitus Handicap Inventory (THI) often requires patients to devote their time to complete the questionnaire than they expect. Given that it limits the effectiveness of THI in a busy clinical practice that desires a quick and easy assessment of tinnitus handicap, this study evaluated clinical usefulness of a Simplified version of Tinnitus Handicap Inventory (THI-S) in measuring the severity of tinnitus handicap as well as predicting the psychological distress associated with tinnitus. Subjects and Methods: A total of 129 outpatients suffering from tinnitus (61 with normal hearing and 68 with hearing loss) participated in this study. The responses of THI-S (10 items) and THI (25 items) were evaluated to quantify the subjective handicap of tinnitus. The self-perceived level of stress, anxiety, and depression of all participants was measured with a series of self-report questionnaires such as Korean version of Brief Encounter Psychosocial Instrument (BEPSI), State Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI), respectively. All the questionnaire responses were analyzed using non-parametric analyses to examine the convergence, comparability, internal consistency reliability and validity of THI-S. Results: The severity of tinnitus handicap and the relevant psychological distress greatly varied across individuals. The THI-S responses were comparable to original THI responses, regardless of hearing status of patients. The internal consistency of THI-S responses was found to be good for total score (Cronbach’s α=0.83-0.91), with moderately high consistency for the emotional, functional, and catastrophic subscales. Significant (p<0.01) correlations of the THI-S with the THI (rs=0.95) as well as with the BEPSI, STAI, BDI questionnaires (rs=0.40-0.45) suggest that the THI-S questionnaire appeared to be useful to provide objective data of subjective tinnitus handicap as well as predict psychological distress. Three factors were extracted through factor analysis, which explained 73% of the total variance. Conclusions: Despite reducing the length of 25 items of THI to 10 items, the THI-S can be used as s a simple but reliable and valid tool for evaluating severity of tinnitus handicap as well as detecting its negative impact on psychological functioning.

참고문헌 (Reference)

1 문미진, "한국형 간소화 이명 설문지의 개발" 대한이비인후과학회 56 (56): 138-143, 2013

2 김지혜, "한국어 번역판 Tinnitus Handicap Inventory의 신뢰도 및 타당도 연구" 대한이비인후과학회 45 (45): 328-334, 2002

3 류소진, "이명장애지수에 영향을 주는 요인에 대한 분석" 한국청각언어재활학회 7 (7): 164-178, 2011

4 이수향, "개인의 정서가 이명재훈련치료에 미치는 영향" 한국청각언어재활학회 9 (9): 66-73, 2013

5 Monzani D., "Validity of the Italian adaptation of the Tinnitus Handicap Inventory; focus on quality of life and psychological distress in tinnitus-sufferers" 28 : 126-134, 2008

6 Bankstahl US., "Validation of the THI-12 questionnaire for international use in assessing tinnitus : a multi-centre, prospective, observational study" 51 : 671-677, 2012

7 Andersson G., "Understanding tinnitus distress: introducing the concepts of moderators and mediators" 47 Suppl 2 : S106-S111, 2008

8 Axelsson A., "Tinnitus--a study of its prevalence and characteristics" 23 : 53-62, 1989

9 Budd RJ., "Tinnitus coping style and its relationship to tinnitus severity and emotional distress" 41 : 327-335, 1996

10 Reynolds P., "Tinnitus and psychological morbidity : a cross-sectional study to investigate psychological morbidity in tinnitus patients and its relationship with severity of symptoms and illness perceptions" 29 : 628-634, 2004

11 Yim JH., "The validity of modified Korean-translated BEPSI(Brief Encounter Psychosocial Instrument. as instrument of stress measurement in outpatient clinic" 17 : 42-49, 1996

12 Pinto PC., "The impact of gender, age and hearing loss on tinnitus severity" 76 : 18-24, 2010

13 Frank SH., "Stress in the clinical setting : the Brief Encounter Psychosocial Instrument" 26 : 533-539, 1988

14 Newman CW., "Self-focused and somatic attention in patients with tinnitus" 8 : 143-149, 1997

15 Zachariae R., "Reliability and validity of a Danish adaptation of the Tinnitus Handicap Inventory" 29 : 37-43, 2000

16 Robinson SK., "Relationship of tinnitus questionnaires to depressive symptoms, quality of well-being, and internal focus" 9 : 97-103, 2003

17 Crocetti A., "Questionnaires to evaluate anxiety and depressive levels in tinnitus patients" 140 : 403-405, 2009

18 Zöger S., "Psychiatric disorders in tinnitus patients without severe hearing impairment : 24 month follow-up of patients at an audiological clinic" 40 : 133-140, 2001

19 Welch D., "Personality and perception of tinnitus" 29 : 684-692, 2008

20 한우재, "Neural Mechanisms and Models of Tinnitus Generation" 한국청각언어재활학회 5 (5): 13-19, 2009

21 Park SN., "Measurement of stress, anxiety and depression in the patients with tinnitus and their clinical significance" 11 : 22-28, 2007

22 Spielberger CD, "Manual for the State-Trait Anxiety Inventory" Consulting Psychologists Press 1970

23 Beck AT., "Internal consistencies of the original and revised Beck Depression Inventory" 40 : 1365-1367, 1984

24 Henry JA., "General review of tinnitus : prevalence, mechanisms, effects, and management" 48 : 1204-1235, 2005

25 Chang Gun Cho, "Evaluation of Anxiety and Depressive Levels in Tinnitus Patients" 대한청각학회 17 (17): 83-89, 2013

26 Newman CW., "Development of the Tinnitus Handicap Inventory" 122 : 143-148, 1996

27 Newman CW., "Development and psychometric adequacy of the screening version of the tinnitus handicap inventory" 29 : 276-281, 2008

28 Cronbach LJ., "Coefficient alpha and the internal structure of tests" 16 : 297-334, 1951

29 Görtelmeyer R., "Assessment of tinnitus-related impairments and disabilities using the German THI-12 : sensitivity and stability of the scale over time" 50 : 523-529, 2011

30 Kim JT., "A study based on the standardization of the STAI for Korea" 21 : 69-75, 1978

31 Han HM., "A standardization study of beck depression inventory in Korea" 25 : 487-502, 1986

32 Rhee MK., "A standardization study of Beck Depression Inventory(II) : Korean version(K-BDI) : Validity" 4 : 96-104, 1995

33 Bae JM., "A quick measurement of stress in outpatient clinic setting" 13 : 809-820, 1992

34 Lee YH., "A Study of the reliability and the validity of the BDI, SDS, and MMPI-D scales" 10 : 98-113, 1991