Outcome measures associated with perceived stress

We tend to think of situations in life as stressful when they are unpredictable, uncontrollable or overloading. Stress is a very personal experience. Perceived stress is a reflection of how such external stressful events and everyday hassles are ‘filtered’ according to our individual personality traits and coping strategies. People with tinnitus describe various stress-related complaints, but these symptoms are not just restricted to tinnitus. Poor concentration, sense of loss of control, sleep disturbance and irritability are also shared with people who are experiencing a state of generalised anxiety or depression. Whatever their origin, the goal of any clinical intervention for people with tinnitus should be to reduce these negative symptoms. This chapter takes a look at the way in which perceived stress associated with tinnitus has been measured. My focus is on clinical trials, but I start from the perspective of questionnaire construction by describing and comparing tinnitus-specific and general stress measures. I then evaluate how these instruments have been applied in a range of contemporary tinnitus trials. The chapter includes tutorials that introduce the reader to fundamental concepts in clinical trial design, understanding the purpose of questionnaires and appreciating the relevance of sample size calculations

Tinnitus pitch, masking, and the effectiveness of hearing aids for tinnitus therapy

Objective: To assess the benefits of hearing aids on tinnitus according to the tinnitus reaction questionnaire (TRQ; Wilson et al, 1991), to verify whether the degree of masking provided by the hearing aid influenced the TRQ score, to examine whether the matched tinnitus pitch predicted the effectiveness of hearing aids in masking tinnitus, and to determine whether prescription of high-frequency amplification might be desirable in tinnitus management when tinnitus pitch is high. Design and study sample: A retrospective evaluation of the clinical outcomes of 70 tinnitus patients fitted with hearing aids was undertaken. The primary outcome measure was the TRQ, with a secondary subjective measure of tinnitus masking. Results: Participants who achieved masking with their hearing aids had greater reduction in TRQ scores. Masking was more likely to be achieved when participants had good low-frequency hearing and tinnitus pitch fell into the frequency range of the hearing aids. Conclusions: The results support the use of hearing aids for tinnitus management, and suggest that masking may be a significant contributor to hearing aid success, implying that high-frequency amplification may be effective in high-pitch tinnitus.6 page(s