Ghulyan-Bédikian V, Paolino M, Giorgetti-D'Esclercs F, Paolino F
Hôpital Clairval, institut méditerranéen pour la recherche et le traitement des acouphènes (IMERTA), 317, boulevard du Redon, 13009 Marseille, France.
Encephale. 2010 Oct;36(5):390-6. doi: 10.1016/j.encep.2009.12.007. Epub 2010 Jan 27.
Tinnitus is a subjective phenomenon and in the majority of cases it is impossible to objectify it. The patient's self-evaluation using questionnaires and rating scales is the only way to quantify this symptom. Among the most widely used tools is the Tinnitus Handicap Inventory (THI). This questionnaire permits the practitioner to quantify the severity of tinnitus and measure the psycho-emotional and functional components of the tinnitus related handicap. It has been translated and validated in many languages. However, there is no French version of the THI. The reliability of the THI as a powerful clinical tool for tinnitus evaluation, and the lack of a French version of this questionnaire led us to translate it into French. The goal of this study was to validate our French adaptation of the THI (fTHI) for the management of French-speaking tinnitus sufferers. This is also essential for an effective international cooperation.
The fTHI was presented to a sample of 174 patients (63% men and 34% women) who had consulted our IMERTA Tinnitus Centre from June 2007 to July 2008. All patients reported tinnitus that had persisted for at least six months (average duration: 5.9 ± 4.3 years) as their primary complaint. The mean age of the sample was 54.2 ± 16.4 years, ranging from 22 to 84. The patients did not present any linguistic or mental problems likely to compromise their capacities to answer French questionnaires. During the first visit, before the consultation with the doctor, the patients were asked to complete the fTHI, and to evaluate the clearness of items and the ease of answering the questionnaire. Using rating scales, the patients were also asked to evaluate the severity of tinnitus and its impact on their quality of life. Internal consistency reliability of the fTHI and each sub-scale was evaluated using Cronbach's alpha coefficient (α). The average values, standard errors and correlations between the items, the scores of fTHI and those of the rating scales were calculated using "Statistica 6" software. The level of significance was set at 0.05. The homogeneity was considered to be satisfactory for α greater than 0.8.
Ninety-seven percent of the patients answered the totality of the fTHI. Ninety-six percent of them evaluated it as simple, comprehensible and easy to answer. Cronbach's α for the fTHI was 0.90 with item/total correlations (p<0.001) ranging from r=0.21 (item n(o) 19) to r=0.71 (items n(o) 17 and 21). Cronbach's α for the functional sub-scale was 0.80 with item/total correlations (p<0.001) ranging from r=0.38 (item n(o) 24) and 0.69 (item n(o) 4). Cronbach's α for the emotional sub-scale was 0.85 with item/total correlations (p<0.001) ranging from r=0.52 (item n(o) 6) and r=0.78 (item n(o) 21). Cronbach's α for the catastrophic sub-scale was 0.49 with item/total correlations (p<0.001) ranging from r=0.51 (item n(o) 19) and 0.63 (item n(o) 23). The total score of the fTHI is correlated significantly (p<0.001) with the functional (r=0.91), emotional (r=0.90) and catastrophic (r=0.69) sub-scales. Correlations between the fTHI and the rating scales vary between 0.26 (p<0.001) and 0.61 (p<0.001). The highest coefficient of correlation is obtained for the "Total score of fTHI"/"Tinnitus impact on quality of life".
Our results show that the French adaptation of the THI and its sub-scales has good internal consistency reliabilities, comparable to those of the original version. Significant inter-correlations are found between the sub-scales items, even if they represent three distinct factors. In addition, the fTHI is correlated with the self-report rating scales of the tinnitus's impact on the patient's quality of life and the severity of tinnitus. Thus, the fTHI is a psychometrically robust, reliable and valid measure of tinnitus related handicaps and can be used in a clinical setting to quantify the impact of tinnitus on French-speaking patients' quality of life, and to monitor their progress with specific therapies.
耳鸣是一种主观现象，在大多数情况下无法客观化。使用问卷和评定量表让患者进行自我评估是量化这种症状的唯一方法。耳鸣 handicap 量表（THI）是最广泛使用的工具之一。该问卷使从业者能够量化耳鸣的严重程度，并测量与耳鸣相关的心理情绪和功能障碍成分。它已被翻译成多种语言并经过验证。然而，尚无 THI 的法语版本。THI 作为评估耳鸣的有力临床工具的可靠性以及该问卷缺乏法语版本，促使我们将其翻译成法语。本研究的目的是验证我们对 THI 的法语改编版（fTHI）在管理说法语的耳鸣患者中的有效性。这对于有效的国际合作也至关重要。
将 fTHI 呈现给 174 名患者（63%为男性，34%为女性）的样本，这些患者在 2007 年 6 月至 2008 年 7 月期间咨询了我们的 IMERTA 耳鸣中心。所有患者均以耳鸣持续至少六个月（平均病程：5.9±4.3 年）作为主要诉求。样本的平均年龄为 54.2±16.4 岁，范围从 22 岁到 84 岁。患者不存在可能影响其回答法语问卷能力的语言或精神问题。在首次就诊时，在与医生会诊之前，要求患者完成 fTHI，并评估项目的清晰度和回答问卷的难易程度。还使用评定量表要求患者评估耳鸣的严重程度及其对生活质量的影响。使用克朗巴赫α系数（α）评估 fTHI 及其每个子量表的内部一致性可靠性。使用“Statistica 6”软件计算项目之间的平均值、标准误差和相关性、fTHI 的得分以及评定量表的得分。显著性水平设定为 0.05。当α大于 0.8 时，认为同质性令人满意。
97%的患者回答了 fTHI 的全部内容。其中 96%的患者认为它简单、易懂且易于回答。fTHI 的克朗巴赫α为 0.90，项目/总分相关性（p<0.001）范围从 r = 0.21（项目编号 19）到 r = 0.71（项目编号 17 和 21）。功能性子量表的克朗巴赫α为 0.80，项目/总分相关性（p<0.001）范围从 r = 0.38（项目编号 24）到 0.69（项目编号 4）。情绪性子量表的克朗巴赫α为 0.85，项目/总分相关性（p<0.001）范围从 r = 0.52（项目编号 6）到 r = 0.78（项目编号 21）。灾难性子量表的克朗巴赫α为 0.49，项目/总分相关性（p<0.001）范围从 r = 0.51（项目编号 19）到 0.63（项目编号 23）。fTHI 的总分与功能性子量表（r = 0.91）、情绪性子量表（r = 0.90）和灾难性子量表（r = 0.69）显著相关（p<0.001）。fTHI 和评定量表之间的相关性在 0.26（p<0.001）到 0.61（p<0.001）之间变化。“fTHI 总分”/“耳鸣对生活质量的影响”的相关性系数最高。
我们的结果表明，THI 的法语改编版及其子量表具有良好的内部一致性可靠性，与原始版本相当。即使子量表项目代表三个不同因素，它们之间也存在显著的相互相关性。此外，fTHI 与耳鸣对患者生活质量的影响以及耳鸣严重程度的自我报告评定量表相关。因此，fTHI 是一种心理测量学上稳健、可靠且有效的与耳鸣相关障碍的测量工具，可用于临床环境中量化耳鸣对说法语患者生活质量的影响，并监测他们在特定治疗中的进展。
