Beukes Eldré W, Allen Peter M, Baguley David M, Manchaiah Vinaya, Andersson Gerhard
Faculty of Science and Technology, Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom.
Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom.
Am J Audiol. 2018 Nov 19;27(3S):431-447. doi: 10.1044/2018_AJA-IMIA3-18-0004.
The purpose of this study was to investigate the long-term outcomes 1 year after undertaking an audiologist-guided Internet-based cognitive behavioral therapy (iCBT) intervention for tinnitus. Secondary aims were to identify any predictors of outcome and whether there were any unwanted events related to undertaking iCBT for tinnitus.
Participants who had previously undertaken a randomized iCBT efficacy trial for tinnitus were invited to participate. Of the 146 who were initially randomized for the efficacy trial, 104 participants completed the 1-year postintervention assessment measures. The primary outcome was a change in tinnitus distress as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for insomnia, anxiety, depression, hearing handicap, hyperacusis, cognitive failures, and satisfaction with life. An intention-to-treat analysis using repeated-measures analysis of variance and hierarchical multiple regression was used for statistical analysis. Unwanted effects were categorized according to the unwanted events checklist.
Undertaking iCBT for tinnitus led to significant improvements 1 year postintervention for tinnitus and related difficulties, for example, insomnia, anxiety, depression, hearing handicap, hyperacusis, and life satisfaction. The best predictors of improving tinnitus severity at 1-year postintervention were greater baseline tinnitus severity scores, reading more of the modules, and higher satisfaction with the intervention. Unwanted events were reported by 11% of the participants and were more likely to be reported by women than men. These events were related to worsening of symptoms, the emergence of new symptoms, negative well-being, and prolongation of treatment.
The clinical benefits of audiologist-guided iCBT for tinnitus and tinnitus-related difficulties were sustained 1 year postintervention. Predictors of outcome indicated that the intervention is applicable to a wide range of participants regardless of their demographic backgrounds. Attempts should be made to minimize unwanted events in subsequent trials.
本研究旨在调查在听力学家指导下进行基于互联网的耳鸣认知行为疗法（iCBT）干预1年后的长期效果。次要目的是确定任何结果预测因素，以及进行耳鸣iCBT是否存在任何不良事件。
邀请之前参加过耳鸣随机iCBT疗效试验的参与者参加。在最初随机分配参加疗效试验的146人中，104名参与者完成了干预后1年的评估措施。主要结果是通过耳鸣功能指数评估的耳鸣困扰变化。次要评估措施包括失眠、焦虑、抑郁、听力障碍、听觉过敏、认知失误和生活满意度。采用重复测量方差分析和分层多元回归的意向性分析进行统计分析。不良影响根据不良事件清单进行分类。
进行耳鸣iCBT干预1年后，耳鸣及相关问题（如失眠、焦虑、抑郁、听力障碍、听觉过敏和生活满意度）有显著改善。干预后1年耳鸣严重程度改善的最佳预测因素是更高的基线耳鸣严重程度评分、阅读更多模块以及对干预更高的满意度。11%的参与者报告了不良事件，女性比男性更有可能报告这些事件。这些事件与症状恶化、新症状出现、幸福感降低和治疗延长有关。
听力学家指导的耳鸣iCBT对耳鸣及耳鸣相关问题的临床益处干预后1年持续存在。结果预测因素表明，无论参与者的人口统计学背景如何，该干预适用于广泛的参与者。在后续试验中应努力尽量减少不良事件。
