Department of Otolaryngology, Changi General Hospital, Singapore.
Saw Swee Hock School of Public Health, National University Health System, National University of Singapore, Singapore.
Singapore Med J. 2019 Dec;60(12):637-641. doi: 10.11622/smedj.2019066. Epub 2019 Jul 11.
Many tinnitus service providers advocate counselling as an initial and important approach for the management of tinnitus. Our tinnitus counselling clinic (TCC) developed a counselling protocol to deliver information and educate patients on self-help strategies. We aimed to obtain feedback on the components of the initial session and the self-help choices made by patients who returned for follow-up.
All patients who were attending the TCC completed a Tinnitus Handicap Inventory (THI) questionnaire during their first and follow-up sessions. At follow-up, patients were asked to rate how helpful each counselling component was and their choice of self-help strategy for tinnitus.
203 patients attended the follow-up session, representing 60.1% of patients initially counselled. THI scores improved, with 45.8% more patients categorised as having no handicap at follow-up compared to the initial 26.1%. Two most helpful counselling components (rated on a 5-point scale) were explanation of self-help strategies (mean score 4.40 ± 0.68) and illustration of healthy and damaged hair cells (mean score 4.30 ± 0.74). The most popular choice for self-help was using a sound strategy plus change in thinking (41.9%, n = 85). A few (32.5%, n = 66) patients were able to change their perception of tinnitus without any sound enrichment, while 17 (8.4%) patients relied solely on sound strategy. Most (97.5%) patients found the initial counselling session helpful. However, 92 (45.3%) patients were still seeking a cure for their tinnitus.
Most patients found the counselling helpful at follow-up. Counselling offered them the opportunity to actively manage their tinnitus.
许多耳鸣服务提供者主张将咨询作为耳鸣管理的初始和重要方法。我们的耳鸣咨询诊所（TCC）制定了咨询方案，为患者提供信息并教育他们自助策略。我们旨在获得有关初始阶段组成部分以及返回复诊患者所做的自助选择的反馈。
所有在 TCC 就诊的患者在首次和复诊时都完成了耳鸣残疾量表（THI）问卷。在复诊时，患者被要求对每个咨询组成部分的有用程度以及他们选择的耳鸣自助策略进行评分。
203 名患者参加了复诊，占最初接受咨询的患者的 60.1％。THI 评分有所改善，与最初的 26.1％相比，复诊时无残疾的患者比例增加了 45.8％。两个最有用的咨询组成部分（评分在 5 分制上）是对自助策略的解释（平均得分为 4.40±0.68）和健康和受损毛细胞的说明（平均得分为 4.30±0.74）。最受欢迎的自助选择是使用声音策略加思维转变（41.9％，n=85）。少数（32.5％，n=66）患者能够在不使用任何声音丰富的情况下改变对耳鸣的感知，而 17（8.4％）患者仅依赖声音策略。大多数（97.5％）患者发现初始咨询阶段很有帮助。但是，92（45.3％）名患者仍在寻求治愈耳鸣的方法。
大多数患者在复诊时发现咨询很有帮助。咨询为他们提供了积极管理耳鸣的机会。
