Boecking Benjamin, Brueggemann Petra, Kleinjung Tobias, Mazurek Birgit
Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Otorhinolaryngology, University Hospital of Zürich, Zurich, Switzerland.
Front Psychol. 2021 Mar 12;12:596037. doi: 10.3389/fpsyg.2021.596037. eCollection 2021.
Measurement of tinnitus-related distress and treatment responsiveness is key in understanding, conceptualizing and addressing this often-disabling symptom. Whilst several self-report measures exist, the heterogeneity of patient populations, available translations, and treatment contexts requires ongoing psychometric replication and validation efforts.
To investigate the convergent validity and responsiveness of the German versions of the Tinnitus Questionnaire [TQ], Tinnitus Handicap Inventory [THI], and Tinnitus Functional Index [TFI] in a large German-speaking sample of patients with chronic tinnitus who completed a psychologically anchored 7-day Intensive Multimodal Treatment Programme.
Two-hundred-and-ten patients with chronic tinnitus completed all three questionnaires at baseline and post-treatment. Intraclass correlation coefficients determined the convergent validity of each questionnaire's total and subscale scores. Treatment responsiveness was investigated by [a] comparing treatment-related change in responders vs. non-responders as classified by each questionnaire's minimal clinically important difference-threshold, and [b] comparing agreement between the questionnaires' responder classifications.
The total scores of all three questionnaires showed high agreement before and after therapy (TQ | THI: 0.80 [Pre], 0.83 [Post], TQ | TFI: 0.72 [Pre], 0.78 [Post], THI | TFI: 0.76 [Pre] 0.80 [Post]). All total scores changed significantly with treatment yielding small effect sizes. The TQ and TFI yielded comparable (19.65 and 18.64%) and the THI higher responder rates (38.15%). The TQ | THI and TQ | TFI showed fair, and the THI | TFI moderate agreement of responder classifications. Independent of classification, responders showed significantly higher change rates than non-responders across most scores. Each questionnaire's total change score distinguished between responders and non-responders as classified by the remaining two questionnaires.
The total scores of all three questionnaires show high convergent validity and thus, comparability across clinical and research contexts. By contrast, subscale scores show high inconsistency. Whilst the TFI appears well suited for research purposes, the THI may be better suited to measure psychological aspects of tinnitus-related distress and their changes with accordingly focused treatment approaches.
测量耳鸣相关痛苦和治疗反应性是理解、概念化和解决这种常导致残疾症状的关键。虽然存在多种自我报告测量方法，但患者群体的异质性、可用翻译以及治疗背景需要持续的心理测量学重复和验证工作。
在一个完成了为期7天心理锚定强化多模式治疗方案的讲德语的慢性耳鸣患者大样本中，研究耳鸣问卷（TQ）、耳鸣障碍量表（THI）和耳鸣功能指数（TFI）德语版本的收敛效度和反应性。
210例慢性耳鸣患者在基线和治疗后完成了所有三份问卷。组内相关系数确定了每份问卷总分和子量表分数的收敛效度。通过以下方式研究治疗反应性：[a]比较根据每份问卷最小临床重要差异阈值分类的反应者与无反应者的治疗相关变化，以及[b]比较问卷反应者分类之间的一致性。
所有三份问卷的总分在治疗前后显示出高度一致性（TQ|THI：0.80[治疗前]，0.83[治疗后]；TQ|TFI：0.72[治疗前]，0.78[治疗后]；THI|TFI：0.76[治疗前]，0.80[治疗后]）。所有总分随治疗有显著变化，效应量较小。TQ和TFI产生了可比的反应率（分别为19.65%和18.64%），而THI的反应率更高（38.15%）。TQ|THI和TQ|TFI显示出一般的反应者分类一致性，THI|TFI显示出中等一致性。无论分类如何，反应者在大多数分数上的变化率显著高于无反应者。每份问卷的总变化分数能够区分出由其余两份问卷分类的反应者和无反应者。
所有三份问卷的总分显示出高收敛效度，因此在临床和研究背景下具有可比性。相比之下，子量表分数显示出高度不一致性。虽然TFI似乎非常适合研究目的，但THI可能更适合测量耳鸣相关痛苦的心理方面及其在相应针对性治疗方法下的变化。
