Beukes Eldré W, Andersson Gerhard, Manchaiah Vinaya
Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK.
Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, CO, USA.
Internet Interv. 2022 Oct 30;30:100583. doi: 10.1016/j.invent.2022.100583. eCollection 2022 Dec.
This study investigated the long-term outcomes 1-year after undertaking an Internet-based cognitive behavioural therapy (ICBT) for tinnitus distress in a US population. Secondary aims were to identify the effects on additional difficulties associate with tinnitus and any unwanted events related to ICBT for tinnitus.
A repeated-measures design with 4 time points was used. Participants previously undertaking two randomized ICBT efficacy trials for tinnitus in the US were invited to participate. Of the 200 invited, 132 (66 %) completed the 1-year follow-up questionnaire. The primary outcome was a change in tinnitus distress from baseline at one year post-intervention, as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for anxiety, depression, insomnia, hearing disability, hyperacusis, tinnitus cognitions and health-related quality of life.
Undertaking ICBT for tinnitus led to significant improvements 1-year post-intervention for tinnitus severity, with a large effect size ( = 1.06; CI: 0.80 to 1.32). Medium effects were found for anxiety ( = 0.54; CI: 0.29 to 0.79), depression ( = 0.46; CI: 0.21 to 0.70), insomnia ( = 0.47; CI: 0.22 to 0.72), and tinnitus cognitions ( = 0.43, CI: 0.18 to 0.68). Small effect sizes were found for hearing disability, hyperacusis and health-related quality of life. Adverse events related to the intervention were only reported by 1 participant.
The benefits of audiologist-guided ICBT for tinnitus and tinnitus-related difficulties were maintained 1-year post-intervention with very few adverse events reported. Ways of disseminate evidence-based easily accessible interventions to the general population with bothersome tinnitus should be sought.
本研究调查了美国人群中针对耳鸣困扰进行基于互联网的认知行为疗法（ICBT）一年后的长期效果。次要目的是确定其对与耳鸣相关的其他困难以及与耳鸣ICBT相关的任何不良事件的影响。
采用具有4个时间点的重复测量设计。邀请了之前在美国参加过两项耳鸣随机ICBT疗效试验的参与者。在200名受邀者中，132名（66%）完成了一年期随访问卷。主要结局是干预后一年耳鸣困扰相对于基线的变化，通过耳鸣功能指数进行评估。次要评估指标包括焦虑、抑郁、失眠、听力残疾、听觉过敏、耳鸣认知和健康相关生活质量。
进行耳鸣ICBT在干预后一年导致耳鸣严重程度显著改善，效应量较大（=1.06；置信区间：0.80至1.32）。在焦虑（=0.54；置信区间：0.29至0.79）、抑郁（=0.46；置信区间：0.21至0.70）、失眠（=0.47；置信区间：0.22至0.72）和耳鸣认知（=0.43，置信区间：0.18至0.68）方面发现了中等效应。在听力残疾、听觉过敏和健康相关生活质量方面发现了小效应量。仅1名参与者报告了与干预相关的不良事件。
听力学家指导的ICBT对耳鸣及与耳鸣相关困难的益处干预后一年仍得以维持，报告的不良事件极少。应寻求向有困扰耳鸣的普通人群传播易于获取的循证干预措施的方法。
