Pryce Helen, Dauman Nicolas, Burns-O'Connell Georgina
Department of Audiology, Aston University, Birmingham, United Kingdom.
Université de Poitiers, Univ Rennes, Univ Angers, Univ Brest, RPPSY, Poitiers, France.
Front Psychol. 2023 Jan 12;13:981776. doi: 10.3389/fpsyg.2022.981776. eCollection 2022.
Tinnitus is a complex experience that often occurs alongside other health conditions, including hearing loss. In the UK, as in other western countries, patterns of health are changing with a rise in multi-morbidity and complexity of health conditions. As we age, we can expect to live with multiple health conditions. Burden of illness has long been recognised. Less well recognised is the burden that accumulates from the treatment of health conditions.
This qualitative thematic analysis of patient accounts described the cumulative burdens of tinnitus, both the experience of hearing the tinnitus and from the treatments undertaken. Between 2017-8 we conducted interviews with 38 participants who were help-seekers in a range of contrasting UK clinical services (Physician led, Audiology led and Hearing Therapy led). We examined these interview data using reflexive thematic analysis methods to identify and explore the cumulative burdens for those who live with and seek help for their tinnitus. Specifically, we used six phased approach to determine and group themes.
The themes provide a coherent description of the nature of the burden that people with tinnitus experience.
In tinnitus, as with most chronic health conditions, the largest treatment workload is devolved to the patient. Patients are required to implement treatments, learn about tinnitus and find new ways of coping. Yet this work happens invisibly, without recognition from clinicians who measure outcomes but not the efforts made to achieve outcomes. Patient-centred care depends upon the recognition of the cumulative burdens that patients experience.
耳鸣是一种复杂的体验,常常与包括听力损失在内的其他健康状况同时出现。在英国,与其他西方国家一样,随着多种疾病并存情况的增加以及健康状况的复杂化,健康模式正在发生变化。随着年龄的增长,我们可能会患有多种健康问题。疾病负担早已得到认可。但人们对因健康问题治疗而累积的负担认识较少。
对患者叙述进行的这项定性主题分析描述了耳鸣的累积负担,包括耳鸣的体验以及所接受治疗带来的负担。在2017年至2018年期间,我们对38名参与者进行了访谈,这些参与者是英国一系列不同临床服务(由医生主导、听力学主导和听力治疗主导)中的求助者。我们使用反思性主题分析方法来研究这些访谈数据,以识别和探究那些患有耳鸣并寻求帮助的人的累积负担。具体而言,我们采用六个阶段的方法来确定和归类主题。
这些主题连贯地描述了耳鸣患者所经历负担的性质。
在耳鸣方面,与大多数慢性健康状况一样,最大的治疗工作量被转移到了患者身上。患者需要实施治疗、了解耳鸣并找到新的应对方法。然而,这项工作是在无形之中进行的,没有得到临床医生的认可,临床医生衡量的是结果而非为实现结果所付出的努力。以患者为中心 的护理取决于对患者所经历的累积负担的认识。