Coco Laura, Hooker Elizabeth R, Gilbert Tess A, Harker Graham R, Clark Khaya D, Reavis Kelly M, Henry James A, Zaugg Tara L, Carlson Kathleen F
VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, Oregon.
VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon.
Semin Hear. 2023 Jul 24;45(1):40-54. doi: 10.1055/s-0043-1770152. eCollection 2024 Feb.
Tinnitus is highly prevalent among military Veterans. Severe tinnitus can be associated with negative impacts on daily life. Veterans with severe tinnitus may also have greater difficulties in functional roles, including work. However, few studies have explicitly explored this relationship. Traumatic brain injury (TBI), also prevalent among Veterans, is associated with tinnitus and can additionally impair work functioning. This quantitative investigation used a population-based survey to assess the relationship between tinnitus severity, measured using the Tinnitus Functional Index (TFI), and the impact of tinnitus on work, measured using a composite score from the Tinnitus History Questionnaire, among a stratified random sample of VA healthcare-using Veterans diagnosed with tinnitus, with and without comorbid TBI. Analyses were weighted to account for sampling design and Veteran non-response; multiple imputation was used to account for missing data. Results indicated that for every 1-point increase in TFI score, there was an average 8% increase in the odds of reporting a high level of impact on work functioning (OR: 1.08; 95% CI: 1.06, 1.11). Veterans with a comorbid TBI diagnosis, compared with those without, were more likely to have high tinnitus-related impact on work functioning (OR: 2.69, 95% CI: 1.85, 3.91), but the relationship between tinnitus severity and the impact of tinnitus on work functioning did not differ by TBI status. These data can help researchers and clinicians understand complex symptoms experienced by Veterans with tinnitus, with and without TBI, supporting the improved provision of clinical services to these patients.
耳鸣在退伍军人中非常普遍。严重耳鸣可能会对日常生活产生负面影响。患有严重耳鸣的退伍军人在履行包括工作在内的各种职能时也可能会遇到更大的困难。然而，很少有研究明确探讨这种关系。创伤性脑损伤（TBI）在退伍军人中也很普遍，与耳鸣有关，还会进一步损害工作功能。这项定量研究使用了一项基于人群的调查，在分层随机抽取的被诊断患有耳鸣（有或没有合并TBI）的退伍军人医疗保健使用者样本中，评估使用耳鸣功能指数（TFI）测量的耳鸣严重程度与使用耳鸣病史问卷综合评分测量的耳鸣对工作的影响之间的关系。分析进行了加权以考虑抽样设计和退伍军人无应答情况；使用多重填补法处理缺失数据。结果表明，TFI评分每增加1分，报告对工作功能有高度影响的几率平均增加8%（比值比：1.08；95%置信区间：1.06，1.11）。与没有合并TBI诊断的退伍军人相比，患有合并TBI诊断的退伍军人更有可能在工作功能方面受到与耳鸣相关的高度影响（比值比：2.69，95%置信区间：1.85，3.91），但耳鸣严重程度与耳鸣对工作功能的影响之间的关系在有无TBI状态方面没有差异。这些数据可以帮助研究人员和临床医生了解患有耳鸣（有或没有TBI）的退伍军人所经历的复杂症状，支持为这些患者改善临床服务的提供。
