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Sökning: AMNE:(MEDICIN OCH HÄLSOVETENSKAP) AMNE:(Annan medicin och hälsovetenskap) AMNE:(Övrig annan medicin och hälsovetenskap) > Andersson Gerhard

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1.
  • Manchaiah, Vinaya, et al. (författare)
  • Problems and Life Effects Experienced by Tinnitus Research Study Volunteers : An Exploratory Study Using the ICF Classification
  • 2018
  • Ingår i: Journal of american academy of audiology. - Reston, VA, United States : American Academy of Audiology. - 1050-0545 .- 2157-3107. ; 29:10, s. 936-947
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Tinnitus is one of the most distressing hearing-related symptoms. It is often associated with a range of physiological and psychological complications, such as depression, anxiety, and insomnia. Hence, approaching tinnitus from a biopsychological perspective may be more appropriate than from purely a biomedical model.Objective: The present studywas aimed at determining the relationship between tinnitus and the problems and life effects experienced by UK-based tinnitus research study volunteers. Open-ended questions were used. Responses were classified using the International Classification of Functioning, Disability and Health (ICF) framework to understand the impact of tinnitus in a multidimensional manner using a biopsychosocial perspective.Research Design: A cross-sectional survey design was used.Study Sample: Study sample included a sample of 240 adults with tinnitus who were interested in undertaking an Internet-based intervention for tinnitus.Data Collection and Analysis: The data were collated using two open-ended questions. The first focused on problems related to having tinnitus and the second to life effects as a result of tinnitus. Responses were analyzed using a simplified content analysis approach to link concepts to ICF categories in accordance with established linking rules. A Wilcoxon signed-rank test was performed to compare the number of responses between the two questions. The most frequent responses related to body function involved ‘‘emotional functions’’ (b152), ‘‘sleep functions’’ (b134), ‘‘hearing functions’’ (b230), ‘‘sustaining attention’’ (b1400), and ‘‘energy level’’ (b1300). For activity limitations and participation restrictions they were ‘‘communicating with—receiving—spokenmessages’’ (d310), ‘‘socialization’’ (d9205), ‘‘handling stress and other psychological demands’’ (d240), and ‘‘recreation and leisure’’ (d920). The most frequently occurring responses related to environmental factors were ‘‘sound intensity’’ (e2500), ‘‘sound quality’’ (e2501), and ‘‘general products and technology for communication’’ (e1250). ‘‘Coping styles’’ was the most frequently occurring personal factor.Conclusions: The study highlights the use of open-ended questions in gathering useful information about the impact of tinnitus. The responses coded to ICF show that tinnitus impacts many domains, not only particularly body function, but also activity limitations and participation restrictions. The results demonstrate the heterogeneous nature of the impact of tinnitus on people affected.Results: There were 764 responses related to problems identified, 797 responses associated with life effects due to tinnitus, and 37 responses that did not fit into any ICF category. No significant differences were observed in the number of responses between the two questions. In addition, no significant association between the number of responses reported and demographic variables was found. Most of the problems and life effects experienced by tinnitus sufferers were related to body function, followed by activity limitations, and participation restrictions. Only a few responses were related to environmental and personal factors.
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2.
  • Manchaiah, Vinaya, et al. (författare)
  • Quality and Readability of English-Language Internet Information for Tinnitus
  • 2019
  • Ingår i: Journal of the American Academy of Audiology. - Reston, VA, United States : Georg Thieme Verlag KG. - 2157-3107 .- 1050-0545. ; 30:1, s. 31-40
  • Tidskriftsartikel (refereegranskat)abstract
    • Because of the wealth of information available on the internet and increasing numbers of individuals relying on websites as a primary source of information for health-related questions, it is important that the readability of their content is within the comprehension level of most readers.The study evaluated the quality and readability of English-language Internet information for tinnitus.Analysis of Internet websites on tinnitus.A total of 134 websites with tinnitus information.Three key words (i.e., tinnitus, ringing in the ear, and buzzing in the ear) were entered in five country-specific versions of the most commonly used internet search engine in August 2016. For each of the 15 searches, the first 20 relevant websites were examined. After removing duplicates, a total of 134 websites were assessed. Their origin (commercial, nonprofit organization, government, personal, or university), quality (Health On the Net [HON] certification and DISCERN scores), and readability (Flesch Reading Ease score, Flesch-Kincaid Reading Grade Level Formula, and Simple Measure of Gobbledygook) were assessed.Most websites were of commercial (49.3%) or nonprofit organization (38.8%) origin. Their quality and readability was highly variable. Only 13.5% of websites had HON certification. χ2 analysis showed that there was significant association between website origin and HON certification [χ2(4) = 132.9, p < 0.0001]. The mean DISCERN scores were 2.39. No association between DISCERN scores and website origin was found. Readability measures showed that on average, only people with at least 10–12 yr of education could read and understand the internet information for tinnitus in websites. Almost all the websites exceeded the most stringent reading level recommended for health information.The results highlight great variability in the quality and readability of health information, specifically for tinnitus in the internet. These findings underscores the need for stakeholders (e.g., web-developers, clinicians) to be aware of this and to develop more user-friendly health information on websites to make it more accessible for people with low literacy.
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3.
  • Laplante-Lévesque, Ariane, et al. (författare)
  • Stages of Change in Adults Who Have Failed an Online Hearing Screening
  • 2015
  • Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS and WILKINS. - 0196-0202 .- 1538-4667. ; 36:1, s. 92-101
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Hearing screening has been proposed to promote help-seeking and rehabilitation in adults with hearing impairment. However, some longitudinal studies point to low help-seeking and subsequent rehabilitation after a failed hearing screening (positive screening result). Some barriers to help-seeking and rehabilitation could be intrinsic to the profiles and needs of people who have failed a hearing screening. Theories of health behavior change could help to understand this population. One of these theories is the transtheoretical (stages-of-change) model of health behavior change, which describes profiles and needs of people facing behavior changes such as seeking help and taking up rehabilitation. According to this model, people go through distinct stages toward health behavior change: precontemplation, contemplation, action, and finally, maintenance. The present study describes the psychometric properties (construct validity) of the stages of change in adults who have failed an online hearing screening. Stages of change were measured with the University of Rhode Island Change Assessment (URICA). Principal component analysis is presented, along with cluster analysis. Internal consistency was investigated. Finally, relationships between URICA scores and speech-in-noise recognition threshold, self-reported hearing disability, and self-reported duration of hearing disability are presented. Design: In total, 224 adults who had failed a Swedish online hearing screening test (measure of speech-in-noise recognition) completed further questionnaires online, including the URICA. Results: A principal component analysis identified the stages of precontemplation, contemplation, and action, plus an additional stage, termed preparation (between contemplation and action). According to the URICA, half (50%) of the participants were in the preparation stage of change. The contemplation stage was represented by 38% of participants, while 9% were in the precontemplation stage. Finally, the action stage was represented by approximately 3% of the participants. Cluster analysis identified four stages-of-change clusters: they were named decision making (44% of sample), participation (28% of sample), indecision (16% of sample), and reluctance (12% of sample). The construct validity of the model was good. Participants who reported a more advanced stage of change had significantly greater self-reported hearing disability. However, participants who reported a more advanced stage of change did not have a significantly worse speech-in-noise recognition threshold or reported a significantly longer duration of hearing impairment. Conclusions: The additional stage this study uncovered, and which other studies have also uncovered, preparation, highlights the need for adequate guidance for adults who are yet to seek help for their hearing. The fact that very few people were in the action stage (approximately 3% of the sample) signals that screening alone is unlikely to be enough to improve help-seeking and rehabilitation rates. As expected, people in the later stages of change reported significantly greater hearing disability. The lack of significant relationships between stages-of-change measures and speech-in-noise recognition threshold and self-reported duration of hearing disability highlights the complex interplay between impairment, disability, and behaviors in adults who have failed an online hearing screening and who are yet to seek help.
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4.
  • Ellis, Rachel, et al. (författare)
  • Predicting Speech-in-Noise Recognition from Performance on the Trail Making Test: Results from a Large-Scale Internet Study
  • 2016
  • Ingår i: Ear and Hearing. - : Lippincott Williams & Wilkins. - 0196-0202 .- 1538-4667. ; 37:1, s. 73-79
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The aim of the study was to investigate the utility of an internet-based version of the trail making test (TMT) to predict performance on a speech-in-noise perception task.Design: Data were taken from a sample of 1509 listeners aged between 18 and 91 years old. Participants completed computerized versions of the TMT and an adaptive speech-in-noise recognition test. All testing was conducted via the internet.Results: The results indicate that better performance on both the simple and complex subtests of the TMT are associated with better speech-in-noise recognition scores. Thirty-eight percent of the participants had scores on the speech-in-noise test that indicated the presence of a hearing loss.Conclusions: The findings suggest that the TMT may be a useful tool in the assessment, and possibly the treatment, of speech-recognition difficulties. The results indicate that the relation between speech-in-noise recognition and TMT performance relates both to the capacity of the TMT to index processing speed and to the more complex cognitive abilities also implicated in TMT performance.
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5.
  • Andersson, Gerhard, et al. (författare)
  • A 3.5-year follow-up of Internet-delivered cognitive behavior therapy for major depression
  • 2013
  • Ingår i: Journal of Mental Health. - London, UK : Informa Healthcare. - 0963-8237 .- 1360-0567. ; 22:2, s. 155-164
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundInternet-delivered cognitive behavior therapy (ICBT) for major depression has been tested in several trials, but only with follow-ups up to 1.5 years.AimThe aim of this study was to evaluate the outcome of ICBT 3.5 years after treatment completion.MethodsA total of 88 people with major depression were randomized to either guided self-help or e-mail therapy in the original trial. One-third was initially on a waiting-list. Treatment was provided for eight weeks and in this report long-term follow-up data were collected. Also included were data from post-treatment and six-month follow-up. A total of 58% (51/88) completed the 3.5-year follow-up. Analyses were performed using a random effects repeated measures piecewise growth model to estimate trajectory shape over time and account for missing data.ResultsResults showed continued lowered scores on the Beck Depression Inventory (BDI). No differences were found between the treatment conditions. A large proportion of participants (55%) had sought and received additional treatments in the follow-up period. A majority (56.9%) of participants had a BDI score lower than 10 at the 3.5-year follow-up.ConclusionsPeople with mild to moderate major depression may benefit from ICBT 3.5-years after treatment completion.
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6.
  • Beukes, Eldre W., et al. (författare)
  • Development and psychometric validation of a questionnaire assessing the impact of tinnitus on significant others
  • 2022
  • Ingår i: Journal of Communication Disorders. - : ELSEVIER SCIENCE INC. - 0021-9924 .- 1873-7994. ; 95
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Despite evidence showing that tinnitus can have a detrimental impact on significant others (SOs), no standardized self-reported measure is currently available that specifically as-sesses the presence of third-party disability for tinnitus. The aim of this study was to develop and assess the psychometric properties of a newly developed self-reported measure for SOs of tinnitus and assess how scores could be meaningfully interpreted. Methods: The research consisted of two phases. During Phase I, the Consequences of Tinnitus on Significant Others Questionnaire (CTSOQ) was developed using the The COnsensus-based Stan-dards for the selection of health Measurement INstruments (COSMIN) guidance. Phase II included the assessment of psychometric properties of the CTSOQ including the construct validity, internal consistency, interpretability, and responsiveness. Pairs of 194 individuals with tinnitus and their SOs completed a series of online questionnaires. SOs completed the CTSOQ measure while in-dividuals with tinnitus completed measures related to tinnitus distress, anxiety, depression, insomnia, and quality of life. Results: A 25 item CTSOQ was developed using a formative model. The questionnaire validation process indicated good psychometric properties with an internal consistency of 0.93 and inter-item correlation of 0.60. Support was found for the construct and discriminative validity of the measure. Floor and ceiling effects were negligible. Scores can be meaningfully interpreted to indicate mild, significant, or severe effect of tinnitus on SOs. The questionnaire was also found to be responsive to treatment-related changes. Conclusions: The CTSOQ was found to have sufficient measurement properties suggesting that it is a suitable measure of third-party disability for SOs of individuals with tinnitus. Further research should be initiated to measure face validity and what scores reflect clinically meaningful change.
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7.
  • Beukes, Eldre W., et al. (författare)
  • Effectiveness of Guided Internet-Based Cognitive Behavioral Therapy vs Face-to-Face Clinical Care for Treatment of Tinnitus A Randomized Clinical Trial
  • 2018
  • Ingår i: JAMA Otolaryngology - Head and Neck Surgery. - : AMER MEDICAL ASSOC. - 2168-6181 .- 2168-619X. ; 144:12, s. 1126-1133
  • Tidskriftsartikel (refereegranskat)abstract
    • IMPORTANCE Accessible clinical care is not always available to individuals with distressing tinnitus. Internet-based cognitive behavioral therapy has the potential to increase access to evidence-based services that manage tinnitus. Research comparing the effectiveness of this internet-based intervention with face-to-face care is required. OBJECTIVE To evaluate whether an internet-based cognitive behavioral therapy intervention is at least as effective as established individualized face-to-face clinical care in reducing tinnitus distress and tinnitus-related difficulties. DESIGN, SETTING. AND PARTICIPANTS A randomized, multicenter, 2-arm parallel group, non-inferiority trial with 2-month follow-up was performed between October 4, 2016, and July 14, 2017. Invited to participate were 374 adults based in the United Kingdom who had been referred to their local tinnitus clinics because of bothersome tinnitus. The experimental group received the internet-based intervention online, and the active control group underwent the usual face-to-face tinnitus care at 1 of 3 UK-based National Health Service hospitals. Participants were randomly assigned (1:1) to either intervention using variable permuted block sizes of 4 and 6. Of 92 participants who were randomized (46 each in the experimental and control groups), 88 participants completed the assessment immediately after intervention and 74 participants completed the follow-up assessment. INTERVENTIONS Participants were randomized to receive either 8 weeks of guided internet-based cognitive behavioral therapy or a mean of 2 to 3 individualized face-to-face appointments in a tinnitus clinic. MAIN OUTCOMES AND MEASURES The primary outcome was a change in tinnitus distress (assessed by the Tinnitus Functional Index). Secondary assessment measures were included for insomnia, anxiety, depression, hearing disability, hyperacusis, cognitive failures, and satisfaction with life. RESULTS Of 92 patients overall, 55 (60%) were men with a mean (SD) age of 52.96 (12.07) years and mean (SD) tinnitus duration of 6.54 (9.25) years. The between-group difference in the Tinnitus Functional Index scores after intervention were 5.18 (95% CI, -4.17 to 14.53) at the initial assessment and 5.52 (95% CI, -4.60 to 15.61) at follow-up; both differences were within the non-inferiority margin of 13 points for the lower 95% CI. For the secondary outcomes, only outcomes for insomnia fell outside the non-inferiority margin, both after intervention and at follow-up, favoring internet-based cognitive behavioral therapy. CONCLUSIONS AND RELEVANCE This is the first trial, to our knowledge, to compare an internet-based intervention with standard individualized face-to-face care for tinnitus. It revealed that both interventions are equally effective for reducing tinnitus distress and most tinnitus-related difficulties.
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8.
  • Beukes, Eldre W., et al. (författare)
  • Internet-Based Audiologist-Guided Cognitive Behavioral Therapy for Tinnitus : Randomized Controlled Trial
  • 2022
  • Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc. - 1438-8871. ; 24:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Tinnitus is a symptom that can be very distressing owing to hearing sounds not related to any external sound source. Managing tinnitus is notoriously difficult, and access to evidence-based care is limited. Cognitive behavioral therapy (CBT) is a tinnitus management strategy with the most evidence of effectiveness but is rarely offered to those distressed by tinnitus. The provision of internet-based CBT for tinnitus overcomes accessibility barriers; however, it is not currently readily available in the United States. Objective: The aim of this study is to investigate the efficacy of internet-based CBT compared with that of weekly monitoring for the management of tinnitus in reducing tinnitus distress; reducing tinnitus-related comorbidities, including tinnitus cognitions, insomnia, anxiety, and depression; and assessing the stability of the intervention effects 2 months after the intervention. Methods: A 2-arm randomized clinical trial comparing audiologist-guided internet-based CBT (n=79) to a weekly monitoring group (n=79) with a 2-month follow-up assessed the efficacy of internet-based CBT. Eligible participants included adults seeking help for tinnitus. Recruitment was conducted on the web using an open-access website. Participants were randomized via 1:1 allocation, but blinding was not possible. The study was undertaken by English or Spanish speakers on the web. The primary outcome was a change in tinnitus distress as measured using the Tinnitus Functional Index. Secondary outcome measures included anxiety, depression, insomnia, tinnitus cognition, hearing-related difficulties, and quality of life. Results: Internet-based CBT led to a greater reduction in tinnitus distress (mean 36.57, SD 22) compared with that in weekly monitoring (mean 46.31, SD 20.63; effect size: Cohen d=0.46, 95% CI 0.14-0.77) using an intention-to-treat analysis. For the secondary outcomes, there was a greater reduction in negative tinnitus cognition and insomnia. The results remained stable over the 2-month follow-up period. No important adverse events were observed. Further, 16% (10/158) of participants withdrew, with low overall compliance rates for questionnaire completion of 72.3% (107/148) at T1, 61% (91/148) at T2, and 42% (62/148) at T3. Conclusions: This study is the first to evaluate and indicate the efficacy of audiologist-delivered internet-based CBT in reducing tinnitus distress in a US population. It was also the first study to offer internet-based CBT in Spanish to accommodate the large Hispanic population in the United States. The results have been encouraging, and further work is indicated in view of making such an intervention applicable to a wider population. Further work is required to improve compliance and attract more Spanish speakers.
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9.
  • Beukes, Eldre W., et al. (författare)
  • Internet-based cognitive behavioural therapy for tinnitus in Spanish: a global feasibility trial
  • 2022
  • Ingår i: International Journal of Audiology. - : TAYLOR & FRANCIS LTD. - 1499-2027 .- 1708-8186. ; 61:8, s. 632-641
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective Internet-based cognitive behavioural therapy (ICBT) for tinnitus is an evidence-based intervention, but only available in a few languages. To increase accessibility, ICBT was translated into Spanish. This studys objective was to determine the feasibility of ICBT for Spanish speakers. Design A single-group pre-test post-test design was used. Compliance, engagement, acceptance and outcome feasibility were measured. Study Sample Forty-six Spanish speakers with tinnitus were screened. There were 32 participants meeting the eligibility criteria, with a mean age of 47 (+/- 11) years. Of these 91% were Hispanic or Latino with 66% living in Spain and 34% living in South America. Results Outcome feasibility was established, as a large pre- and post-test within-group effect size of d = 0.90 was found for tinnitus severity. Large pre- and post-test effect sizes were also present for the secondary outcomes of anxiety and depression with a medium effect for insomnia, health-related quality of life, and tinnitus cognitions. Intervention engagement and compliance were not optimal although no participants withdrew. Intervention acceptance rates indicated scope for improvement. Conclusions ICBT for Spanish communities appears to be feasible. A randomised controlled trial is required to further investigate the effects and identify ways of improving engagement and attracting Spanish speakers from different countries.
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10.
  • Beukes, Eldre W., et al. (författare)
  • Internet-Based Intervention for Tinnitus: Outcome of a Single-Group Open Trial
  • 2017
  • Ingår i: Journal of american academy of audiology. - : AMER ACAD AUDIOLOGY. - 1050-0545 .- 2157-3107. ; 28:4, s. 340-351
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Managing chronic tinnitus is challenging, and innovative ways to address the resulting health-care burden are required. Internet-based cognitive behavioral therapy (iCBT) for tinnitus shows promise as a cost-effective treatment option. The feasibility and effectiveness of iCBT in the United Kingdom are yet to be explored. Furthermore, it is not known if iCBT can be supported by an audiologist rather than a psychologist. Purpose: This study aimed to determine the feasibility of guided iCBT using audiological support on tinnitus distress and tinnitus-related comorbidities. Furthermore, it aimed to establish the feasibility of iCBT for tinnitus distress in the United Kingdom, by determining recruitment, attrition, and compliance rates. Finally, it aimed to identify which aspects of the protocol require refinement for subsequent clinical trials. Research Design: A single-group open trial design was implemented. This study would serve as a prerequisite study, to identify barriers, before undertaking effectiveness trials. Study Sample: Participants consisted of 37 adults (18 males, 19 females), with an age range of between 50 and 59 yr. The mean preintervention tinnitus severity rating was 56.15 (standard deviation = 18.35), which is categorized as "severe tinnitus" as measured by the Tinnitus Functional Index (TFI). Five participants withdrew during the study, and 29 of the remaining participants completed the postintervention questionnaire. Intervention: The guided iCBT intervention ran over an eight-week period and consisted of 16 obligatory modules and five optional modules. The intervention was designed to be interactive, interesting, and stimulating. A key element was the provision of support from an audiologist throughout the program. Data Collection and Analysis: Online questionnaires were used throughout the study. These were administered at baseline and postintervention to determine attrition and compliance rates and to facilitate sample size estimates for further clinical trials. Outcome measures for tinnitus severity, hearing handicap, insomnia, cognitive functioning, hyperacusis, anxiety, depression, and life satisfaction were used to investigate the effects of iCBT with audiological support. In addition, a weekly questionnaire was incorporated to monitor change in tinnitus distress while undertaking the intervention. Results: Feasibility was established using an audiologist to support this guided iCBT intervention, as a significant change postintervention was found for tinnitus severity, as measured by the TFI and the Tinnitus Handicap Inventory, Screening version. The attrition rate was 22% and compliance was variable. Although these results were based on a small sample, they provide encouraging evidence for the feasibility of delivering iCBT treatment for tinnitus symptoms with audiology support in the United Kingdom. Conclusions: An Internet-based intervention of tinnitus appears to be feasible in the United Kingdom when using audiological support. Randomized controlled trials to further investigate the effectiveness of iCBT for tinnitus in the United Kingdom are required.
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