RESUMO
BACKGROUND: Both tinnitus and hearing loss are multidimensional. The purpose of this study was to identify and determine the degree of mental fatigue in patients with hearing loss and/or tinnitus participating in audiological rehabilitation, and to examine the self-reported mental fatigue scale (MFS) in this patient group. METHODS: Patients undergoing audiological rehabilitation at the Department of Audiology and Neurotology, Karolinska University Hospital, Sweden, between 2011 and 2017 who completed a self-reported MFS questionnaire were investigated. Data on 76 patients were analysed in this pilot study. Patients were also assessed using the Tinnitus Handicap Inventory (THI). RESULTS: The study population had an age range of 38-65 years, and most had normal hearing (37%) or mild to moderate hearing loss (46%). Only 17% had severe to profound hearing loss. A total of 56.5% had tinnitus, of whom 39.5% scored ≥57 on the THI, indicating severe tinnitus, whereas 43.5% reported no tinnitus. The MFS scores, ranging from 13 to 42.5 points, were divided into three severity levels for analysis: 10.5-15, 15.5-20, and ≥20.5. In total, 67% of the patients had MFS scores ≥ 20.5. Importantly, most of the participants (90%) with a THI score ≥ 57 belonged to that group. A significant positive correlation between a high MFS score and severe tinnitus was found. CONCLUSIONS: The study reveals that severe mental fatigue is more common in patients with severe tinnitus than sole hearing loss.
RESUMO
PURPOSE: To study the quality of life (QoL) and psychosocial consequences in terms of sick leave and audiological rehabilitation given to patients with severe to profound hearing impairment. METHOD: A retrospective study of data on 2319 patients with severe to profound hearing impairment in The Swedish Quality Register of Otorhinolaryngology, followed by a posted questionnaire including The Hospital Anxiety and Depression Scale (HADS). RESULTS: The results indicate greater levels of anxiety and depression among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo had strong negative effects on QoL. The proportion of sick leave differed between the studied dimensions in the study. The proportion of patients who received extended audiological rehabilitation was 38% in the present study. CONCLUSIONS: Treatment focused on anxiety, depression, tinnitus and vertigo must be given early in the rehabilitation process in patients with severe or profound hearing impairment. Because sick leave differs greatly within this group of patients, collaboration with the regional Social Insurance Agency is crucial part of the rehabilitation. The study also shows that presently, only a small proportion of patients in Sweden with severe to profound hearing impairment receive extended audiological rehabilitation. Implications for Rehabilitation Greater levels of anxiety and depression have been found among patients with severe or profound hearing impairment than in the general population, and annoying tinnitus and vertigo have strong negative effects on QoL in this group of patients. Only a small proportion of patients with severe to profound hearing impairment receive extended audiological rehabilitation today, including medical, technical and psychosocial efforts. Extended audiological rehabilitation focused on anxiety, depression, tinnitus and vertigo must be given, together with technical rehabilitation, early in the rehabilitation process in patients with severe or profound hearing impairment.
