Study On Experience And Correlative Factors In Elderly Patients With Tinnitus

Objective:Tinnitus is defined as the perception of a sound in the absence of any external acoustic stimuli and can comprise different forms of ear noises(e.g.,ringing,buzzing,or whistling).Tinnitus is a common clinical symptom,especially in the elderly patients,which can often lead to dysfunction,dizziness,postural instability,pain and insomnia.It can not only affect vision and hearing,mental decline and limit their activities but also aggravate other diseases and affect the quality of life among the elderly patients.The questionnaire survey and qualitative interview method were conducted in this research to explore the influencing factors of tinnitus severity as well as self-management experience in elderly patients with tinnitus.This study aims to investigate some potential factors which may worsen the tinnitus symptoms among the elderly patients with tinnitus and improve the quality of life in the elderly with tinnitus which may provide a theoretical reference and practical guidance.Methods:Part ?:A qualitative research on the experience in elderly patients with tinnitus.22 elderly patients with tinnitus were selected through the purpose sampling method.The subjective experiences of patients was extracted through in-depth and semi-structured interviews.The interview tapes,notes and other related information were transformed and integrated into the transcript as the analysis database after the interviews to analysis the experiences in elderly patients with tinnitus.Part ?:The study on characteristics of tinnitus and potential correlative factors of tinnitus severity in elderly patients.Literature review and questionnaire survey were conducted to analysis characteristics of tinnitus and the factors that may impact tinnitus severity in elderly patients.On the basis of convenience sampling,357 cases of elderly patients with subjective tinnitus in the otology outpatient of 3 hospitals in Shanghai were investigated by general information questionnaire,tinnitus related factors questionnaire and the tinnitus handicap inventory(THI).SPSS software was used to analysis the data by means of descriptive analysis,correlation analysis and multiple regression analysis.Results:Part ?:A qualitative research on the experience in elderly patients with tinnitus.Based on the depth interview of elderly patients with tinnitus,the illness experience in elderly patients with tinnitus included four themes which were "there were both physical and mental effects caused by tinnitus","giving reasonable explanations to tinnitus"," taking a variety of coping styles" and “the patients' illness experience were influenced by many factors ”.Part ?:The study on characteristics of tinnitus and correlative factors of tinnitus severity in elderly patients.A total of 357 patients were included in this study,consisting of 187 male and 170 female patients,with a mean age of 69.5±6.8 years(range: 60–87 years).Tinnitus duration ranged from 3 days to 30 years.Among those patients,192 cases were acute tinnitus,50 cases were sub-acute tinnitus while 115 cases were chronic tinnitus.And 202cases(56.6%)were associated with sleep disorders.The most severe THI rating of the tinnitus was level 2,total case were 147.The second one was level 3,total cases are 118.Then level 4,51 cases.Level 1and level 5 were relatively less,the cases were 26 and 15.Gender,age,personality,duration had no correlation with the severity of the tinnitus(P>0.05),however,there was a correlation between tinnitus severity and sleep disorder and whether the elderly patients had general diseases(P< 0.05).Conclusions:Part ?:There were both physical and mental effects to the elderly patients with tinnitus,mainly including the quality of sleep was affected,hearing loss and emotional experience,while these emotional experiences were main components of tinnitus.Different coping styles impact patients' perception of tinnitus from the behavior level.Different attribution style affects the patient perception of tinnitus symptoms from the cognitive level.The coping behaviors during the process of tinnitus may be influenced by some factors,mainly including the patients' faith,the control of systemic comorbidities,the severity of tinnitus patients perceived and available resources.Part ?:The severity of tinnitus in elderly patients was affected by many factors,but there was no correlation with gender,age and audiological index.Sleep disorders and systemic disease were the main factors that influence the severity of tinnitus.Therefore,in addition to control the symptom of tinnitus,the elderly patients should also control their general diseases and combine with psychological counseling,relaxation training,voice therapy and other rehabilitation training methods to control tinnitus in the elderly patients.