Why Is Tinnitus a Problem? A Qualitative Analysis of Problems Reported by Tinnitus Patients.
Ontology highlight
ABSTRACT:
SUBMITTER: Watts EJ
PROVIDER: S-EPMC6277754 | biostudies-literature | 2018 Jan-Dec
REPOSITORIES: biostudies-literature
Publications
Why Is Tinnitus a Problem? A Qualitative Analysis of Problems Reported by Tinnitus Patients.
Watts Emily J EJ Fackrell Kathryn K Smith Sandra S Sheldrake Jacqueline J Haider Haúla H Hoare Derek J DJ
Trends in hearing 20180101
Tinnitus is a prevalent complaint, and people with bothersome tinnitus can report any number of associated problems. Yet, to date, only a few studies, with different populations and relatively modest sample sizes, have qualitatively evaluated what those problems are. Our primary objective was to determine domains of tinnitus problem according to a large clinical data set. This was a retrospective analysis of anonymized clinical data from patients who attended a U.K. Tinnitus Treatment Center bet ...[more]
Similar Datasets
Project description:BackgroundTo better direct assessments and interventions toward the general population during both the ongoing COVID-19 pandemic and future crises with societal restrictions, data on the types of practical and emotional problems that people are experiencing are needed.ObjectiveThe aim of this study was to examine the types of practical and emotional problems that the general population is experiencing during the COVID-19 pandemic and to construct an empirically derived inventory based on the findings.MethodsA total of 396 participants, recruited among members of the general public in Sweden who were experiencing practical and/or emotional problems during the pandemic, accessed a self-guided digital problem-solving intervention for a period of 1 week to report and solve the problems they experienced. Prior to accessing the intervention, the participants completed a short self-assessment regarding symptoms of depression and anxiety. Content analysis was used to account for the types of problems participants reported. A set of items for an inventory was later proposed based on the problem categories derived from the analysis.ResultsA majority of participants had clinically relevant symptoms of either depression or anxiety. The problems reported were categorized as 13 distinct types of problems. The most common problem was difficulty managing daily activities. Based on the categories, a 13-item inventory was proposed.ConclusionsThe 13 types of problems, and the proposed inventory, could be valuable when composing assessments and interventions for the general population during the ongoing pandemic or similar crises with societal restrictions. The most common problem was of a practical nature, indicating the importance of including examples of such problems within assessments and interventions.Trial registrationClinicalTrials.gov NCT04677270; https://clinicaltrials.gov/ct2/show/NCT04677270.
| S-EPMC8491645 | biostudies-literature
Project description:IntroductionIn tinnitus treatment, there is a tendency to shift from a "one size fits all" to a more individual, patient-tailored approach. Insight in the heterogeneity of the tinnitus spectrum might improve the management of tinnitus patients in terms of choice of treatment and identification of patients with severe mental distress. The goal of this study was to identify subgroups in a large group of tinnitus patients.MethodsData were collected from patients with severe tinnitus complaints visiting our tertiary referral tinnitus care group at the University Medical Center Groningen. Patient-reported and physician-reported variables were collected during their visit to our clinic. Cluster analyses were used to characterize subgroups. For the selection of the right variables to enter in the cluster analysis, two approaches were used: (1) variable reduction with principle component analysis and (2) variable selection based on expert opinion.ResultsVarious variables of 1,783 tinnitus patients were included in the analyses. Cluster analysis (1) included 976 patients and resulted in a four-cluster solution. The effect of external influences was the most discriminative between the groups, or clusters, of patients. The "silhouette measure" of the cluster outcome was low (0.2), indicating a "no substantial" cluster structure. Cluster analysis (2) included 761 patients and resulted in a three-cluster solution, comparable to the first analysis. Again, a "no substantial" cluster structure was found (0.2).ConclusionTwo cluster analyses on a large database of tinnitus patients revealed that clusters of patients are mostly formed by a different response of external influences on their disease. However, both cluster outcomes based on this dataset showed a poor stability, suggesting that our tinnitus population comprises a continuum rather than a number of clearly defined subgroups.
| S-EPMC5377919 | biostudies-literature
Project description:BackgroundPatient monitoring is critical for perioperative patient safety as anesthesiologists routinely make crucial therapeutic decisions from the information displayed on patient monitors. Previous research has shown that today's patient monitoring has room for improvement in areas such as information overload and alarm fatigue. The rationale of this study was to learn more about the problems anesthesiologists face in patient monitoring and to derive improvement suggestions for next-generation patient monitors.MethodsWe conducted a two-center qualitative/quantitative study. Initially, we interviewed 120 anesthesiologists (physicians and nurses) about the topic: common problems with patient monitoring in your daily work. Through deductive and inductive coding, we identified major topics and sub themes from the interviews. In a second step, a field survey, a separate group of 25 anesthesiologists rated their agree- or disagreement with central statements created for all identified major topics.ResultsWe identified the following six main topics: 1. "Alarms," 2. "Artifacts," 3. "Software," 4. "Hardware," 5. "Human Factors," 6. "System Factors," and 17 sub themes. The central statements rated for the major topics were: 1. "problems with alarm settings complicate patient monitoring." (56% agreed) 2. "artifacts complicate the assessment of the situation." (64% agreed) 3. "information overload makes it difficult to get an overview quickly." (56% agreed) 4. "problems with cables complicate working with patient monitors." (92% agreed) 5. "factors related to human performance lead to critical information not being perceived." (88% agreed) 6. "Switching between monitors from different manufacturers is difficult." (88% agreed). The ratings of all statements differed significantly from neutral (all p < 0.03).ConclusionThis study provides an overview of the problems anesthesiologists face in patient monitoring. Some of the issues, to our knowledge, were not previously identified as common problems in patient monitoring, e.g., hardware problems (e.g., cable entanglement and worn connectors), human factor aspects (e.g., fatigue and distractions), and systemic factor aspects (e.g., insufficient standardization between manufacturers). An ideal monitor should transfer the relevant patient monitoring information as efficiently as possible, prevent false positive alarms, and use technologies designed to improve the problems in patient monitoring.
| S-EPMC6540409 | biostudies-literature
Project description:BackgroundThere are a large number of assessment tools for tinnitus, with little consensus on what it is important to measure and no preference for a minimum reporting standard. The item content of tinnitus assessment tools should seek to capture relevant impacts of tinnitus on everyday life, but no-one has yet synthesised information about the range of tinnitus complaints. This review is thus the first comprehensive and authoritative collection and synthesis of what adults with tinnitus and their significant others report as problems in their everyday lives caused by tinnitus.MethodsElectronic searches were conducted in PubMed, Embase, CINAHL, as well as grey literature sources to identify publications from January 1980 to June 2015 in which participants were enrolled because tinnitus was their primary complaint. A manual search of seven relevant journals updated the search to December 2017. Of the 3699 titles identified overall, 84 records (reporting 86 studies) met our inclusion criteria and were taken through to data collection. Coders collated generic and tinnitus-specific complaints reported by people with tinnitus. All relevant data items were then analyzed using an iterative approach to narrative synthesis to form domain groupings representing complaints of tinnitus, which were compared patients and significant others.ResultsFrom the 86 studies analyzed using data collected from 16,381 patients, 42 discrete complaints were identified spanning physical and psychological health, quality of life and negative attributes of the tinnitus sound. This diversity was not captured by any individual study alone. There was good convergence between complaints collected using open- and closed-format questions, with the exception of general moods and perceptual attributes of tinnitus (location, loudness, pitch and unpleasantness); reported only using closed questions. Just two studies addressed data from the perspective of significant others (n?=?79), but there was substantial correspondence with the patient framework, especially regarding relationships and social life.ConclusionsOur findings contribute fundamental new knowledge and a unique resource that enables investigators to appreciate the broad impacts of tinnitus on an individual. Our findings can also be used to guide questions during diagnostic assessment, to evaluate existing tinnitus-specific HR-QoL questionnaires and develop new ones, where necessary.Trial registrationPROSPERO registration number: CRD42015020629 . Protocol published in BMJ Open. 2016;6e009171.
| S-EPMC5896078 | biostudies-literature
Project description:Life presents us with problems of varying complexity. Yet, complexity is not accounted for in theories of human decision-making. Here we study instances of the knapsack problem, a discrete optimisation problem commonly encountered at all levels of cognition, from attention gating to intellectual discovery. Complexity of this problem is well understood from the perspective of a mechanical device like a computer. We show experimentally that human performance too decreased with complexity as defined in computer science. Defying traditional economic principles, participants spent effort way beyond the point where marginal gain was positive, and economic performance increased with instance difficulty. Human attempts at solving the instances exhibited commonalities with algorithms developed for computers, although biological resource constraints-limited working and episodic memories-had noticeable impact. Consistent with the very nature of the knapsack problem, only a minority of participants found the solution-often quickly-but the ones who did appeared not to realise. Substantial heterogeneity emerged, suggesting why prizes and patents, schemes that incentivise intellectual discovery but discourage information sharing, have been found to be less effective than mechanisms that reveal private information, such as markets.
| S-EPMC5054396 | biostudies-literature
Project description:Aim:Money is an essential element in gambling but gambling disorders are more often discussed from the perspective of individual and psychological experiences than in the context of financial practices. Losing money is often among the first signs of problem gambling as well as being a motive for treatment-seeking. This article asks: what kinds of practices and meanings do problem gamblers assign to money in their everyday lives? Design:The data consist of 17 individual interviews with problem gamblers in Finland. The participants form a heterogeneous group of people with different financial backgrounds. Their discourses on money are systematically organised into a structured qualitative content analysis. Results:The results reveal four main conceptual traits of money as an everyday gambling-related problem: (1) a compelling need for money; (2) disposable money defining the tempo of gambling; (3) the balance between using money for gambling and spending it on other matters of everyday life; and (4) gradual spiral of increased money-related problems. Conclusions:Problem gambling re-organises the uses and sources of money in everyday life, and changes the meanings of money. Nevertheless, gambling spending does not seem to be utterly out of control, rather, on one hand, disposable income organises spending episodically, and on the other hand, problem gamblers exercise a certain degree of control over their household expenses. This observation could promote problem gamblers' sense of control when recovering.this page for more information about identifying these."-->.
| S-EPMC7450852 | biostudies-literature
Project description:Commonly used paradigms for studying child psychopathology emphasize individual-level factors and often neglect the role of context in shaping risk and protective factors among children, families, and communities. To address this gap, we evaluated influences of ecocultural contextual factors on definitions, development of, and responses to child behavior problems and examined how contextual knowledge can inform culturally responsive interventions. We drew on Super and Harkness' "developmental niche" framework to evaluate the influences of physical and social settings, childcare customs and practices, and parental ethnotheories on the definitions, development of, and responses to child behavior problems in a community in rural Nepal. Data were collected between February and October 2014 through in-depth interviews with a purposive sampling strategy targeting parents (N = 10), teachers (N = 6), and community leaders (N = 8) familiar with child-rearing. Results were supplemented by focus group discussions with children (N = 9) and teachers (N = 8), pile-sort interviews with mothers (N = 8) of school-aged children, and direct observations in homes, schools, and community spaces. Behavior problems were largely defined in light of parents' socialization goals and role expectations for children. Certain physical settings and times were seen to carry greater risk for problematic behavior when children were unsupervised. Parents and other adults attempted to mitigate behavior problems by supervising them and their social interactions, providing for their physical needs, educating them, and through a shared verbal reminding strategy (samjhaune). The findings of our study illustrate the transactional nature of behavior problem development that involves context-specific goals, roles, and concerns that are likely to affect adults' interpretations and responses to children's behavior. Ultimately, employing a developmental niche framework will elucidate setting-specific risk and protective factors for culturally compelling intervention strategies.
| S-EPMC5201200 | biostudies-literature
Project description:BackgroundA shift in research interest from separate care problem to care problem clusters among caregivers of people living with dementia may contribute to a better understanding of dementia care. However, the care problems network among caregivers of people living with dementia are still unknown. This study aimed to identify care problem clusters and core care problems, and explore demographic variables associated with these care problem clusters among caregivers of people living with dementia.MethodsParticipants were recruited through memory clinics and WeChat groups. The principal component analysis was applied to identify care problem clusters. The network analysis was conducted to describe the relationships among care problems and clusters. Multiple linear models were used to explore the associated factors for the occurrence of the overall care problems and top three central care problem clusters.ResultsA total of 1,012 carer-patient pairs were included in the analysis. Nine care problem clusters were identified. In the entire care problem network, "deterioration in activities of daily living" was the most core care problem cluster across the three centrality indices, followed by "verbal and nonverbal aggression" and "loss of activities of daily living." Variables including marital status, years of dementia diagnosis, number of dementia medication type, and caregiver's educational attainment were associated with the prevalence of these three care problem clusters.ConclusionOur study suggests that there is a need to evaluate care problem clusters for the improvement of care problem management among people living with dementia. It is particularly important to include assessment and treatment of core care problem as an essential component of the dementia care.
| S-EPMC10449331 | biostudies-literature
Project description:BACKGROUND:Elderly patients with multiple health problems often experience disease complications and functional failure, resulting in a need for health care across different health care systems during care trajectory. The patients' perspective of the care trajectory has been insufficiently described, and thus there is a need for new insights and understanding. The study aims to explore how elderly patients with complex health problems engage in and interact with their care trajectory across different health care systems where several health care personnel are involved. METHODS:The study had an explorative design with a qualitative multi-case approach. Eleven patients (n?=?11) aged 65-91?years participated. Patients were recruited from two hospitals in Norway. Observations and repeated interviews were conducted during patients' hospital stays, discharge and after they returned to their homes. A thematic analysis method was undertaken. RESULTS:Patients engaged and positioned themselves in the care trajectory according to three identified themes: 1) the patients constantly considered opportunities and alternatives for handling the different challenges and situations they faced; 2) patients searched for appropriate alliance partners to support them and 3) patients sometimes circumvented the health care initiation of planned steps and took different directions in their care trajectory. CONCLUSIONS:The patients' considerations of their health care needs and adjustments to living arrangements are constant throughout care trajectories. These considerations are often long term, and the patient engagement in and management of their care trajectory is not associated with particular times or situations. Achieving consistency between the health care system and the patient's pace in the decision-making process may lead to a more appropriate level of health care in line with the patient's preferences and goals.
| S-EPMC7325247 | biostudies-literature
Project description:Conversion of wild habitats to human dominated landscape is a major cause of biodiversity loss. An approach to mitigate the impact of habitat loss consists of designating reserves where habitat is preserved and managed. Determining the most valuable areas to preserve in a landscape is called the reserve design problem. There exists several possible formulations of the reserve design problem, depending on the objectives and the constraints. In this article, we considered the dynamic problem of designing a reserve that contains a desired area of several key habitats. The dynamic case implies that the reserve cannot be designed in one time step, due to budget constraints, and that habitats can be lost before they are reserved, due for example to climate change or human development. We proposed two heuristics strategies that can be used to select sites to reserve each year for large reserve design problem. The first heuristic is a combination of the Marxan and site-ordering algorithms and the second heuristic is an augmented version of the common naive myopic heuristic. We evaluated the strategies on several simulated examples and showed that the augmented greedy heuristic is particularly interesting when some of the habitats to protect are particularly threatened and/or the compactness of the network is accounted for.
| S-EPMC5854297 | biostudies-literature