Tinnitus E-Programme online tinnitus clinic

Measures

Before you complete and send in your THI, please ensure you have read and understood our Conditions of Use and be aware that from 1st July 2018, the Tinnitus E-Programme is therapist-supported. From 1st October 2018, the course is hosted by CourseCraft.

The main tinnitus distress measure used is the Tinnitus Functional Index (TFI). This Tinnitus Handicap Inventory is used as a secondary measure of tinnitus distress for those looking to use the CBT for Tinnitus E-Programme.

Please complete the THI (Tinnitus Handicap Inventory) below.

The aim of this questionnaire is to identify your current level of tinnitus distress. Tick YES, SOMETIMES or NO for each question. To score the questionnaire, YES = 4; SOMETIMES = 2; NO = 0

Complete the questionnaire and press send.

You will receive an email confirming your THI answers but no further emails unless you request further guidance regarding your best option at the end of this questionnaire. The CBT for Tinnitus E-Programme is here to support - not to bombard you with unnecessary emails

CONSENT:*

I give my explicit consent for the Tinnitus E-Programme to receive details of my name, email address, country and my answers to the Tinnitus Handicap Inventory. I give my permission to be contacted by email and for the information I give to be kept securely until such time as I unsubscribe from the Tinnitus E-Programme. I confirm that I have read and agree to the Conditions of Use of the Tinnitus E-Programme.

I agree

Date*

Name*

Your email*

Country*

Other country e.g. Spain, France etc:

Emergency contact info - following a recent loss of email access by a current TEP User, it seems like a good idea to have a second way to be in touch - only in such cases as loss of access to emails

Your mobile number (UK and Ireland only) OR alternate email address:

How did you find out about CBT for Tinnitus E-Programme?*

PLEASE READ THE FOLLOWING STATEMENT ABOUT HOW YOUR THI RESULTS MAY BE USED FOR RESEARCH PURPOSES

* I agree that the anonymous results of my THI may be included in future research of the Tinnitus E-Programme, by Debbie Featherstone and NIHR NHBRC (National Institute of Hearing Research, Nottingham Biomedical Research Centre) and in either case that my personal data is NOT for publication.

Please choose your answer from the drop down menu*

TINNITUS HANDICAP INVENTORY (THI)

F1. Because of your tinnitus is it difficult for you to concentrate?*

F2. Does the loudness of your tinnitus make it difficult for you to hear?*

E3. Does your tinnitus make you angry?*

F4. Does your tinnitus make you feel confused?*

C5. Because of your tinnitus do you feel desperate?*

E6. Do you complain a great deal about your tinnitus?*

F7. Because of your tinnitus do you have trouble falling asleep?*

C8. Do you feel as though you cannot escape your tinnitus?*

F9. Does your tinnitus interfere with your ability to enjoy social activities such as going out to dinner, cinema?*

E10. Because of your tinnitus do you feel frustrated?*

C11. Because of your tinnitus do you feel you have a terrible disease?*

F12. Does your tinnitus make it difficult for you to enjoy life?*

F13. Does your tinnitus interfere with your job or household responsibilities?*

F14. Because of your tinnitus do you find that you are often irritable?*

F15. Because of your tinnitus is it difficult for you to read?*

E16. Does your tinnitus make you upset?*

E17. Do you feel that your tinnitus has placed stress on your relationship with members of your family, friends?*

F18. Do you find it difficult to focus your attention away from your tinnitus and on to other things?*

C19. Do you feel that you have no control over your tinnitus?*

F20. Because of your tinnitus are you often tired?*

E21. Because of your tinnitus do you feel depressed?*

E22. Does your tinnitus make you feel anxious?*

C23. Do you feel that you can no longer cope with your tinnitus?*

F24. Does your tinnitus get worse under stress?*

E25. Does your tinnitus make you feel insecure?*

What is your total score?

Don't worry too much if you haven't added up your scores. After you have sent this questionnaire through at the end of this form, a copy of your answers will come to you by email. If you would like to include any comments about the questionnaire, you can do so in the space below:

Tinnitus Specialist Hearing Therapist Debbie Featherstone has 25+ years experience of working with patients with severe tinnitus distress and all that this debilitating condition can bring in to the lives of so many. It doesn't have to stay that way! I look forward to meeting you soon!

I am happy to contact you by email if you need further guidance*

Now press SEND