An Exploratory Step Toward Measuring the “Meaning of Life” in Patients with Tinnitus and in Cochlear Implant Users
15 April 2020 (online)
Background Many questionnaires attempt to quantify the “quality of life.” However, we believe understanding the quality of life is complex, and many widely used questionnaires do not capture the broad range of factors that we believe are important. Many do not include questions about communicating.
Purpose We developed a preliminary questionnaire designed to measure “The Meaning of Life” from a broader perspective.
Research Design We reviewed other scales and sought input from individuals with disabilities and developed an initial 23-item questionnaire.
Study Sample As a first step, we sampled 116 adults with tinnitus and 196 with cochlear implants (CIs). Individuals who were participating in our CI or tinnitus research programs participated.
Data Collection and Analysis To compare differences between the two participant groups, independent sample f-tests were completed for specific items on the questionnaire and for the total score. We compared age and gender differences across all participants using f-tests. Statistical significance was defined as p < 0.05. An exploratory factor analysis was conducted to examine the relationship among the questionnaire items using oblique rotation to produce correlated factors. Extracted factors with an eigenvalue >1.0 were retained according to the Kaiser-Guttman rule.
Results Four factors were prominent in this initial sample, which we labeled (1) friendship and positive outlook, (2) physical health, (3) hearing and mental health, and (4) satisfaction with life. Participants with tinnitus reported more trouble sleeping than participants with CI, whereas both groups had lower scores on hearing. Older patients reported more difficulty with remembering things but were more satisfied with their financial situation. Female participants reportedly had more hobbies and were more satisfied with their sex lives than male participants.
Conclusions This exploratory study intended to take a broader look at quality of life scales. Further work is needed with a larger sample including younger and older participants with and without disabilities.
- 1 Barton GR, Bankart J, Davis AC. A comparison of the quality of life of hearing-impaired people as estimated by three different utility measures. Int J Audiol 2005; 44: 157-163
- 2 Brazier JB, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ 2002; 21: 271-292
- 3 Burckhardt CS, Anderson KL. The Quality of Life Scale (QOLS): reliability, validity, and utilization. Health Qual Life Outcomes 2003; 23 (01) 60-66
- 4 Chia EM, Wang JJ, Rochtchina E, Cumming RR, Newall P, Mitchell P. Hearing impairment and health-related quality of life: the Blue Mountains Hearing Study. Ear Hear 2007; 28 (02) 187-195
- 5 Contrera KJ, Betz J, Li L, Blake CR, Sung YK, Choi JS, Lin FR. Quality of life after intervention with a cochlear implant or hearing aid. Laryngoscope 2016; 126 (09) 2110-2115
- 6 Decety J, Jackson PL. The functional architecture of human empathy. Behav Cogn Neurosci Rev 2004; 3: 71-100
- 7 Edwards P. Questionnaires in clinical trials: guidelines for optimal design and administration. Trials 2010; 11: 2-9
- 8 Feeny D, Furlong W, Boyle M, Torrance GW. Multi-attribute health status classification systems. Health Utilities Index. PharmacoEconomics 1995; 7 (06) 490-502
- 9 Firszt JB, Holden LK, Skinner MW, Tobey EA, Peterson A, Gaggl W, Runge-Samuelson CL, Wackym PA. Recognition of speech presented at soft to loud levels by adult cochlear implant recipients of three cochlear implant systems. Ear Hear 2004; 25: 375-387
- 10 Flanagan JC. A research approach to improving our quality of life. Am Psychol 1978; 33: 138-147
- 11 Garrat AM, Schmidt L, Mackintosh A, Fitzpatrick R. Quality of life measurement: bibliographic study of patient assessed health outcome measures. BMJ Open 2002; 324: 1417-1421
- 12 Gopinath B, Schneider J, Hickson L, McMahon CM, Burlutsky G, Leeder SR, Mitchell P. Hearing handicap, rather than measured hearing impairment, predicts poorer quality of life over 10 years in older adults. Maturitas 2012; 72: 146-151
- 13 Henry JA, Griest S, Zaugg TL, Thielman E, Kaelin C, Galvez G, Carlson KF. Tinnitus and hearing survey: a screening tool to differentiate bothersome tinnitus from hearing difficulties. Am JAudiol 2015; 24 (01) 66-77
- 14 Hinderink JB, Krabbe PF, Van Den Broek P. Development and application of a health-related quality-of-life instrument for adults with cochlear implants: the Nijmegen cochlear implant questionnaire. Otolaryngol Head Neck Surg 2000; 123 (06) 756-765
- 15 Koivisto K, Reinikainen KJ, Hanninen T, Vanhanen M, Helkala E, Mykkanen L, Laakso M, Pyorala K, Riekkinen PJ. Prevalence of aged-associated memory impairment in a randomly selected population from eastern Finland. Neurology 1995; 45: 741-747
- 16 Kuk FK, Tyler RS, Russell D, Jordan H. The psychometric properties of a tinnitus handicap questionnaire. Ear Hear 1990; 11 (06) 434-442
- 17 Lin FR, Chien WW, Li L, Clarrett DM, Niparko JK, Francis HW. Cochlear implantation in older adults. Medicine 2012; 91 (05) 229-241
- 18 Maillet CJ, Tyler RS, Jordan HN. Change in the quality of life of adult cochlear implant patients. Ann Otol Rhinol Laryngol Suppl 1995; 165: 31-48
- 19 McKenna L. Tinnitus and insomnia. In: Tyler RS. , ed. Tinnitus Handbook. San Diego, CA: Singular Publishing Group; 2000: 59-84
- 20 McKenna L, Daniel HC. Tinnitus-related insomnia treatment. In: Tyler RS. , ed. Tinnitus Treatment: Clinical Protocols. New York, NY: Thieme; 2006: 81-95
- 21 McRackan TR, Velozo CA, Holcomb MA, Camposeo EL, Hatch JL, Meyer TA, Lambert PR, Melvin CL, Dubno JR. Use of adult patient focus groups to develop the initial item bank for a cochlear implant quality-of-life instrument. JAMA Otolaryngol Head Neck Surg 2017; 143 (10) 975-982
- 22 Morgan A, Hickson L, Worral L. The impact of hearing impairment on quality of life of older people. Asia Pacif J Speech Lang Hear 2002; 7: 39-53
- 23 NIH. National Institute on Deafness and Other Communication Disorders (NIDCD) 2017–2021 Strategic Plan. Bethesda, MD: National Institute of Health; 2008. https://www.nidcd.nih.gov/about/strategic-plan/2017-2021-nidcd-strategic-plan/ . Accessed February 1, 2018
- 24 Pisoni DB. Cognitive factors and cochlear implants: some thoughts on perception, learning, and memory in speech perception. Ear Hear 2000; 21: 70-78
- 25 Rueckert L, Naybar N. Gender differences in empathy: the role of the right hemisphere. Brain Cogn 2008; 67 (02) 162-167
- 26 Stark P, Hickson L. Outcomes of hearing aid fitting for older people with hearing impairment and their significant others. Int J Audiol 2004; 43 (07) 390-398
- 27 The EuroQol Group. EuroQol-a new facility for the measurement of health-related quality of life. Health Policy 1990; 36: 199-208
- 28 The WHOQOL Group. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 1995; 41: 1403
- 29 Tyler RS, Baker LJ. Difficulties experienced by tinnitus sufferers. J Speech Hear Disord 1983; 48 (02) 150-154
- 30 Tyler RS, Gehringer AK, Noble W, Dunn CC, Witt SA, Bardia A. Tinnitus activities treatment. In: Tyler RS. , ed. Tinnitus Treatment: Clinical Protocols. New York, NY: Thieme; 2006: 116-132
- 31 Tyler RS, Gogel SA, Gehringer AK. Tinnitus activities treatment. Prog Brain Res 2007; 166: 425-434
- 32 Tyler RS, Kelsay D. Advantages and disadvantages reported by some of the better cochlear implant patients. Am J Otol 1990; 11 (04) 282-289
- 33 Ware JE, Sherbourne CD. The MOS 36-item short health survey (SF-36) I. Conceptual framework and item selection. Med Care 1992; 30: 473-483
- 34 Wexler M, Miller LW, Berliner KI, Crary WG. Psychological effects of cochlear implant: patient and ‘index relative’ perceptions. Ann Otol Rhinol Laryngol 1982; 91: 59-61
- 35 WHO, Cataloguing-in-Publication Data. Ubstun TB, Kostanjsek N, Chatterji S, Rehm J. eds. Measuring Health and Disability: Manual for World Health Organization Disability Assessment Schedule (WHODAS 2.0). 2010 http://apps.who.int/iris/bitstream/handle/10665/43974/9789241547598_eng.pdfjsessionid=1B6A854A5D2F8165D539DBBFB6106E64?sequence=1 . Accessed February 4, 2018