Why is tinnitus a problem? A large-scale qualitative evaluation of problems reported by tinnitus patients in mainland China

Figures & data

Table 1. Summary of patient responses across the four recruitment centres.

Question	Centre location in China
	Nanjing	Ningbo	Shanghai	Zhuhai	Overall
No. participants	69	71	175	192	507
Age in years M (SD)	49.2 (14.5)	44.8 (12.5)	47.5 (14.7)	43.0 (15.0)	45.65 (14.66)
Sex (M:F)	26:43	30:41	59:116^a	95:97	210:297
Lateralisation (R:L:bilat:head)	15:24:26:4	20:25:26:0	32:58:77:8	51:55:71:15	118:162:200:27
Fluctuating (Y:N)	42:27	33:38	50:125	75:117	200:307
Onset (Sudden:gradual)	44:25	38:31^(2 missing)	103:70^(2 missing)	98:93^(1 missing)	283:219
Prior treatment (Y:N)	57:12^a	32:39	107:68	112:80	308:199
Tinnitus awareness M (SD)	69.7 (28.8)	67.3 (34.8)	64.0 (33.2)	69.1 (29.0)	67.18 (31.35)
Tinnitus annoyance M (SD)	57.0 (33.5)	43.4 (35.4)	34.4 (30.0)	58.3 (28.3)	47.77 (32.48)
Tinnitus problem M (SD)	6.5 (2.6)	6.6 (2.5)	6.4 (2.5)	6.1 (2.4)	6.32 (2.50)
Hearing problem M (SD)	4.6 (3.5)	2.7 (3.5)	2.8 (3.2)	3.0 (3.2	3.08 (3.31)
Sound tolerance M (SD)	5.1 (2.7)	3.0 (3.6)	2.2 (3.1)	3.7 (3.4)	3.26 (3.39)
Hearing aid user (Y:N)	0:69	2:69	2:173	4:188	8:499
Previous tinnitus treatments? (Y:N)	57:12^a	32:39	107:68	112:80	308:199

^aIndicates where the proportion differs across centres; M: mean; SD: standard deviation; M: male; F: female; R: right; L: left; Bilat: bilateral; Y: yes; N: no.

Table 2. Domains of tinnitus-reported complaints and illustrative examples as translated from the original Chinese.

Categories	n codes in the sample	Examples of relevant codes
Annoyance	80	A very annoying thing; can make me easily irritated; tinnitus is irritating
Constant awareness	24	Its continuous without any gap; the ear is listening to the tinnitus sound; can hear a buzzing sound around me all day long
Effect on listening	67	Can’t hear clearly; affects my hearing and communication; makes my hearing worse
Effect on sleep and alertness	201	When I sleep I can feel my tinnitus; makes my quality of sleep worse; hard to fall asleep
Emotional reactions and consequences	79	Tinnitus is bothering me; makes me feel very anxious; affects my mood; I’m feeling depressed
Fear	38	I am afraid that; I am worried that; I feel nervous; I suspect that there may be a serious disease
Feeling deficient due to tinnitus	1	While others will not be able to hear it, I can, making me feel different, I feel that I have a disease
Inability to concentrate	16	Affects my concentration; makes my memory fail; affected my thinking and judgement
Intrusiveness	0	N/A
Need for knowledge	23	I was wondering if; I want to make sure if; I am curious about; I suspect that
Loss of control	0	N/A
Loss of peace	0	N/A
Loss of quiet	21	I feel worse when its quiet during the daytime; when I am alone, when it the environment is quiet, I cannot feel quiet; cannot have a rest; the feeling of being unable to calm down is very bad
Loss of sense of self	0	N/A
Physical effects of tinnitus	48	Tinnitus caused my vertigo; I feel there is a layer of something blocking my eardrum; makes my head feel bigger; not energetic
Reduced quality of life	59	Basically affects everything; affects my normal life; affects work efficiency; affects many aspects of my work
Unpleasantness of percept	57	Very loud; those kind of sounds are nonsense and disturb me; like the sound of howling
Uncomfortable	54	Makes me feel uncomfortable; it does not feel comfortable like this; I am uncomfortable

Figure 1. Cluster analysis indicating relatedness of tinnitus problems within the responses from individual patients.