1. Becauseofyourtinnitus,isitdifficultforyoutoconcentrate?
Yes(4) Sometimes(2) No(0)
2. Doestheloudnessofyourtinnitusmakeitdif-ficultforyoutohearpeople?
Yes(4) Sometimes(2) No(0)
3. Doesyourtinnitusmakeyouangry? Yes(4) Sometimes(2) No(0)
4. Doesyourtinnitusmakeyouconfused? Yes(4) Sometimes(2) No(0)
5. Becauseofyourtinnitus,areyoudesperate? Yes(4) Sometimes(2) No(0)
6. Doyoucomplainagreatdealaboutyourtin-nitus?
Yes(4) Sometimes(2) No(0)
7. Becauseofyourtinnitus,doyouhavetroublefallingasleepatnight?
Yes(4) Sometimes(2) No(0)
8. Doyoufeelasthoughyoucannotescapefromyourtinnitus?
Yes(4) Sometimes(2) No(0)
9. Doesyourtinnitusinterferewithyourabilitytoenjoysocialactivities(suchasgoingouttodin-nerortothecinema)?
Yes(4) Sometimes(2) No(0)
10.Becauseofyourtinnitus,doyoufeelfrustrated? Yes(4) Sometimes(2) No(0)
11. Becauseofyourtinnitus,doyoufeelthatyouhaveaterribledisease?
Yes(4) Sometimes(2) No(0)
Thepurposeofthisquestionnaireistoidentifytheproblemsyourtinnitusmaybecausingyou.Check‘Yes’,‘Sometimes’,or‘No’foreachquestion.Pleaseanswerallquestions.
Name:________________________________________________
Date: _________________________________________________
TinniTus Handicap inventory (tHi)
1/3ThisquestionnaireisreproducedwiththekindpermissionofCraigNewman,Ph.D
12. Doesyourtinnitusmakeitdifficulttoenjoylife? Yes(4) Sometimes(2) No(0)
13. Doesyourtinnitusinterferewithyourjoborhouseholdresponsibilities?
Yes(4) Sometimes(2) No(0)
14.Becauseofyourtinnitus,doyoufindthatyouareoftenirritable
Yes(4) Sometimes(2) No(0)
15.Becauseofyourtinnitus,isitdifficultforyoutoread?
Yes(4) Sometimes(2) No(0)
16.Doesyourtinnitusmakeyouupset? Yes(4) Sometimes(2) No(0)
17.Doyoufeelthatyourtinnitushasplacedstressonyourrelationshipswithmembersofyourfamilyand/orfriends?
Yes(4) Sometimes(2) No(0)
18.Doyoufinditdifficulttofocusyourattentionawayfromyourtinnitusandontootherthings?
Yes(4) Sometimes(2) No(0)
19.Doyoufeelthatyouhavenocontroloveryourtinnitus?
Yes(4) Sometimes(2) No(0)
20.Becauseofyourtinnitus,doyouoftenfeeltired?
Yes(4) Sometimes(2) No(0)
21.Becauseofyourtinnitus,doyoufeeldepressed? Yes(4) Sometimes(2) No(0)
22.Doesyourtinnitusmakeyoufeelanxious? Yes(4) Sometimes(2) No(0)
23.Doyoufeelyoucannolongercopewithyourtinnitus?
Yes(4) Sometimes(2) No(0)
24.Doesyourtinnitusgetworsewhenyouareunderstress?
Yes(4) Sometimes(2) No(0)
25.Doesyourtinnitusmakeyoufeelinsecure? Yes(4) Sometimes(2) No(0)
2/3ThisquestionnaireisreproducedwiththekindpermissionofCraigNewman,Ph.D
For clinician use onlyTotalTHIScore:(numberof‘Yes’responsesx4)+(numberof‘Sometimes’responsesx2)=___________
DeterminepresenceofperceivedtinnitushandicapbasedontotalTHIscore.
0-16:Slightornohandicap(Grade1)18-36:Mildhandicap(Grade2)38-56:Moderatehandicap(Grade3)58-76:Severehandicap(Grade4)78-100:Catastrophichandicap(Grade5)
ThisquestionnaireisreproducedwiththekindpermissionofCraigNewman,Ph.D
ReferencesNewman,C.W.,Jacobson,G.P.,&Spitzer,J.B.(1996).DevelopmentoftheTinnitusHandicapInventory.Arch Otolaryngol Head Neck Surg, 122,143-148.
McCombe,A.,Bagueley,D.,Coles,R.,McKenna,L.,McKinney,C.&Windle-Taylor,P.(2001).Guidelinesforthegradingoftinnitusseverity:TheresultsofaworkinggroupcommissionedbytheBritishAssociationofOtolaryngologists,HeadandNeckSurgeons,1999.Clin Otolaryngol,26,388-393.
ThisquestionnaireisreproducedwiththekindpermissionofCraigNewman,Ph.D 3/3
