Tinnitus Handicap Inventory TEST

TINNITUS HANDICAP INVENTORY Form

 

The aim of this questionnaire is to find out what problem tinnitus might be giving you.  Check yes, sometimes, or no for each question.

 

YESSOMETIMESNO
F1Because of your tinnitus is it difficult for you to concentrate?
F2Does the loudness of your tinnitus make it difficult for you to hear?
E3Does your tinnitus make you angry?
F4Does your tinnitus make you feel confused?
C5Because of your tinnitus do you feel desperate?
E6Do you complain a great deal about your tinnitus?
F7Because of your tinnitus do you have trouble falling asleep?
C8Do you feel as though you cannot escape your tinnitus?
F9Does your tinnitus interfere with your ability to enjoy social activities such as going out to dinner, cinema?
E10Because of your tinnitus do you feel frustrated?
C11Because of your tinnitus do you feel you have a terrible disease?
F12Does your tinnitus make it difficult for you to enjoy life?
F13Does your tinnitus interfere with your job or household responsibilities?
F14Because of your tinnitus do you find that you are often irritable?
F15Because of your tinnitus is it difficult for you to read?
E16Does your tinnitus make you upset?
E17Do you feel that your tinnitus has placed stress on your relationship with members of your family, friends?
F18Do you find it difficult to focus your attention away from your tinnitus and on to other things?

 

 YESSOMETIMESNO
C19Do you feel that you have no control over your tinnitus?   
F20Because of your tinnitus are you often tired?   
E21Because of your tinnitus do you feel depressed?   
E22Does your tinnitus make you feel anxious?   
C23Do you feel that you can no longer cope with your tinnitus?   
F24Does your tinnitus get worse when you are under stress?   
E25Does your tinnitus make you feel insecure?   

 

 

HOW TO SCORE THE QUESTIONNAIRE

 

YES = 4

SOMETIMES = 2

NO = 0

 

 

TOTAL SCORE

 

0-16     Slight (Only heard in quiet environments)

18-36   Mild (Easily masked by environmental sounds and easily forgotten with                                                        activities)

 

38-56   Moderate (Noticed in presence of background noise, although daily activities can still be performed)

 

58-76   Severe (Almost always heard, leads to disturbed sleep patterns and can interfere with daily activities)

 

78-100 Catastrophic (Always heard, disturbed sleep patterns, difficulty with any activities)