Asking these questions can help you determine how your patient is coping and their understanding of their condition so that you can offer them relevant guidance.
The Tinnitus Thermometer is a tool to help patients explain how they are experiencing their tinnitus at the time of their appointment. It recognizes that patients might feel tinnitus and its effects differently from time to time, so it is important to start each session as a new beginning. This tool can be used in every appointment.
The Tinnitus Thermometer tool consists of three questions to help you structure conversations and measure how patients are experiencing their tinnitus in a particular moment. The questions are open-ended to allow for a diversity of answers.
The tool also helps you acknowledge that it is the patients themselves who best know how they experience their tinnitus. It is important for you to listen actively and give patients space to express their feelings and thoughts on tinnitus in order to provide them with the best care.
How to use this tool
Ask the patient each question and write down the answers in the relevant boxes. It will take approximately five minutes to ask the three questions.
The first question is, “When you think of tinnitus, what do you think of? Say one or two words that describes how you feel about tinnitus.”
We know from psychology that people can retain only a few important beliefs about any one topic. If we can discover what a person's beliefs are, we can tailor our information and counseling to their priorities.
The second question is, “What do you expect from this appointment?”
This question is important because it focuses on the patient's needs in a specific moment. It also helps explore options and adjust expectations for the outcome of the appointment.
The third question is, “During the last week, was there a time when your tinnitus was less bothersome?”
If the patient cannot think of a situation, you might ask, “Is there anything you know of that might help with your tinnitus or helped someone else?”
The third question emphasizes what positive experiences, if any, have occurred in relation to your patient's tinnitus. Focusing on positive experiences can also contribute to strategizing what could help your patient in the future, whether it's psychotherapy, training in mindfulness, or sound therapy, among other options.
The questions can also help you find out how your patient experiences tinnitus: As a sound or as a physical and/or an emotional pain. This could be further explored by asking the patient to close their eyes and imagine what they see when they think of their tinnitus, and to asking them to describe what that looks like.
Finally, you can explain the following: “The reason I have been asking you these questions is to gauge your 'tinnitus temperature' right now to find out what your concerns are about your tinnitus and how best to address those concerns. Are there other things about your situation you would like me to know? Or other things that you would like to know about?”
The Thermometer's questions might seem simple, but they can be an effective way to “measure” how bothersome or intrusive a patient's tinnitus is at that moment. The three questions can complement other instruments like the TRQ (T Reaction Questionnaire), THI (T Handicap Inventory) and TFI (T Functional Index) that most HCPs will already know.
After the patient has answered the questions and you have written down the answers, you can ask the patient to rate their level of discomfort on the Thermometer below the box. Ask the patient to, “Mark the number from 0-10, that best describes how much tinnitus has bothered you in the past week, including today.” Zero indicates “No tinnitus,” and 10 is the “Worst possible tinnitus.”
The Tinnitus Thermometer can also be used to track or monitor how patients progress over time and determine the most effective rehabilitation strategies for them. If there is improvement, you can show this to your patient to remind them how far they have come.