# Patient Health Experiences: Using Patient Narratives to Improve Tinnitus Rehabilitation Services and Outcomes

> **NIH VA I21** · PORTLAND VA MEDICAL CENTER · 2022 · —

## Abstract

Tinnitus, a chronic condition for which there is no “cure,” is the most common service-connected
disability at the Department of Veterans Affairs1. The functional effects of chronic tinnitus can vary widely,
ranging from being a mild nuisance to being completely disabling.2 Veterans who are negatively impacted by
tinnitus commonly report sleep disturbance, difficulty concentrating, and disruptive emotional reactions2. In
addition, Veterans with tinnitus also suffer from multiple comorbidities, including depression, anxiety, sleep
disorders, post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and suicidal ideation3-5. Although
some Veterans with tinnitus spontaneously develop their own unique coping strategies to reduce the impact of
tinnitus on their lives, others need a lot of support to improve quality of life and functional status, especially in
the context of other physical or mental health comorbidities.
 In our program of research on tinnitus among Veterans6,7, we have found that there are inconsistent
standards of tinnitus care in VA settings8. Cognitive Behavioral Therapy (CBT) has been shown to improve
quality of life and functional status with tinnitus9, however, many VA health care providers report being
unaware that the method can be used to assist people negatively impacted by tinnitus7. In contrast to the
relative difficulty finding providers who are knowledgeable about effective, evidence-based care for tinnitus,
patients find easy access to products (supplements, ear drops, untested devices, etc.) that falsely promise a
cure and are directly marketed, often via the internet, to people struggling with tinnitus. Trying multiple over-
the-counter products in hopes of finding a cure that does not exist often exacerbates anxiety and frustration in
Veterans with tinnitus, a vulnerable population already burdened with managing multiple co-morbid behavioral
health conditions. Past interviews with individuals with hearing loss and tinnitus has shown that peer
testimonials are important factors in Veterans' sense of hope about their future and in their willingness seeking
help for these conditions10. Thus, Veterans' stories about their challenges, decision-making processes,
experiences with seeking a cure, and experiences with trying various coping strategies in spite of the lack of a
cure could be leveraged as an invaluable source of wisdom, information, and support for their peers with
bothersome tinnitus who are struggling and seeking answers that are hard to find.
 The gold standard of rendering patient narratives on health conditions is called the “The Database of
Individual Patients' Experience” (DIPEx). DIPEx is rigorous, evidence-based methodology for eliciting rich
information on the health experiences of a broad range of patients with diverse chronic health conditions. The
specific aims of this mixed-method are to: (1) Use DIPEx methodology to document Veterans' experiences (n=
10-15) with bothersome tinnitus and ...

## Key facts

- **NIH application ID:** 10486422
- **Project number:** 1I21RX004098-01
- **Recipient organization:** PORTLAND VA MEDICAL CENTER
- **Principal Investigator:** KHAYA Delaine CLARK
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-06-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10486422

## Citation

> US National Institutes of Health, RePORTER application 10486422, Patient Health Experiences: Using Patient Narratives to Improve Tinnitus Rehabilitation Services and Outcomes (1I21RX004098-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10486422. Licensed CC0.

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