Background: Self-efficacy refers to the beliefs (i.e., confidence) individuals have in their
capabilities to perform skills needed to accomplish a specific goal or behavior. Research
in the treatment of various health conditions such as chronic pain, balance disorders,
and diabetes shows that self-efficacy beliefs play an important role in treatment
outcomes and management of the condition. This article focuses on the application
of self-efficacy to the management of tinnitus. The first step in formally incorporating
self-efficacy in existing treatment regimens or developing a self-efficacy approach
for tinnitus treatment is to have a valid and reliable measure available to assess
the level of tinnitus self-efficacy.
Purpose: The objective of this study was to develop the Self-Efficacy for Tinnitus Management
Questionnaire (SETMQ) and to obtain the psychometric properties of the questionnaire
in a group of patients with tinnitus.
Research Design: Observational study.
Study Sample: A total of 199 patients who were enrolled in the Tinnitus Clinic at the James H.
Quillen Veterans Affairs Medical Center participated in the current study.
Data Collection and Analysis: The SETMQ was mailed to patients enrolled in the Tinnitus Clinic. The participants
who completed one copy of the SETMQ were mailed a second copy to complete approximately
2 weeks later. An exploratory factor analysis was conducted to identify the most coherent
subscale structure of the SETMQ. The internal consistency and test–retest reliability
for each of the subscales and the questionnaire as a whole were assessed. The validity
of the SETMQ also was evaluated by investigating the relations between the SETMQ and
other clinical measures related to tinnitus.
Results: Five components emerged from the factor analysis that explained 75.8% of the variance
related to the following areas: (1) routine tinnitus management, (2) emotional response
to tinnitus, (3) internal thoughts and interaction with others, (4) tinnitus concepts,
and (5) use of assistive devices. Four items failed to load on any factor and were
discarded, resulting in 40 items on the final SETMQ. The internal consistency reliability
of the overall questionnaire and for each subscale was good (Chronbach's α ranged
from .74 to .98). Item-total correlations ranged from .47 to .86, indicating that
each item on the SETMQ correlated at a moderate or marked level with the SETMQ aggregate
score. Intraclass correlation coefficients were computed to determine the test–retest
reliability of the SETMQ total scale and separately for each subscale, which were
all above .80, indicating good test–retest reliability. Correlations among the SETMQ
subscales and various tinnitus-related measures (e.g., Tinnitus Handicap Inventory,
tinnitus loudness rating, tinnitus distress rating, etc.) were significant, albeit
indicative of fair to good relations overall (range r = –.18 to –.53).
Conclusions: The results of the current study suggest that the SETMQ is a valid and reliable measure
that may be an insightful instrument for clinicians and investigators who are interested
in assessing tinnitus self-efficacy. Incorporating self-efficacy principles into tinnitus
management would provide clinicians with another formalized treatment option. A self-efficacy
approach to treating tinnitus may result in better outcomes compared with approaches
not focusing on self-efficacy principles.
Key Words
hearing loss - outcome measures - psychometrics - questionnaire - self-efficacy -
tinnitus
