K S Lyons | PubMed Health

PubMed2006

Clinical trial to compare tinnitus masking and tinnitus retraining therapy.

CONCLUSION: Both tinnitus masking (TM) and tinnitus retraining therapy (TRT) can be effective therapies for amelioration of tinnitus. TM may be more effective for patients in the short term, but with continued treatment TRT may produce the greatest effects. OBJECTIVES: Although TM and TRT have been used for many years, research has not documented definitively the efficacy of these methods. The present study was a controlled clinical trial to prospectively evaluate the clinical efficacy of these two methods for US military veterans with severe tinnitus. SUBJECTS AND METHODS: Over 800 veterans were screened to ensure that enrolled patients had tinnitus of sufficient severity to justify 18 months of individualized treatment. Qualifying patients (n=123) were placed quasi-randomly (alternating placement) into treatment with either TM or TRT. Treatment was administered at 0, 3, 6, 12, and 18 months. Outcomes of treatment were evaluated primarily using three self-administered tinnitus questionnaires (Tinnitus Handicap Inventory, Tinnitus Handicap Questionnaire, Tinnitus Severity Index). RESULTS: Findings are presented from the three written questionnaires with respect to three categories of patients: describing tinnitus as a 'moderate,' 'big,' and 'very big' problem at baseline. Based on effect sizes, both groups showed considerable improvement overall. In general, TM effects remained fairly constant over time while TRT effects improved incrementally. For the patients with a 'moderate' and 'big' problem, TM provided the greatest benefit at 3 and 6 months; benefit to these TRT patients was slightly greater at 12 months, and much greater at 18 months. For patients with a 'very big' problem, TM provided the greatest benefit at 3 months. For these latter patients, results were about the same between groups at 6 months, and improvement for TRT was much greater at 12 months, with further gains at 18 months.

Acoustic Stimulation↗

PubMed2005

Using multilevel modeling in caregiving research.

Recently, caregiving research has moved towards a greater emphasis on the interactive and dynamic processes of the care situation. As a result, many of the questions are multilevel in nature, involving more than one unit of analysis and placing greater focus on the context of the care dyad. Nevertheless, most caregiving studies use methods that fail to address the hierarchical nature of the care dyad and consequently fail to illuminate variation both within and between dyad processes. The focus of this paper is to promote a dyad approach to the analysis of caregiving data and to highlight the advantages and appropriateness of multilevel modeling when dealing with clustered or hierarchical data. In particular, we discuss how multilevel modeling can be adapted to study change in the care dyad over time, improve the way we evaluate interventions, and enhance our understanding of dyad congruence.

Aging↗

PubMed1999

Formal and informal support: the great divide.

As we approach the next century, it is clear that neither formal services nor informal family caregivers can meet the needs of a growing population. It is therefore pertinent to reconceptualize the linkages between formal and informal care and move towards an integrative model. This paper explores several models of such an interface that exist in the literature and proposes that many of these overlap. Various predictors of formal service use are also explored, with an emphasis on the outcomes of both the informal caregiver and the care recipient. Implications for future research include further exploring and understanding the link between formal and informal support and the need to increase receipt of formal care among family caregivers.

Aged↗