Tinnitus, the perception of sound in the absence of external auditory stimuli, is a prevalent audiological condition affecting millions of individuals worldwide. It is characterized by the perception of various phantom sounds such as ringing, buzzing, hissing, or clicking, which can significantly impact a person's quality of life. 

Tinnitus can impair a person's daily life in a number of ways, such as making it difficult for them to fall asleep, making them feel depressed and irritated, interfering with their social life, causing them to have hearing problems, making them feel disoriented, and interfering with their employment and regular activities. Tinnitus can have a negative impact on a person's day-to-day activities, such as social interactions, academic achievement, and job advancement. These side effects can include psychological problems, difficulties sleeping, and difficulty focusing. Some studies have made the connection between young people with tinnitus and anxiety, depression, and suicide [3-4].

Despite its high prevalence and potential negative consequences, there is a lack of awareness and understanding about tinnitus among the general population, including patients seeking healthcare services. Understanding the knowledge and perceptions regarding tinnitus is crucial for multiple reasons. Firstly, it enables healthcare professionals to identify the level of awareness among patients, which can influence their approach to diagnosis, treatment, and patient education. Secondly, it helps in dispelling myths and misconceptions surrounding tinnitus, thus reducing anxiety and improving overall well-being. Lastly, assessing the knowledge gaps can guide the development of educational materials and awareness campaigns tailored to the specific needs of the population.

The Civil Hospital Jogindernagar serves as a major healthcare facility in the region, catering to a diverse patient population. By focusing on this specific outpatient department, the study aims to obtain a representative sample of individuals seeking medical care for various conditions, including those who may have experienced tinnitus symptoms.

The aim of the present study is to fill the existing knowledge gap by exploring the patients' awareness, understanding, and attitudes towards tinnitus, which can aid in designing appropriate educational interventions and support strategies. By bridging the knowledge gap and promoting accurate understanding of tinnitus, healthcare providers can empower patients to make informed decisions, seek appropriate interventions, and cope effectively with the challenges associated with this distressing audiological condition.

Objectives of the Study

This objective of this research article is to assess the knowledge and perceptions regarding tinnitus among patients attending the outpatient department of Civil Hospital Jogindernagar, located in the picturesque state of Himachal Pradesh, India.

Research Methodology

• Research Approach: Descriptive

• Research Design: Hospital based cross-sectional survey design

• Setting of the study-OPD in Civil hospital Jogindernagar, , Himachal Pradesh

• Study Duration: Between January 2023- April 2023

• Study Population: Patients aged above 18 years came to OPD

• Sample Size: 400 Patients, assuming 50% have adequate knowledge regarding tinnitus, 5% absolute error, 95% confidence level, and 5% non-response rate

• Sampling Technique: Convenience  Sampling technique

• Sampling Criteria: first five patients who came to OPD were selected everyday till the completion of sample size after explaining the purpose of the study. Informed consent was taken from them and confidentiality of the selected  participants was also maintained

• Inclusive Criteria:   Patients who were willing to participate in the study

• Exclusion Criteria: Patients who were not willing to participate in the study

Description of Tool 

• Demographic Data Survey Instrument: The demographic form elicited information on participants’ background: age, gender, marital status, religion, employment, education, family’s monthly income etc

• Questionnaire: The questionnaire contains 20 structured knowledge related questions having three options (yes, no, don’t know).  The participants have to choose right one. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as>80% (16-20) = very good,60-79% (12-15) = Good,41-59% (8-11) = Fair,<40% (<8) = poor

• Validity of Tool: By the experts in this field

• Data collection by under the guidance of supervisors and patients were given 30 minutes time to complete that questionnaire and collected at the end of the prescribed time

• Data analysis with Epi Info V7 Software with appropriate statistical test in terms of frequencies, percentage

The goal of the current study was to assess the awareness regarding tinnitus among patients attending outpatient department of Civil hospital, Jogindernagar, Himachal Pradesh.

A total of 400 respondents including 145 (36.25%) were from urban area and 255(63.75%) were from rural area were participated in the study. Among the total of 400 patients came to OPD, maximum 226(56.5%) were males, 118(29.5%) were having age between 21-30 years, educated up to Matric & Senior Secondary 166(41.5%), Hindu 376(94.0%) and were  employed 301(75.25%).

In the present study 14%(56)  participants had very good knowledge (16-20 marks) towards Tinnitus, 30.5% (122) had good knowledge (12-15 marks), 31.25%(125) had fair knowledge  (8-11 marks) and 24.25% (97) having poor knowledge (<8 marks).

Table 1: Socio Demographic Characteristics of the Participants

Table-2: Knowledge Regarding Causes, Effects and Management of Tinnitus

Table 3: Knowledge Towards Tinnitus Among Study Participants

Maximum =20 Minimum=6

The present study aimed to assess the knowledge and perceptions regarding tinnitus among patients attending the outpatient department of Civil Hospital Jogindernagar, Himachal Pradesh. The results provide valuable insights into the participants' demographics and their level of knowledge regarding tinnitus.

In terms of demographics, the study included a total of 400 respondents, with 36.25% (145) from urban areas and 63.75% (255) from rural areas. This distribution reflects the diverse patient population attending the Civil Hospital Jogindernagar and provides a representation of both urban and rural communities in the region. Among the total respondents, 56.5% (226) were males, indicating a higher male participation rate in the study. Furthermore, a significant proportion of participants (29.5%) fell within the age range of 21-30 years, suggesting that tinnitus affects individuals in their younger adult years. The educational background of the participants revealed that 41.5% had completed education up to Matric and Senior Secondary level, highlighting the need to tailor educational interventions to various literacy levels. Religion-wise, the majority of participants (94.0%) identified themselves as Hindus, reflecting the religious composition of the region. Additionally, 75.25% of the participants were employed, indicating the potential impact of tinnitus on occupational activities and productivity.

Regarding knowledge about tinnitus, the study findings demonstrate varying levels of awareness among the participants. Only 14% (56) of the respondents had very good knowledge (16-20 marks) regarding tinnitus, while 30.5% (122) had good knowledge (12-15 marks). A significant proportion of participants (31.25%, 125) had fair knowledge (8-11 marks), and 24.25% (97) had poor knowledge (<8 marks). Hence, in this study, majority of participants did not know about Tinnitus, its causes, effects and management. Similarly, in the study done by Vedika Bagwandin. et al [3], the majority of participants (69.86%) were not aware of the existence of tinnitus and most of the participants did not know about the causes or effects of tinnitus. These results highlight the overall gaps in understanding and awareness of tinnitus among the surveyed population.

In comparison to studies conducted in developed countries, where tinnitus awareness campaigns and educational initiatives are more prevalent, the current study's findings might indicate a lower level of knowledge. This emphasizes the need for targeted interventions in regions with limited resources and awareness regarding tinnitus. By addressing the specific knowledge gaps identified in this study, healthcare providers and policymakers can develop tailored educational programs to improve tinnitus literacy and promote effective management strategies.

It is apparent that today's population makes loud noises while enjoying leisure activities. These people are considered to listen to music excessively due to societal expectations and standards. Therefore, while participating in recreational activities, using PLDs, and listening to loud music from other sources, these individuals run the risk of developing tinnitus. People should therefore be made aware of the dangers of extended exposure to loud noise during parties, concerts, and nightclubs, as well as the advantages of using hearing protection devices (HPDs) [3,8-9].

People might not always be aware that there are tinnitus control options, and as a result, they might not seek assistance. These strategies include the use of hearing aids, counselling, acoustic therapy, relaxation techniques, pharmaceutical, and surgical approaches. Furthermore, it is asserted that because tinnitus is not painful, people may not seek treament because they do not consider it to be a major health problem [3,10-11].

It is evident that people need to have a greater understanding of what tinnitus is, how it occurs, and how to deal with it. However, it might be more beneficial to educate people about the specific effects of tinnitus on their life rather than focusing on how tinnitus typically occurs. If people are aware of how something personally affects them, they may be more willing to take precautions. Recent research suggests that in order to increase the possibility that individuals will heed advice, tinnitus health promotion efforts should be introduced to people in a number of ways [1-3,11].

Limitations of the Study 

The present study has certain limitations such as cross sectional in nature, and small sample size that made difficult to generalize the findings. Future research should be focused on larger sample and qualitative studies such as focus group interviews to identify barriers to promote appropriate knowledge and practices about tinnitus.

In conclusion, the findings of this study indicate a considerable  lack of knowledge and awareness about tinnitus among patients attending the outpatient department of Civil Hospital Jogindernagar, Himachal Pradesh. The results emphasize the need for educational interventions and awareness campaigns to bridge the knowledge gap and empower patients to seek appropriate management strategies. Further research and collaboration are warranted to address the specific challenges faced by patients in the region and develop comprehensive strategies for the management of tinnitus.

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3. Bagwandin, V. and Joseph, L. "A survey exploring awareness and experience of tinnitus in young adults." South African Journal of Communication Disorders, vol. 64, no. 1, 2017, p. 545.

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