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Tinnitus disability questionnaire

Explanation: Aim is to understand the degree of your tinnitus. Just answer yes, no or sometimes. 

1-Do you have difficulty to consentrate because of your tinnitus?
Yes Sometimes No 

2-Do you have difficulty to hear human beings because of tinnitus?
Yes Sometimes No 

3-Do you get nervous because of tinnitus?
Yes Sometimes No 

4-Do you feel mixed up because fo tinnitus?
Yes Sometimes No 

5-Do you feel hopeless because of tinnitus?
Yes Sometimes No 

6-Are you complaint of tinnitus very much?
Yes Sometimes No 

7-Do you get difficulty getting into sleep?
Yes Sometimes No 

8-Do you feel that you cannot get rid of your tinnitus?
Yes Sometimes No 

9-Does tinnitus prevent you to get joy from your social activities?
Yes Sometimes No 

10- Do you feel handicapped because of tinnitus?
Yes Sometimes No 

11- Do you think that you get a terrible disease because of your tinnitus?
Yes Sometimes No 

12-Does tinnitus cause lost of your life joy?
Yes Sometimes No 

13-Does it prevent to do your responsibilities?
Yes Sometimes No 

14-Do yo feel touchy becuase of tinnitus?
Yes Sometimes No 

15-Is it difficult to read because ıf tinnitus?
Yes Sometimes No 

16-Does it make you sad?
Yes Sometimes No 

17-Do you think that tinnitus causes pressure in your relations with your family and friends?
Yes Sometimes No 

18-Do you think that it is difficult to seperate your ideas from tinnitus and concentrate on other things?
Yes Sometimes No 

19-Do you feel that you have not any control on your tinnitus?
Yes Sometimes No 

20-Do you feel tired frequently because of tinnitus?
Yes Sometimes No 

21-Do you feel depressed because of tinnitus?
Yes Sometimes No 

22-Does tinnitus make you feel nervous?
Yes Sometimes No 

23-Do you think that you do not overcome with tinnitus anymore?
Yes Sometimes No 

24-Does tinnitus become worse when you have problems?
Yes Sometimes No 

25-Does tinnitus make you feel unsafe?
Yes Sometimes No 

Evaluation of the questionnaire (Aksoy S. 2007)
4 0 2
Yes Sometimes No 

First degree 0-16 Weak (Only can be heard in quiet places) 

Second degree 18-36 Medium (Can be masked with noise and can be ignored while in activitiy) 

Third degree 38-56 Moderate (Still routine activities can be performed even tinnitus is heard) 

Fourth degree 58-76 Strong (Tinnitus is heard almost always and may disturb sleep and daily activities) 

Fifth degree 78-100 Disaster (Heard always, disturbs sleep and causes difficulty in routine work)

My persistent symptoms 31 May, 2013 - 12:14

I am writing to you from St. John's, Newfoundland (Canada). I have a sinus problem started in Nov 2008 upon working for more than a month in a gas plant. I did not have sinus problems prior to this date.

At that time, I may have been exposed to airborne asbestos and other irritants. In the place where I lived at that time, the Winter is so harsh. Temperature during Winter is normally at least 25 Cecilius below zero.

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