The quality of life of adults with tinnitus in Malta

Abstract

The aim of this research was to explore tinnitus severity and quality of life among adults living in Malta. This was achieved through three main objectives: validating the Maltese Tinnitus Functional Index (TFI), identifying predictors of tinnitus severity and examining the impact of tinnitus severity on quality of life, including physical, psychological, social, and environmental aspects. A cross-sectional design was employed. Fifty-one participants (mean age = 61.49 years) took part in the study. Participants provided their responses using three instruments: the Maltese TFI, the WHOQOL-BREF, and a demographic-health questionnaire. Statistical analyses, including non-parametric group comparisons, correlations, and regression modelling, were conducted to address the three research questions. Findings indicated that the newly translated Maltese TFI exhibits excellent internal reliability (α=.844−.985), complemented by strong face and content validity. One English subscale (Sense of Control, α = .662) fell below acceptable levels, supporting the linguistic cultural appropriateness of the Maltese version of the TFI. Findings showed that the variable ‘Head and neck injury’ emerged as the strongest predictor of tinnitus severity, significantly affecting multiple TFI subdomains and the total score (ps < .05). ‘Pharmaceutical ototoxicity risk’ was also significant, with participants at high risk reporting greater tinnitus severity compared to those at no or moderate risk (p = .020). When examining the impact of tinnitus severity on quality of life, findings show that Emotional Distress significantly predicted lower Physical Health (β = –.598, p = .009), while Relaxation difficulties predicted reduced Environmental QoL (β = .506, p = .038). Limitations included a small sample size, subgroup imbalances, reliance on self-report, lack of a control group and limited psychometric testing. Future research should use larger, more diverse samples and assess test–retest reliability and construct validity. Overall, these findings support the use of the Maltese TFI in clinical settings for screening purposes, while also highlighting the importance of trauma assessment, ototoxicity monitoring, and the integration of psychological care in tinnitus management.