Research Article

Reliability and Validity of the Persian Version of the 12-Item Tinnitus Primary Function Questionnaire

Abstract

Background and Aim: Tinnitus creates socioeconomic challenges. Questionnaires are widely used to assess their impact on daily life. This study aimed to validate the Persian version of the 12-item Tinnitus Primary Function Questionnaire (P-TPFQ) to provide a culturally appropriate tool for evaluating tinnitus-related disability in Persian speakers.
Methods: This study with a cross-sectional design was conducted on 56 adults experiencing tinnitus. The TPFQ was translated according to the international quality of life assessment protocol. Content validity and face validity was evaluated using the Content Validity Ratio (CVR), Content Validity Index (CVI) and the Face Validity Index (FVI). Internal consistency was determined using Cronbach’s alpha. Convergent validity was tested by assessing the correlation with the scores of the Tinnitus Handicap Inventory (THI), Beck Depression Inventory-II (BDI-II), and Pittsburgh Sleep Quality Index (PSQI). Test-retest reliability was assessed using the Intraclass Correlation Coefficients (ICC). Confirmatory Factor Analysis (CFA) examined the construct validity.
Results: Content and face validity were excellent (CVR=1.0, CVI=1.0, FVI=1.0). The CFA confirmed a four-factor structure with high loadings (0.85–0.97). Internal consistency was high (Cronbach’s α=0.956 for the overall scale; 0.922–0.969 for the subscales). The total P-TPFQ score had a strong and significant correlation with the THI score (r=0.845), and a moderate and significant correlation with BDI-II (r=0.600) and PSQI (r=0.416) scores (p<0.001). Test–retest reliability was high (ICC=0.956).
Conclusion: The P-TPFQ with 12 items and four subscales has excellent reliability and validity. As a multidimensional tool, it can be used for assessing tinnitus-related behavioural aspects.

1. Piccirillo JF, Rodebaugh TL, Lenze EJ. Tinnitus. Jama. 2020;323(15):1497-8. [DOI:10.1001/jama.2020.0697]
2. Jalessi M, Farhadi M, Asghari A, Kamrava SK, Amintehran E, Ghalehbaghi S, et al. Tinnitus: an epidemiologic study in Iranian population. Acta Med Iran. 2013;51(12):886-91.
3. Han BI, Lee HW, Kim TY, Lim JS, Shin KS. Tinnitus: Characteristics, causes, mechanisms, and treatments. J Clin Neurol. 2009;5(1):11-9. [DOI:10.3988/jcn.2009.5.1.11]
4. Tunkel DE, Bauer CA, Sun GH, Rosenfeld RM, Chandrasekhar SS, Cunningham ER Jr, et al. Clinical practice guideline: Tinnitus executive summary. Otolaryngol Head Neck Surg. 2014;151(4):533-41. [DOI:10.1177/0194599814547475]
5. Newman CW, Jacobson GP, Spitzer JB. Development of the Tinnitus Handicap Inventory. Arch Otolaryngol Head Neck Surg. 1996;122(2):143-8. [DOI:10.1001/archotol.1996.01890140029007]
6. Kuk FK, Tyler RS, Russell D, Jordan H. The psychometric properties of a tinnitus handicap questionnaire. Ear Hear. 1990;11(6):434-45. [DOI:10.1097/00003446-199012000-00005]
7. Meikle MB, Henry JA, Griest SE, Stewart BJ, Abrams HB, McArdle R, et al. The tinnitus functional index: Development of a new clinical measure for chronic, intrusive tinnitus. Ear Hear. 2012;33(2):153-76. [DOI:10.1097/AUD.0b013e31822f67c0]
8. Rolstad S, Adler J, Rydén A. Response burden and questionnaire length: Is shorter better? A review and meta-analysis. Value Health. 2011;14(8):1101-8. [DOI:10.1016/j.jval.2011.06.003]
9. Langguth B, Goodey R, Azevedo A, Bjorne A, Cacace A, Crocetti A, et al. Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006. Prog Brain Res. 2007;166:525-36. [DOI:10.1016/S0079-6123(07)66050-6]
10. Tyler R, Ji H, Perreau A, Witt S, Noble W, Coelho C. Development and validation of the tinnitus primary function questionnaire. Am J Audiol. 2014;23(3):260-72. [DOI:10.1044/2014_AJA-13-0014]
11. Shin J, Heo S, Lee HK, Tyler R, Jin IK. Reliability and validity of a Korean version of the tinnitus primary function questionnaire. Am J Audiol. 2019;28(2):362-8. [DOI:10.1044/2018_AJA-18-0131]
12. Xin Y, Tyler R, Yao ZM, Zhou N, Xiong S, Tao LY, et al. Tinnitus assessment: Chinese version of the tinnitus primary function questionnaire. World J Otorhinolaryngol Head Neck Surg. 2022;9(1):27-34. [DOI:10.1002/wjo2.60]
13. Lu T, Liu JH, Li G, Xiang T, Ma Y, Zhong J, et al. Reliability and validity of the Mandarin version of the tinnitus primary function questionnaire: A preliminary observational study. Medicine. 2019;98(25):e16104. [DOI:10.1097/MD.0000000000016104]
14. Talaat HS, Ali RH, Zein El Abedein AM. Trans-adaptation and standardization of Arabic version of tinnitus primary function questionnaire. Egypt J Ear, Nose Throat Allied Sci. 2020;21(2):51-5. [DOI:10.21608/ejentas.2019.13299.1116]
15. Coradini PP, Gonçalves SN, Oiticica J. Translation and validation of the Tinnitus Primary Function Questionnaire into Brazilian Portuguese. Braz J Otorhinolaryngol. 2022;88 Suppl 3(Suppl 3):S109-16. [DOI:10.1016/j.bjorl.2022.06.004]
16. Shaurya Ch, Ravichandran A, Kumar S. Transadaptation and standardization of tinnitus primary function questionnaire in Hindi. Int Tinnitus J. 2018;22(1):23-9. [DOI:10.5935/0946-5448.20180004]
17. Namvar Arefi H, Haddadi Aval M, Ranjbar N, Jafarzadeh S. The Translation and Psychometric Evaluation of the Persian Version of Iowa Tinnitus Primary Function Questionnaire. Aud Vestib Res. 2023;32(3):213-8. [DOI:10.18502/avr.v32i3.12937]
18. Gorsuch R. Factor analysis. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1983.
19. Chermak GD, Dengerink JE. Characteristics of temporary noiseinduced tinnitus in male and female subjects. Scand Audiol. 1987;16(2):67-73. [DOI:10.3109/14992028709042158]
20. Mahmoudian S, Shahmiri E, Rouzbahani M, Jafari Z, Keyhani M, Rahimi F, et al. Persian language version of the “Tinnitus Handicap Inventory”: Translation, standardization, validity and reliability. Int Tinnitus J. 2011;16(2):93-103.
21. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory--Second edition: BDI-II-PERSIAN. Depress Anxiety. 2005;21(4):185-92. [DOI:10.1002/da.20070]
22. Farrahi Moghaddam J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep Breath. 2012;16(1):79-82. [DOI:10.1007/s11325-010-0478-5]
23. Aaronson NK, Acquadro C, Alonso J, Apolone G, Bucquet D, Bullinger M, et al. International quality of life assessment (IQOLA) project. Qual Life Res. 1992;1(5):349-51. [DOI:10.1007/BF00434949]
24. Yusoff MSB. ABC of response process validation and face validity index calculation. Educ Med J. 2019;11(3):55-61. [DOI:10.21315/eimj2019.11.3.6]
25. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155-63. [DOI:10.1016/j.jcm.2016.02.012]
Files
IssueVol 35 No 3 (2026) QRcode
SectionResearch Article(s)
Keywords
Tinnitus questionaries tinnitus primary functional questionaries validity reliability
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Ranjbar A, Rahimi V, Tavanai E, Tyler R, Abadeh M. Reliability and Validity of the Persian Version of the 12-Item Tinnitus Primary Function Questionnaire. Aud Vestib Res. 2025;35(3):295-302.