Validation and Assessment of Cultural Compatibility of the Arabic Tinnitus Handicap Index (THI) for a Saudi Population

Abstract Objective: Subjective measurements of tinnitus play an important role in tinnitus assessment. The tinnitus handicap index (THI) is a widely used measure that focuses on the psychological impact of tinnitus. The Arabic version of the THI has been partially validated in a Lebanese population. This study aimed to complete a psychometric validation process and assess the measure’s cultural adaptability to a Saudi population. Subject and Methods: One hundred and sixty-one native Arabic-speaking individuals above 18 years of age with tinnitus living in Saudi Arabia completed the standard Arabic version of the THI questionnaire and three additional questions assessing cultural adaptability. THI responses were analyzed using confirmatory factor analysis. Results: Goodness of fit measures (comparative fit index = 0.83, Tucker-Lewis Index = 0.81) showed a reasonable fit to the model. The total internal consistency of the scale was (alpha = 0.90). Functional, emotional, and catastrophic subscales internal consistency alpha values were 0.79, 0.77, and 0.64, respectively. Frequency bars demonstrating responses to the field study questions showed that 83.9% found all the questions to be clear, 90.7% found all the questions easy to understand and 91.9% found all the questions to be culturally appropriate. The item total scale correlations ranged between 0.21 and 0.62. Item subscale correlations ranged from 0.23 to 0.59. Conclusion: The standard Arabic THI is a valid and culturally acceptable measure of tinnitus impact in the Saudi population.