Tinnitus and hyperacusis therapy specialist unit

Noise Impact Questionnaire (adult version)

Please answer each item to the best of your ability as close to your experience as possible.

Over the last 2 weeks, how often would you say the following has occurred because of exposure to noises when you were at home or outdoors, for example noise from neighbours, airplanes, trains, power lines, road traffic, industrial workshops, entertainment venues (when you were not actually on the road, or in the workshop or the venue in question), or noise related to plumbing, air conditioning and other domestic appliances?
1. Feeling irritated or angry
2. Avoiding some places or having to shut the doors/windows because of the noise
3. Lack of concentration?
4. Difficulty in carrying out some day-to-day activities/tasks?
5. Lack of enjoyment from leisure activities?
6. Feeling helpless?
7. Sleep difficulties?
8. Reducing the noise using headphones, earplugs or background music?
For Hearing Healthcare Professionals