{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T03:02:30Z","timestamp":1779678150727,"version":"3.53.1"},"reference-count":51,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Tinnitus is a common and potentially distressing phenomenon for which no broadly effective curative treatment exists. Self-management skills and empowerment are crucial for coping with chronic conditions, but empirical studies investigating the association of these on individuals burdened by tinnitus are scarce. The primary aim of this cross-sectional study was to investigate the association between the use of an online self-help platform for people with tinnitus and self-perceptions of empowerment, self-management skills, and the cognitive and emotional representations of tinnitus. Methods: One hundred and fifty-two adult participants were recruited from an online self-help platform for people with tinnitus, resulting in a self-selected convenience sample. Self-management skills were assessed using the Patient Assessment of Chronic Illness Care (PACIC) and the Partners in Health Questionnaire. The cognitive and emotional representations of tinnitus were measured with the Illness Perception Questionnaire. Finally, the Empowering Processes and Outcomes Questionnaire was used to evaluate empowerment associated with engagement in the self-help platform. The type and frequency of user activity on the self-help platform were used to explore the relationship between the nature of contributions to the platform and the measured outcomes. Results: The key findings include: (1) The representations of tinnitus were negatively related to their ability to self-manage the condition. (2) The duration of tinnitus did not correlate with improved self-management skills. (3) Comparing those who visited a healthcare provider for their tinnitus with those who did not, we found that treatment adherence was higher among participants with clinical visits. (4) Participants in this study scored lower on all aspects of self-management skills (as measured by the PACIC) compared to patients using primary healthcare services. (5) Participants who actively contributed to the self-help platform by posting scored higher in two empowering processes: helping others and sharing experiences. Conclusions: The present findings suggest that tinnitus self-management skills are independent of tinnitus duration, whereas those skills correlate negatively with illness perception. Further, clinical visits are associated with higher treatment adherence, and active self-help platform use increases feelings related to helping others and shared experiences. Taken together, these results highlight the need for fostering self-management skills and structured peer-to-peer support programs. Because this was a self-selected convenience sample of users of an online tinnitus self-help platform, the findings should be interpreted in light of this recruitment context and not generalized to the broader tinnitus population.<\/jats:p>","DOI":"10.3390\/jcm15114043","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T01:45:08Z","timestamp":1779673508000},"page":"4043","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Empowerment, Self-Management and Illness Perception of Users of an Online Self-Help Platform for Tinnitus: A Cross-Sectional Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3397-2319","authenticated-orcid":false,"given":"Jorge","family":"Piano Sim\u00f5es","sequence":"first","affiliation":[{"name":"Department of Psychology, Health and Technology, University of Twente, 7522 NB Enschede, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Engelke","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazel","family":"Goedhart","sequence":"additional","affiliation":[{"name":"Tinnitus Hub, 1071 LR Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku","family":"Vesala","sequence":"additional","affiliation":[{"name":"Tinnitus Hub, 1071 LR Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfried","family":"Schlee","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany"},{"name":"Institute for Information and Process Management, Eastern Switzerland University of Applied Sciences, 9471 Buchs, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7639-5318","authenticated-orcid":false,"given":"Steven","family":"Marcrum","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University Hospital Regensburg, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/S0140-6736(13)60142-7","article-title":"Tinnitus","volume":"382","author":"Baguley","year":"2013","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Baguley, D.M., Caimino, C., Gilles, A., and Jacquemin, L. (2022). The International Vocabulary of Tinnitus. Front. Neurosci., 16.","DOI":"10.3389\/fnins.2022.887592"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s10162-022-00874-y","article-title":"Low Evidence for Tinnitus Risk Factors: A Systematic Review and Meta-analysis","volume":"24","author":"Biswas","year":"2022","journal-title":"J. Assoc. Res. Otolaryngol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1001\/jamaneurol.2022.2189","article-title":"Global Prevalence and Incidence of Tinnitus: A Systematic Review And Meta-Analysis","volume":"79","author":"Jarach","year":"2022","journal-title":"JAMA Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2331216518812250","DOI":"10.1177\/2331216518812250","article-title":"Why Is Tinnitus a Problem? A Qualitative Analysis of Problems Reported by Tinnitus Patients","volume":"22","author":"Watts","year":"2018","journal-title":"Trends Hear."},{"key":"ref_6","first-page":"278","article-title":"Chronic Tinnitus: An Interdisciplinary Challenge","volume":"110","author":"Kreuzer","year":"2013","journal-title":"Dtsch. \u00c4rzteblatt Int."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Simoes, J., Neff, P., Schoisswohl, S., Bulla, J., Schecklmann, M., Harrison, S., Vesala, M., Langguth, B., and Schlee, W. (2019). Toward Personalized Tinnitus Treatment: An Exploratory Study Based on Internet Crowdsensing. Front. Public Health, 7.","DOI":"10.3389\/fpubh.2019.00157"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s00103-018-2850-8","article-title":"Participation in self-help groups: Impact on self-management and knowledge","volume":"62","author":"Nickel","year":"2019","journal-title":"Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1080\/14992027.2018.1512013","article-title":"Promotion and views on tinnitus self-help within United Kingdom national health service audiology departments","volume":"57","author":"Smith","year":"2018","journal-title":"Int. J. Audiol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Probst, T., Pryss, R.C., Langguth, B., Spiliopoulou, M., Landgrebe, M., Vesala, M., Harrison, S., Schobel, J., Reichert, M., and Stach, M. (2017). Outpatient Tinnitus Clinic, Self-Help Web Platform, or Mobile Application to Recruit Tinnitus Study Samples?. Front. Aging Neurosci., 9.","DOI":"10.3389\/fnagi.2017.00113"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1111\/j.1369-7625.2011.00757.x","article-title":"Empowerment, patient centred care and self-management","volume":"17","author":"Pulvirenti","year":"2012","journal-title":"Health Expect."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2469","DOI":"10.1001\/jama.288.19.2469","article-title":"Patient self-management of chronic disease in primary care","volume":"288","author":"Bodenheimer","year":"2002","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/S0738-3991(02)00032-0","article-title":"Self-management approaches for people with chronic conditions: A review","volume":"48","author":"Barlow","year":"2002","journal-title":"Patient Educ. Couns."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1080\/088704403100081321","article-title":"A meta-analytic review of the common-sense model of illness representations","volume":"18","author":"Hagger","year":"2003","journal-title":"Psychol. Health"},{"key":"ref_15","first-page":"1","article-title":"The revised illness perception questionnaire (IPQ-R)","volume":"17","author":"Weinman","year":"2002","journal-title":"Psychol. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e31805","DOI":"10.1016\/j.heliyon.2024.e31805","article-title":"Illness perception: A bibliometric study","volume":"10","author":"Singh","year":"2024","journal-title":"Heliyon"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1177\/1359105320947790","article-title":"Patient activation in adults with chronic conditions: A systematic review","volume":"26","author":"Newland","year":"2021","journal-title":"J. Health Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Vainauskien\u0117, V., and Vaitkien\u0117, R. (2021). Enablers of Patient Knowledge Empowerment for Self-Management of Chronic Disease: An Integrative Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18052247"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.pec.2016.01.022","article-title":"Identifying components of self-management interventions that improve health-related quality of life in chronically ill patients: Systematic review and meta-regression analysis","volume":"99","author":"Jonkman","year":"2016","journal-title":"Patient Educ. Couns."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Huang, Y., Li, S., Lu, X., Chen, W., and Zhang, Y. (2024). The Effect of Self-Management on Patients with Chronic Diseases: A Systematic Review and Meta-Analysis. Healthcare, 12.","DOI":"10.3390\/healthcare12212151"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1017\/psrm.2018.28","article-title":"Recruiting large online samples in the United States and India: Facebook, Mechanical Turk, and Qualtrics","volume":"8","author":"Boas","year":"2018","journal-title":"Political Sci. Res. Methods"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.3758\/BRM.41.4.1149","article-title":"Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses","volume":"41","author":"Faul","year":"2009","journal-title":"Behav. Res. Methods"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"33267","DOI":"10.1525\/collabra.33267","article-title":"Sample Size Justification","volume":"8","author":"Lakens","year":"2022","journal-title":"Collabra Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies","volume":"12","author":"Altman","year":"2014","journal-title":"Int. J. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S0079-6123(07)66050-6","article-title":"Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006","volume":"166","author":"Langguth","year":"2007","journal-title":"Prog. Brain Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.jpsychores.2005.10.020","article-title":"The Brief Illness Perception Questionnaire","volume":"60","author":"Broadbent","year":"2006","journal-title":"J. Psychosom. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1097\/01.mlr.0000160375.47920.8c","article-title":"Development and validation of the Patient Assessment of Chronic Illness Care (PACIC)","volume":"43","author":"Glasgow","year":"2005","journal-title":"Med. Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1071\/PY03022","article-title":"The Partners in Health scale: The development and psychometric properties of a generic assessment scale for chronic condition self-management","volume":"9","author":"Battersby","year":"2003","journal-title":"Aust. J. Prim. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1177\/1049732307313429","article-title":"Empowering processes and outcomes of participation in online support groups for patients with breast cancer, arthritis, or fibromyalgia","volume":"18","author":"Drossaert","year":"2008","journal-title":"Qual. Health Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/0738-3991(95)00730-N","article-title":"Empowerment: From philosophy to practice","volume":"26","author":"Feste","year":"1995","journal-title":"Patient Educ. Couns."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1093\/biomet\/75.4.800","article-title":"A sharper Bonferroni procedure for multiple tests of significance","volume":"75","author":"Hochberg","year":"1988","journal-title":"Biometrika"},{"key":"ref_32","first-page":"e24","article-title":"Package \u2018corrplot\u2019","volume":"56","author":"Wei","year":"2017","journal-title":"Statistician"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v048.i04","article-title":"qgraph: Network visualizations of relationships in psychometric data","volume":"48","author":"Epskamp","year":"2012","journal-title":"J. Stat. Softw."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"195","DOI":"10.3758\/s13428-017-0862-1","article-title":"Estimating psychological networks and their accuracy: A tutorial paper","volume":"50","author":"Epskamp","year":"2017","journal-title":"Behav. Res. Methods"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1044\/2022_AJA-22-00178","article-title":"Directed Attention and Habituation: Two Concepts Critical to Tinnitus Management","volume":"32","author":"Henry","year":"2023","journal-title":"Am. J. Audiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"210","DOI":"10.5539\/gjhs.v7n2p210","article-title":"An overview of chronic disease models: A systematic literature review","volume":"7","author":"Grover","year":"2014","journal-title":"Glob. J. Health Sci."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Convery, E., Hickson, L., Keidser, G., and Meyer, C. (2019). The chronic care model and chronic condition self-management: An introduction for audiologists. Proceedings of Seminars in Hearing, Thieme Medical Publishers.","DOI":"10.1055\/s-0038-1676780"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.ijcard.2017.11.057","article-title":"Benefits and limitations of implementing Chronic Care Model (CCM) in primary care programs: A systematic review","volume":"258","author":"Yeoh","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.jpsychores.2012.04.009","article-title":"When the ringing in the ears gets unbearable: Illness representations, self-instructions and adjustment to tinnitus","volume":"73","author":"Vollmann","year":"2012","journal-title":"J. Psychosom. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1111\/j.1365-2273.2004.00879.x","article-title":"Tinnitus and psychological morbidity: A cross-sectional study to investigate psychological morbidity in tinnitus patients and its relationship with severity of symptoms and illness perceptions","volume":"29","author":"Reynolds","year":"2004","journal-title":"Clin. Otolaryngol. Allied Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1097\/AUD.0000000000000826","article-title":"Evaluation of a Cognitive Behavioral Model of Tinnitus Distress: A Cross-Sectional Study Using Structural Equation Modeling","volume":"41","author":"Handscomb","year":"2020","journal-title":"Ear Hear."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1177\/01945998221088286","article-title":"Evaluation and Management of Tinnitus: Are There Opportunities for Improvement?","volume":"168","author":"Grundfast","year":"2022","journal-title":"Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Langguth, B., Kleinjung, T., Schlee, W., Vanneste, S., and De Ridder, D. (2023). Tinnitus Guidelines and Their Evidence Base. J. Clin. Med., 12.","DOI":"10.3390\/jcm12093087"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1177\/01632787231158402","article-title":"Seeking Help for Tinnitus and Satisfaction With Healthcare Providers Including Diagnosis, Clinical Services, and Treatment: A Scoping Review","volume":"46","author":"Carmody","year":"2023","journal-title":"Eval. Health Prof."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1080\/14992027.2023.2292964","article-title":"Help-seeker satisfaction with diagnosis and treatment of tinnitus","volume":"63","author":"Carmody","year":"2023","journal-title":"Int. J. Audiol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"McFerran, D., Hoare, D.J., Carr, S., Ray, J., and Stockdale, D. (2018). Tinnitus services in the United Kingdom: A survey of patient experiences. BMC Health Serv. Res., 18.","DOI":"10.1186\/s12913-018-2914-3"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1176\/appi.focus.20220042","article-title":"EMPOWER: Toward the Global Dissemination of Psychosocial Interventions","volume":"20","author":"Patel","year":"2022","journal-title":"Focus"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1002\/capr.12698","article-title":"Comparison of data from six psychotherapy research measures obtained through MTurk versus traditional clinics","volume":"24","author":"Russell","year":"2023","journal-title":"Couns. Psychother. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"25152459231218610","DOI":"10.1177\/25152459231218610","article-title":"Natural Experiments: Missed Opportunities for Causal Inference in Psychology","volume":"7","author":"Grosz","year":"2024","journal-title":"Adv. Methods Pract. Psychol. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1146\/annurev.publhealth.23.100901.140546","article-title":"The importance of the normality assumption in large public health data sets","volume":"23","author":"Lumley","year":"2002","journal-title":"Annu. Rev. Public Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"n2061","DOI":"10.1136\/bmj.n2061","article-title":"A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance","volume":"374","author":"Skivington","year":"2021","journal-title":"BMJ"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/11\/4043\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T02:05:17Z","timestamp":1779674717000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/11\/4043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,23]]},"references-count":51,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcm15114043"],"URL":"https:\/\/doi.org\/10.3390\/jcm15114043","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,23]]}}}