Identification of aspects of functioning, disability and health relevant to patients experiencing vertigo: a qualitative study using the international classification of functioning, disability and health

  • Background Vertigo and dizziness are among the most common health problems in medical practice [1, 2, 3, 4, 5]. Vertigo and dizziness include both consequences of disease as well as definable disease entities such as benign paroxysmal positional vertigo, Meniere?s disease, or vestibular migraine. Irrespective of the various causes and underlying health conditions, vertigo and dizziness have significant impact on functioning and overall quality of life of the affected individuals To give some examples, the most common peripheral-vestibular disorder benign paroxysmal positioning vertigo - which is also the most frequent type of vestibular disorder - causes brief rotatory vertigo attacks, mainly triggered by rapid head movements, e.g. when turning around in the bed or lacing shoes. Central-peripheral disorders, which may be caused by brain ischemia, multiple sclerosis, or other permanent or transient brain lesions, can make vertigo attacks lasting from minutes to even weeks [6]. In addition, vertigo and dizziness are a considerable burden to economy and health care [4, 7, 8]. Precondition of effective management and treatment of potentially disabling conditions like vertigo is - besides careful diagnosis of the underlying condition -the assessment of outcomes which are relevant to the patient. This is not only important to monitor treatment effects but also to set goals and to plan therapy [6]. As summarized by Morris et al. [9] outcome measures in vertigo vary by the entities they are addressing, such as subjective experience of disability or signs and symptoms. Most of them reflect either the patients? or health professionals? experience. As an example, the frequently used Dizziness Handicap Inventory [10] addresses the patients? experience of the consequences of vertigo on daily living. Most outcome measures are developed and validated on the basis of empirical findings or professional experience [11]. However, none of them refer to a common theoretical framework. A theoretical framework is fundamental for defining an Outcome measurement and helps to ensure that the whole potential spectrum of issues is reflected [12]. In addition to the lack of theoretical foundation there is still no agreement on standards used to measure outcomes in patients with vertigo. This is illustrated by a recently published Cochrane Review in the field of vestibular rehabilitation which noted 15 different outcome measures of patients? complaints in 21 studies [13]. To address both these issues, the Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders ( IFB LMU ) at the Ludwig-Maximilians-Universität in Munich set up a project that aims to develop an international standard for the description of functioning and disability in patients with vertigo and dizziness based on the International Classification of Functioning, Disability and Health (ICF). With the ICF, which is part of the family of international classifications of the World Health Organisation (WHO), there is a common theoretical framework for describing and measuring health and disability. The ICF models the individuals' functioning and health as a complex interaction between a health condition.

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Author:Martin Müller
Parent Title (English):Health and quality of life outcomes
Editor: Academic onFile
Document Type:Article (peer reviewed)
Publication Year:2012
Tag:Dizziness; Quality of life; Vertigo; aged
Peer reviewed:Ja
faculties / departments:Fakultät für Angewandte Gesundheits- und Sozialwissenschaften
Dewey Decimal Classification:3 Sozialwissenschaften / 30 Sozialwissenschaften, Soziologie