Analysis of vestibular-balance symptoms according to symptom duration: dimensionality of the Vertigo Symptom Scale-short form

Health and Quality of Life Outcomes

Tatsuo Akechi⁹  Norio Watanabe⁷  Meiho Nakayama⁴  Tetsuo Ikezono²  Hiroaki Shimogori⁸  Makoto Hashimoto⁸  Takao Imai⁶  Tadashi Kitahara¹  Fumiyuki Goto⁵  Kensuke Kiyomizu³  Masaki Kondo⁹ 

[1] Department of Otorhinolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara, Nara, Japan;Department of Otolaryngology, Saitama Medical University, Iruma, Saitama, Japan;Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan;Department of Otolaryngology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan;Department of Otorhinolaryngology, National Hospital Organization, Tokyo Medical Center, Meguro, Tokyo, Japan;Department of Otolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan;Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan;Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan;Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan

关键词: Japanese;    Reliability;    Validity;    Factor analysis;    Anxiety;    Dizziness;    Vertigo;    Psychosomatic medicine;    Vestibular disease;   

Others  :  1133898
DOI  :  10.1186/s12955-015-0207-7

 received in 2014-09-16, accepted in 2015-01-05,  发布年份 2015

【 摘 要 】

Background

Dizziness or vertigo is associated with both vestibular-balance and psychological factors. A common assessment tool is the Vertigo Symptom Scale (VSS) -short form, which has two subscales: vestibular-balance and autonomic-anxiety. Despite frequent use, the factor structure of the VSS-short form has yet to be confirmed. Here, we clarified the factor structure of the VSS-short form, and assessed the validity and reliability of the Japanese version of this tool.

Methods

We conducted a cross-sectional, multicenter, psychometric evaluation of patients with non-central dizziness or vertigo persisting for longer than 1 month. Participants completed the VSS-short form, the Dizziness Handicap Inventory, and the Hospital Anxiety and Depression Scale. They also completed the VSS-short form a second time 1–3 days later. The questionnaire was translated into Japanese and cross-culturally adapted. We conducted a confirmatory factor analysis followed by an exploratory factor analysis. Convergent and discriminant validity, internal consistency, and test-retest reliability were evaluated.

Results

The total sample and retest sample consisted of 159 and 79 participants, respectively. Model-fitting for a two-subscale structure in a confirmatory factor analysis was poor. An exploratory factor analysis produced a three-factor structure: long-duration vestibular-balance symptoms, short-duration vestibular-balance symptoms, and autonomic-anxiety symptoms. Regarding convergent and discriminant validity, all hypotheses were clearly supported. We obtained high Cronbach’s α coefficients for the total score and subscales, ranging from 0.758 to 0.866. Total score and subscale interclass correlation coefficients for test-retest reliability were acceptable, ranging from 0.867 to 0.897.

Conclusions

The VSS-short form has a three-factor structure that was cross-culturally well-matched with previous data from the VSS-long version. Thus, it was suggested that vestibular-balance symptoms can be analyzed separately according to symptom duration, which may reflect pathophysiological factors. The VSS-short form can be used to evaluate vestibular-balance symptoms and autonomic-anxiety symptoms, as well as the duration of vestibular-balance symptoms. Further research using the VSS-short form should be required in other languages and populations.

【 授权许可】

   
2015 Kondo et al.; licensee BioMed Central.

【 参考文献 】

• [1]Hannaford PC, Simpson JA, Bisset AF, Davis A, McKerrow W, Mills R: The prevalence of ear, nose and throat problems in the community: Results from a national cross-sectional postal survey in Scotland. Fam Pract 2005, 22:227-33.
• [2]Neuhauser HK, Radtke A, von Brevern M, Lezius F, Feldmann M, Lempert T: Burden of dizziness and vertigo in the community. Arch Intern Med 2008, 168:2118-24.
• [3]Yardley L, Owen N, Nazareth I, Luxon L: Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract 1998, 48:1131-5.
• [4]Jacob RG, Furman JM: Psychiatric consequences of vestibular dysfunction. Curr Opin Neurol 2001, 14:41-6.
• [5]Yardley L, Redfern MS: Psychological factors influencing recovery from balance disorders. J Anxiety Disord 2001, 15:107-19.
• [6]Staab JP: Chronic subjective dizziness. Continuum (Minneap Minn) 2012, 18:1118-41.
• [7]Jacobson GP, Newman CW: The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg 1990, 116:424-7.
• [8]Yardley L, Masson E, Verschuur C, Haacke N, Luxon L: Symptoms, anxiety and handicap in dizzy patients: development of the vertigo symptom scale. J Psychosom Res 1992, 36:731-41.
• [9]Yardley L, Barker F, Muller I, Turner D, Kirby S, Mullee M, Morris A, Little P: Clinical and cost effectiveness of booklet based vestibular rehabilitation for chronic dizziness in primary care: single blind, parallel group, pragmatic, randomised controlled trial. BMJ 2012, 344:e2237.
• [10]Schmid G, Henningsen P, Dieterich M, Sattel H, Lahmann C: Psychotherapy in dizziness: a systematic review. J Neurol Neurosurg Psychiatry 2011, 82:601-6.
• [11]Duracinsky M, Mosnier I, Bouccara D, Sterkers O, Chassany O: Literature review of questionnaires assessing vertigo and dizziness, and their impact on patients’ quality of life. Value Health 2007, 10:273-84.
• [12]Yardley L, Medina SM, Jurado CS, Morales TP, Martinez RA, Villegas HE: Relationship between physical and psychosocial dysfunction in Mexican patients with vertigo: a cross-cultural validation of the vertigo symptom scale. J Psychosom Res 1999, 46:63-74.
• [13]Tschan R, Wiltink J, Best C, Bense S, Dieterich M, Beutel ME, Eckhardt-Henn A: Validation of the German version of the Vertigo Symptom Scale (VSS) in patients with organic or somatoform dizziness and healthy controls. J Neurol 2008, 255:1168-75.
• [14]Gloor-Juzi T, Kurre A, Straumann D, de Bruin ED: Translation and validation of the vertigo symptom scale into German: A cultural adaption to a wider German-speaking population. BMC Ear Nose Throat Disord 2012, 12:7. BioMed Central Full Text
• [15]Sokolova L, Hoerr R, Mishchenko T: Treatment of Vertigo: A Randomized, Double-Blind Trial Comparing Efficacy and Safety of Ginkgo biloba Extract EGb 761 and Betahistine. International journal of otolaryngology 2014, 2014:682439.
• [16]Yardley L, Burgneay J, Andersson G, Owen N, Nazareth I, Luxon L: Feasibility and effectiveness of providing vestibular rehabilitation for dizzy patients in the community. Clin Otolaryngol Allied Sci 1998, 23:442-8.
• [17]Wilhelmsen K, Strand LI, Nordahl SH, Eide GE, Ljunggren AE: Psychometric properties of the Vertigo symptom scale - Short form. BMC Ear Nose Throat Disord 2008, 8:2. BioMed Central Full Text
• [18]Hancock GR, Mueller RO: The Reviewer’s Guide to Quantitative Methods in the Social Sciences. Routledge, New York; 2010.
• [19]Schmitt TA: Current methodological considerations in exploratory and confirmatory factor analysis. J Psychoeduc Assess 2011, 29:304-21.
• [20]The COSMIN checklist manual. [http://www.cosmin.nl/images/upload/files/COSMIN%20checklist%20manual%20v9.pdf]
• [21]Guideline for Equilibrium Disorders by Japan Society for Equilibrium Research. [http://www.memai.jp/shindan/shindan-frame.html]
• [22]Yanik B, Kulcu DG, Kurtais Y, Boynukalin S, Kurtarah H, Gokmen D: The reliability and validity of the Vertigo Symptom Scale and the Vertigo Dizziness Imbalance Questionnaires in a Turkish patient population with benign paroxysmal positional vertigo. J Vestib Res 2008, 18:159-70.
• [23]Yardley L, Beech S, Zander L, Evans T, Weinman J: A randomized controlled trial of exercise therapy for dizziness and vertigo in primary care. The British journal of general practice: the journal of the Royal College of General Practitioners 1998, 48:1136-40.
• [24]Soderman AC, Bergenius J, Bagger-Sjoback D, Tjell C, Langius A: Patients’ subjective evaluations of quality of life related to disease-specific symptoms, sense of coherence, and treatment in Meniere’s disease. Otol Neurotol 2001, 22:526-33.
• [25]Mutlu B, Serbetcioglu B: Discussion of the dizziness handicap inventory. J Vestib Res 2013, 23:271-7.
• [26]Masuda K, Goto F, Fujii M, Kunihiro T: Investigation of the Reliability and Validity of Dizziness Handicap Inventory (DHI) Translated into Japanese. Equilibrium Research (Japanese) 2004, 63:555-63.
• [27]Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983, 67:361-70.
• [28]Matsudaira T, Igarashi H, Kikuchi H, Kano R, Mitoma H, Ohuchi K, Kitamura T: Factor structure of the Hospital Anxiety and Depression Scale in Japanese psychiatric outpatient and student populations. Health Qual Life Outcomes 2009, 7:42. BioMed Central Full Text
• [29]Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002, 52:69-77.
• [30]Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC: Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007, 60:34-42.
• [31]Kellar SP, Kelvin EA: Munro's statistical methods for health care research. 6th edition. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia; 2012.
• [32]Cohen J: Statistical power analysis for the behavioral sciences. 2nd edition. Lawrence Erlbaum Associates, New Jersey; 1988.
• [33]Kanda Y: Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 2013, 48:452-8.