Abstract
Vertigo, dizziness and imbalance are frequent symptoms among patients in clinical practice. We present the development of a new multipurpose measure specific to patients with these symptoms: the VDI questionnaire. Items of the VDI questionnaire were generated through an international panel of clinicians, in-depth interviews with 25 patients and an extensive literature search. Items were reduced by qualitative and quantitative methods. Psychometric properties were tested in 130 patients recruited in primary care general practices, neurologists and ENT out-patient clinics. Patients were clinically evaluated and administered several specific and generic health status instruments: the Balance Scale, the SF-12 Health Survey and the General Health Questionnaire 12 items. The VDI symptoms and the VDI health related quality of life (HRQoL) scales were administered during the visit and some weeks after. Correlation and confirmatory factor analysis were used. Reliability of the VDI was high (0.92 for VDI HRQoL scale and 0.86 for VDI symptoms). VDI scores were more correlated with Balance Scale scores than with mental health indicators. All factor loadings were significantly different from zero and confirmed the expected relations. In the second administration, VDI scores showed a deterioration among those reporting a worsening in their symptoms and an improvement among those reporting feeling better. The data presented suggest that the VDI questionnaire is a reliable, valid and responsive instrument for patients with vertigo, dizziness or imbalance. The VDI questionnaire could be a useful complement of the clinical evaluation of these patients at both group and individual level.
Similar content being viewed by others
References
Bailey KE, Sloane PD, Mitchel M, Preisser J. Which primary care patients with dizziness will develop persistent impairment? Arch Family Med 1993; 2: 847–852.
Froehling DA, Silverstein MD, Mohr DN, Beatty CW. Does this dizzy patient have a serious form of vertigo? J Am Med Assoc 1994; 271: 385–388.
Kroenke K, Arrington ME, Mangelsdorf AD. The prevalence of symptoms in medical outpatients and the adequacy of therapy. Arch Intern Med 1990; 150: 1685–1689.
Kroenke K, Mangelsdorf AD. Common symptoms in ambulatory care: incedence, evaluation, therapy, and outcome. Am J Med 1989; 86: 262–266.
Colledge NR, Wilson JA, Macintyre CCA, MacLennan WJ. The prevalence and characteristics of dizziness in an elderly community. Age Ageing 1994; 23: 117–120.
Towler HMA. Clinical algorithms dizziness and vertigo. BMJ 1984; 288: 1739–1743.
Fife TD, Baloh RW. Disequilibrium of unknown cause in older people. Ann Neurol 1995; 34: 694–702.
Clark MR, Sullivan MD, Katon WJ et al. Psychiatric and medical factors associated with disability in patients with dizziness. Psychosomatics 1993; 34: 409–415.
Kroenke K, Lucas CA, Rosenberg ML, Scherokman BJ. Psychiatric disorders and functional impairment in patients with persistent dizziness. J Gen Intern Med 1993; 8: 530–535.
Fielder H, Denholm SW, Lyons RA, Fielder CP. Measurement of health status in patients with vertigo. Clin Otolaryngol 1996; 21: 124–126.
Jacobson GP, Newman CW. The development of the Dizziness Handicap Inventory. Arch Otolaryngol Head Neck Surg 1990; 116: 424–427.
Yardley L. Contribution of symptoms and beliefs to handicap in people with vertigo: a longitudinal study. Br J Clin Psychol 1994; 33: 101–113.
Yardley L. Prediction of handicap and emotional distress in patients with recurrent vertigo: symptoms, co** strategies, control beliefs and reciprocal causation. Soc Sci Med 1994; 39: 573–581.
Yardley L, Luxon LM, Haacke AA, Haacke NP. A longitudinal study of symptoms, anxiety and subjective well-being in patients with vertigo. Clin Otolaryngol 1994; 19: 109–116.
Yardley L, Putman J. Quantitative analysis of factors contributing to handicap and distress in vertiginous patients: a questionnaire study. Clin Otolaryngol 1992; 17: 231–236.
Ware JE Jr, Sherbourne CD. The MOS 36-Item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473–483.
McHorney CA, Ware JE Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247–263.
McHorney CA, Ware JE, Lu JFR, Sherbourne CD. The MOS 36-Item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions and reliability across diverse patient groups. Med Care 1994; 32: 40–66.
Guyatt GH, Cook DJ. Health status, quality of life and the individual. J Am Med Assoc 1994; 272: 630–631.
Hunt SM, Mckenna SP. The QLDS: a scale for the measurement of quality of life in depression. Health Policy 1992; 22: 307–319.
Maslow AH. A theory of human motivation. Psychol Rev 1943; 50: 370–396.
Wagner TH, Patrick DL, Mckenna SP, Froese PS. Crosscultural development of a quality of life measure for men with erection difficulties. Qual Life Res 1996; 5: 443–449.
Yardley L, Verschuur C, Masson E, Luxon L, Haacke N. Somatic and psychological factors contributing to handicap in people with vertigo. Br J Audiol 1992; 26: 283–290.
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: 731–741.
Streiner DL, Norman GR. Health Measurement Sales: a Practical Guide to their Development and Use. Oxford: Oxford University Press, 1989.
Prieto L, Alonso J, Viladrich MC, Antó JM. Scaling the Spanish version of the Nottingham Health Profile: evidence of limited value of item weights. J Clin Epidemiol 1996; 49: 31–38.
Nunnally JC, Bernstein IH. Psychometric Theory. New York: McGraw-Hill, 1994.
Berg K, Wood-Dauphinee S, Williams JI, Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiother Can 1989; 41: 304–311.
Berg K, Wood-Dauphinee SL, Williams JI, Maki BE. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992; 83: S7-S10.
Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil 1992; 73: 1073–1080.
Berg K, Wood-Dauphinee S, Williams JI. The Balance Scale: reliability assessment with elderly residents and patient with an acute stroke. Scand J Rehabil Med 1994; 27: 27–36.
Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996; 34: 220–233.
Goldberg D, Williams P. A User's Guide to the General Health Questionnaire. Windsor: Nfer-Nelson, 1991.
Bentler PM. EQS Structural Equations Program Manual. Encino, CA: Multivariate Software, Inc., 1995.
Bentler PM, Stein JA. Structural equation models in medical research. Stat Methods Med Res 1992; 1: 159–181.
Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Elrbaum Associates, 1988.
Cohen J. A power primer. Psychol Bull 1992; 112: 155–159.
Kazis LE, Anderson JJ, Meenan RF. Effect sizes for interpreting changes in health status. Med Care 1989; 27: S178-S189.
McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res 1995; 4: 293–307.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Prieto, L., Santed, R., Cobo, E. et al. A new measure for assessing the health-related quality of life of patients with vertigo, dizziness or imbalance: the VDI questionnaire. Qual Life Res 8, 131–139 (1999). https://doi.org/10.1023/A:1026433113262
Issue Date:
DOI: https://doi.org/10.1023/A:1026433113262