gms | German Medical Science

Background: Vertigo is one of the most frequent reasons for consulting medical care. However, it is unknown if the aspects currently addressed in instruments used in clinical assessment or research reflect the salient aspects of functioning and disability. Most established instruments cover body functions in terms of symptoms rather than the view of patients experiencing vertigo. The objective of this study is to explore this potential gap.

Methods: This study is part of an effort to develop an international standard for outcome measurement within the currently established Integrated Center for Research and Treatment of Vertigo, Balance and Ocular Motor Disorders (IFBLMU) at University Hospital Munich, Germany. Ultimate goal of the project is to provide a patient-orientated assessment instrument to measure the impact of vertigo for the use in clinical and epidemiological research. We conducted a series of semi-structured interviews. All interviews were audio recorded and transcribed verbatim. The interviews were analyzed following a qualitative-descriptive approach to identify relevant aspects of functioning and disability. Those aspects were translated into the language of the International Classification of Functioning, Disability and Health (ICF). Patients were consecutively included following a maximum variation strategy. All patients were recruited from the outpatient clinic of the IFBLMU.

Results: We extracted 142 different ICF-categories from 12 interviews representing patient-relevant aspects of functioning and health (40 categories from the ICF component “Body Functions”, 62 from “Activities & Participation”, 40 from “Environmental Factors”). About 4 % of the concepts derived from the interviews could not be linked to specific ICF categories because they pertained to “Personal Factors” or were either too general or disease specific.

Discussion: Our study showed that from the patients’ perspective vertigo has impact on a multitude of aspects of functioning. Physiological, psychological and mental functions are affected to the same extent as patients’ activities and social participation. Our results also showed that various environmental and personal contextual factors contribute to the experience of functioning and disability. This underscores the need for developing a new assessment instrument including all these areas to broaden the perspective towards the patients’ experiences. Based on the results of this study, a cross-sectional survey will be carried out to identify prevalence of patient-relevant aspects of functioning and disability in patients experiencing vertigo.