Validation of the Polish version of the <i>Dizziness Handicap Inventory</i>

Abstract

Background:The Dizziness Handicap Inventory (DHI) was established to assess the impact of dizziness and balance problems on the quality of life. The aim of the study was to validate the Polish version of DHI for patients with vestibular disorders. Material and Methods: Two hundred and thirty patients diagnosed with vestibular impairment and/or positional vertigo were included in the study. The mean age of the study group was 56.2 years (SD = 13.6). The factor structure (the principal component analysis − PCA), internal consistency (Cronbach's α), and discrimination ability (the receiver operating characteristic [ROC] curve) were examined. Results: A satisfactory internal consistency was found (Cronbach's α coefficient = 0.92), while no floor or ceiling effect was revealed. The Dizziness Handicap Inventory demonstrated a good ability to discriminate between patients with and without the handicap (sensitivity and specificity about 80%, the cutoff point = 56). In PCA a 3-factor solution was obtained, with the factors related to restrictions in daily life, positional symptoms and visual-vestibular symptoms, which was not in agreement with the subscales provided in the original version. Conclusions: The Polish version of DHI demonstrates satisfactory measurement properties and can be used to assess the impact of dizziness on handicap and the quality of life. The functional, emotional, and physical subscales were not confirmed. In particular, the functional subscale revealed no satisfactory internal consistency which provides an indication for further studies. Med Pr. 2019;70(5):529-34

Measurement Properties of the Dizziness Handicap Inventory: A Systematic Review

“…No studies were found in which the primary goal was to assess the content validity of the English or translated versions of the DHI. However, the majority of studies which translated the DHI (20 out of 22) included some form of pilot testing for (one or more aspects of) the content validity, that is, relevance, comprehensiveness and/or comprehensibility (22,(25)(26)(27)29,32,34,35,37,38,42,43,(46)(47)(48)(49)51,54,57,58). We rated the methodological quality for these individual studies as ''doubtful,'' mainly because clear descriptions of the process of executing the cognitive interviews were lacking.…”

“…Comprehensibility of the DHI was addressed in 20 translation studies (22,(25)(26)(27)29,32,34,35,37,38,42,43,(46)(47)(48)(49)51,54,57,58). Overall, the patients in these studies had no difficulty understanding or answering the questions.…”

“…Table 3 presents an overview of the fourteen studies addressing structural validity (24,27,28,31,35,39,41,(47)(48)(49)(50)52,53,56). Methodological quality is rated as inadequate for six studies, mainly due to small sample size (27,35,47,49,52).…”

Dizziness Handicap Inventory in Clinical Evaluation of Dizzy Patients

“…The DHI was originally developed in the English language for USA patients, but in the past decades, it has been translated and validated in many other languages, e.g., to German [ 9 ] or Spanish [ 10 ]. However, it has been observed that this questionnaire yields limited conclusions related to the clinically important information [ 8 , 10 , 11 ]. In the literature, a few studies have already concentrated on the relationship between the DHI score and (1) selected diseases or clinical status [ 12 , 13 ], and (2) vestibular testing objective methods [ 14 , 15 ].…”

Instrumental and Non-Instrumental Measurements in Patients with Peripheral Vestibular Dysfunctions

“…There are three subscales: Physical (P), Functional (F), and Emotional (E). Although it was originally written in English, DHI has been translated into many languages, e.g., Polish, German, Norwegian, Brazilian, and Spanish [ 20 ]. The other common, widely used questionnaire is the Vertigo Symptom Scale, published by Yardley in 1992.…”