Equip d'Atenció Primària Florida Sud, Institut Català de la Salut, Hospitalet de Llobregat, Barcelona, Spain.
Equip d'Atenció Primària Florida Nord, Institut Català de la Salut, Hospitalet de Llobregat, Barcelona, Spain.
BMC Fam Pract. 2019 Nov 13;20(1):156. doi: 10.1186/s12875-019-1035-3.
Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Little is known on how posterior canal BPPV affects health-related quality of life in patients diagnosed and treated at primary care facilities or on whether patients with subjective and objective disease perceive the effects differently. This study was designed to describe how patients diagnosed with posterior canal BPPV in primary care perceive disability.
Cross-sectional descriptive study performed at two urban primary care centers. Participants were patients aged 18 years or older with suspected posterior canal BPPV recruited for baseline evaluation in a clinical trial on the effectiveness of the Epley maneuver in primary care. The recruitment period was from November 2012 to January 2015. Perceived disability was evaluated using the Dizziness Handicap Inventory - Screening version (DHI-S). Other variables collected were age and sex, a history or diagnosis of anxiety or depression, treatment with antidepressants and/or anxiolytics, and results of the Dix-Hallpike (DH) test, which was considered positive when it triggered vertigo with or without nystagmus and negative when it triggered neither.
The DH test was positive in 134 patients, 40.30% of whom had objective BPPV (vertigo with nystagmus). The median age of the patients was 52 years (interquartile range [IQR], 39.00-68.50 years) and 76.1% were women. The median total score on the DHI-S was 16 out of 40 (IQR, 8.00-22.00). Scores were higher (greater perceived disability) in women (p < 0.001) and patients with subjective BPPV (vertigo without nystagmus) (p = 0.033). The items perceived as causing the greatest disability were feeling depressed (67.1%) and worsening of the condition on turning over in bed (88%).
Patients diagnosed with posterior canal BPPV in primary care perceive their condition as a disability according to DHI-S scores, with higher levels of disability reported by women and patients with subjective BPPV. Feelings of depression and turning over in bed were associated with the greatest perceived difficulties.
ClinicalTrials.gov Identifier: NCT01969513. Retrospectively registered. First Posted: October 25, 2013. https://clinicaltrials.gov/ct2/show/NCT01969513.
良性阵发性位置性眩晕（BPPV）是眩晕最常见的原因。对于在初级保健机构诊断和治疗的后管 BPPV 如何影响患者的健康相关生活质量，以及主观和客观疾病的患者是否感知到不同的影响，人们知之甚少。本研究旨在描述在初级保健中被诊断为后管 BPPV 的患者如何感知残疾。
在两个城市初级保健中心进行的横断面描述性研究。参与者为年龄在 18 岁或以上、疑似患有后管 BPPV 的患者，他们在一项关于 Epley 手法在初级保健中有效性的临床试验中接受基线评估而被招募。招募期为 2012 年 11 月至 2015 年 1 月。使用眩晕障碍量表-筛选版（DHI-S）评估感知残疾。收集的其他变量包括年龄和性别、焦虑或抑郁的病史或诊断、抗抑郁药和/或抗焦虑药治疗以及 Dix-Hallpike（DH）测试结果，当 DH 测试引发眩晕伴或不伴眼球震颤时，DH 测试结果被认为是阳性，当 DH 测试既不引发眩晕也不引发眼球震颤时，DH 测试结果被认为是阴性。
DH 测试阳性的患者有 134 名，其中 40.30%的患者存在客观 BPPV（伴眼球震颤的眩晕）。患者的中位年龄为 52 岁（四分位距[IQR]，39.00-68.50 岁），76.1%为女性。DHI-S 的总分中位数为 40 分中的 16 分（IQR，8.00-22.00 分）。女性（p<0.001）和主观 BPPV（无眼球震颤的眩晕）患者（p=0.033）的评分较高（感知残疾程度更高）。感知残疾程度最高的项目是感到沮丧（67.1%）和在床上翻身时病情恶化（88%）。
在初级保健中被诊断为后管 BPPV 的患者根据 DHI-S 评分感知到自己的病情是一种残疾，女性和主观 BPPV 患者的残疾程度更高。抑郁和在床上翻身的感觉与感知到的最大困难有关。
ClinicalTrials.gov 标识符：NCT01969513。回顾性注册。首次发布：2013 年 10 月 25 日。https://clinicaltrials.gov/ct2/show/NCT01969513。
