研究前庭康复中的健康差异。
Investigating health disparities in vestibular rehabilitation.
机构信息
Department of Physical Therapy, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Our Lady of the Lake Hearing and Balance Center, Baton Rouge, LA, USA.
出版信息
J Vestib Res. 2024;34(4):205-214. doi: 10.3233/VES-240002.
BACKGROUND
Health disparities (HD) impact care delivery and health outcomes in individuals with vestibular disorders (IVD).
OBJECTIVE
The purpose of this study is to identify whether health disparities (HD) exist in Vestibular Rehabilitation (VR) between individuals identifying as Caucasians or racial or ethnic minorities (REM).
METHODS
This study was a retrospective chart review of IVD who attended outpatient VR between 1/2014 and 9/2020. Data recorded included age, gender, race/ethnicity, vestibular diagnosis, VR interventions, and pre-post outcome measures such as Dizziness Handicap Inventory (DHI), and Activities-Specific Balance Confidence Scale (ABC), Gait speed (GS), and Functional Gait Assessment (FGA). Chi-squared tests, one-tailed, and two-tailed t-tests (α= 0.05) were utilized to compare Caucasian and REM groups.
RESULTS
Three hundred and forty-three charts (N = 343) met inclusion/exclusion criteria. REM demonstrated higher median DHI scores (46 vs. 38, p = 0.008) and lower ABC scores (53.10% vs. 66.30%, p < 0.001) at VR evaluation compared to Caucasians. There were no statistically significant differences in DHI, ABC, FGA, and GS scores between Caucasians and REM at discharge.
CONCLUSIONS
VR was able to equalize HD in DHI and ABC which initially existed between REM and Caucasians. VR therapists should work with public health and policy researchers to improve access to VR.
背景
健康差异（HD）会影响患有前庭障碍（IVD）的个体的护理提供和健康结果。
目的
本研究旨在确定在白人或少数族裔（REM）之间，前庭康复（VR）是否存在健康差异（HD）。
方法
这是一项回顾性图表审查研究，纳入了 2014 年 1 月至 2020 年 9 月期间接受门诊 VR 的 IVD。记录的数据包括年龄、性别、种族/民族、前庭诊断、VR 干预措施以及前后结果测量，如头晕残疾量表（DHI）、活动特异性平衡信心量表（ABC）、步态速度（GS）和功能性步态评估（FGA）。采用卡方检验、单尾和双尾 t 检验（α=0.05）比较白人和 REM 组。
结果
343 份图表（N=343）符合纳入/排除标准。与白人相比，REM 在 VR 评估时的 DHI 评分中位数（46 分比 38 分，p=0.008）和 ABC 评分中位数（53.10%比 66.30%，p<0.001）更高。在出院时，白人与 REM 之间在 DHI、ABC、FGA 和 GS 评分方面没有统计学上的显著差异。
结论
VR 能够平衡 REM 和白人之间最初存在的 DHI 和 ABC 方面的 HD。VR 治疗师应与公共卫生和政策研究人员合作，以改善 VR 的可及性。
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