Priorities of elderly dizzy patients in general practice. Findings and psychometric properties of the"Dizziness Needs Assessment" (DiNA).
BACKGROUND
Dizziness as a geriatric syndrome needs to be assessed using a multi-dimensional, patient-centred approach in addition to a disease-orientated strategy. The aim of the study was to determine the priorities of elderly patients by a specific needs questionnaire, the"Dizziness Needs Assessment" (DiNA), and to evaluate its psychometric properties.


METHODS
General practitioners (GPs) distributed questionnaires containing the DiNA as well as the Patients' Intentions Questionnaire (PIQ) to patients aged at least 65 years and suffering from dizziness. Items of both questionnaires were analysed by frequencies, means and rank correlations. Factor structure was explored by principal component analysis.


RESULTS
A total of n=123 patients (mean age 76 years, 73% women) had suffered from dizziness on average for more than 3 years (57% chronic, i.e. >6 months). Knowing the cause of the dizziness was rated as very important by patients, and about half of them wished that their doctor would make more effort to investigate this. Among other differences, chronically dizzy patients ranked the risk of falling significantly higher than those with acute dizziness. Factor analysis revealed four subscales: "handicap and mobility" showed a very good reliability of 0.77 (Cronbach's α), indicating a "trait", whereas the other subscales rather indicated "state" characteristics. Validation coefficients showed that PIQ assesses general patient needs compared to the more specific dizziness-related needs revealed by the DiNA.


CONCLUSIONS
The DiNA proved to be a valuable instrument to assess the specific priorities of elderly patients suffering from dizziness. Regarding the limited therapy options for dizziness in old age, a doctor-guided shift of patients' attention from causes to symptom-related implications could be a promising approach.
Kruschinski
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Institute of General Practice, OE 5440, Hannover Medical School, Carl-Neuberg-Str.1, 30625 Hannover. kruschinski.carsten@mh-hannover.de
Klaassen
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Breull
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Broll
A
A
Hummers-Pradier
E
E
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004244:Dizziness / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D058006:General Practice; D005858:Germany; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D020380:Needs Assessment; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires