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Reliability and validity of a Central Kurdish version of the Dizziness Handicap Inventory.

ABSTRACT: We cross-culturally adapted the Dizziness Handicap Inventory (DHI) into Central Kurdish dialect (DHI-CK) and verified its reliability and validity. A cross-sectional study was utilised to measure the impacts of vestibular disorders. Along with the DHI-CK, two comparators were introduced: the Visual Analogue Scale and the Clinical Test of Sensory Interaction and Balance. External and internal reliability were tested with intraclass correlation coefficient (ICC) and Cronbach's alpha/composite reliability, respectively. Patients (n?=?301; mean age?=?44.5?±?15.2 years; 59.8% women) presenting with vestibular symptoms for at least 30 days who were diagnosed with a vestibular disorder and healthy participants (n?=?43; mean age?=?42?±?17.9 years; 62.8% women) (N?=?344). The DHI-CK and its three sub-scales-Physical, Emotional, Functional-exhibited good to excellent external reliability: ICCs in the test-retest were 0.93, 0.88, 0.91, and 0.92, respectively. Cronbach's alphas were 0.87, 0.71, 0.75, and 0.73, respectively. Convergent validity was supported by Spearman's correlations between the DHI-CK and the comparators. The receiver operating characteristic curve analysis confirmed discriminating validity. The DHI-CK was cross-culturally validated. It is a reliable and valid tool that can be used by clinicians and researchers to quantify vestibular disorder outcomes in Kurdish-speaking populations.

SUBMITTER: Zmnako SSF

PROVIDER: S-EPMC6562039 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Reliability and validity of a Central Kurdish version of the Dizziness Handicap Inventory.

Zmnako Sherko Saeed F SSF Chalabi Yousif Ibrahim YI

Scientific reports 20190612 1

We cross-culturally adapted the Dizziness Handicap Inventory (DHI) into Central Kurdish dialect (DHI-CK) and verified its reliability and validity. A cross-sectional study was utilised to measure the impacts of vestibular disorders. Along with the DHI-CK, two comparators were introduced: the Visual Analogue Scale and the Clinical Test of Sensory Interaction and Balance. External and internal reliability were tested with intraclass correlation coefficient (ICC) and Cronbach's alpha/composite reli ...[more]

PMID: 31189988

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Project description:BackgroundThe Dizziness Handicap Inventory (DHI) is a validated, self-report questionnaire which is widely used as an outcome measure. Previous studies supported the multidimensionality of the DHI, but not the original subscale structure. The objectives of this survey were to explore the dimensions of the Dizziness Handicap Inventory - German version, and to investigate the associations of the retained factors with items assessing functional disability and the Hospital Anxiety and Depression Scale (HADS). Secondly we aimed to explore the retained factors according to the International Classification of Functioning, Disability and Health (ICF).MethodsPatients were recruited from a tertiary centre for vertigo, dizziness or balance disorders. They filled in two questionnaires: (1) The DHI assesses precipitating physical factors associated with dizziness/unsteadiness and functional/emotional consequences of symptoms. (2) The HADS assesses non-somatic symptoms of anxiety and depression. In addition, patients answered the third question of the University of California Los Angeles-Dizziness Questionnaire which covers the impact of dizziness and unsteadiness on everyday activities. Principal component analysis (PCA) was performed to explore the dimensions of the DHI. Associations were estimated by Spearman correlation coefficients.ResultsOne hundred ninety-four patients with dizziness or unsteadiness associated with a vestibular disorder, mean age (standard deviation) of 50.6 (13.6) years, participated. Based on eigenvalues greater one respectively the scree plot we analysed diverse factor solutions. The 3-factor solution seems to be reliable, clinically relevant and can partly be explained with the ICF. It explains 49.2% of the variance. Factor 1 comprises the effect of dizziness and unsteadiness on emotion and participation, factor 2 informs about specific activities or effort provoking dizziness and unsteadiness, and factor 3 focuses on self-perceived walking ability in relation to contextual factors. The first factor correlates moderately with disability and the HADS (values >/=0.6). The second factor is comparable with the original physical subscale of the DHI and factors retained in previous studies.ConclusionsThe results of the present survey can not support the original subscale structure of the DHI. Therefore only the total scale should be used. We discuss a possible restructuring of the DHI.

Project description:BackgroundThe impact of dizziness on quality of life is often assessed by the Dizziness Handicap Inventory (DHI), which is used as a discriminate and evaluative measure. The aim of the present study was to examine reliability and validity of a translated Norwegian version (DHI-N), also examining responsiveness to important change in the construct being measured.MethodsTwo samples (n = 92 and n = 27) included participants with dizziness of mainly vestibular origin. A cross-sectional design was used to examine the factor structure (exploratory factor analysis), internal consistency (Cronbach's alpha), concurrent validity (Pearson's product moment correlation r), and discriminate ability (ROC curve analysis). Longitudinal designs were used to examine test-retest reliability (intraclass correlation coefficient (ICC) statistics, smallest detectable difference (SDD)), and responsiveness (Pearson's product moment correlation, ROC curve analysis; area under the ROC curve (AUC), and minimally important change (MIC)). The DHI scores range from 0 to 100.ResultsFactor analysis revealed a different factor structure than the original DHI, resulting in dismissal of subscale scores in the DHI-N. Acceptable internal consistency was found for the total scale (alpha = 0.95). Concurrent correlations between the DHI-N and other related measures were moderate to high, highest with Vertigo Symptom Scale-short form-Norwegian version (r = 0.69), and lowest with preferred gait (r = - 0.36). The DHI-N demonstrated excellent ability to discriminate between participants with and without 'disability', AUC being 0.89 and best cut-off point = 29 points. Satisfactory test-retest reliability was demonstrated, and the change for an individual should be >/= 20 DHI-N points to exceed measurement error (SDD). Correlations between change scores of DHI-N and other self-report measures of functional health and symptoms were high (r = 0.50 - 0.57). Responsiveness of the DHI-N was excellent, AUC = 0.83, discriminating between self-perceived 'improved' versus 'unchanged' participants. The MIC was identified as 11 DHI-N points.ConclusionsThe DHI-N total scale demonstrated satisfactory measurement properties. This is the first study that has addressed and demonstrated responsiveness to important change of the DHI, and provided values of SDD and MIC to help interpret change scores.

Project description:Fatigue is a common symptom in the general population and has a substantial effect on individuals' quality of life. The Multidimensional Fatigue Inventory (MFI) has been widely used to quantify the impact of fatigue, but no Traditional Chinese translation has yet been validated. The goal of this study was to translate the MFI from English into Traditional Chinese ('the MFI-TC') and subsequently to examine its validity and reliability.The study recruited a convenience sample of 123 people from various age groups in Taiwan. The MFI was examined using a two-step process: (1) translation and back-translation of the instrument; and (2) examination of construct validity, convergent validity, internal consistency, test-retest reliability, and measurement error. The validity and reliability of the MFI-TC were assessed by factor analysis, Spearman rho correlation coefficient, Cronbach's alpha coefficient, intraclass correlation coefficient (ICC), minimal detectable change (MDC), and Bland-Altman analysis. All participants completed the Short-Form-36 Health Survey Taiwan Form (SF-36-T) and the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) concurrently to test the convergent validity of the MFI-TC. Test-retest reliability was assessed by readministration of the MFI-TC after a 1-week interval.Factor analysis confirmed the four dimensions of fatigue: general/physical fatigue, reduced activity, reduced motivation, and mental fatigue. A four-factor model was extracted, combining general fatigue and physical fatigue as one factor. The results demonstrated moderate convergent validity when correlating fatigue (MFI-TC) with quality of life (SF-36-T) and sleep disturbances (PSQI) (Spearman's rho = 0.68 and 0.47, respectively). Cronbach's alpha for the MFI-TC total scale and subscales ranged from 0.73 (mental fatigue subscale) to 0.92 (MFI-TC total scale). ICCs ranged from 0.85 (reduced motivation) to 0.94 (MFI-TC total scale), and the MDC ranged from 2.33 points (mental fatigue) to 9.5 points (MFI-TC total scale). The Bland-Altman analyses showed no significant systematic bias between the repeated assessments.The results support the use of the Traditional Chinese version of the MFI as a comprehensive instrument for measuring specific aspects of fatigue. Clinicians and researchers should consider interpreting general fatigue and physical fatigue as one subscale when measuring fatigue in Traditional Chinese-speaking populations.

Project description:BackgroundCore vestibular symptoms are vague, hard for patients to describe, and difficult for examiners to quantify. Reliable and validated patient-reported outcome measures (PROMs) have obtained acceptance and popularity in the specialty of vestibular disorders. In Kurdish, there is a critical shortage of such measures. The aim of this survey was to assess the psychometric properties of a central Kurdish version (VSS?-?SF?- CK) of the Vertigo Symptom Scale-Short Form (VSS?-?SF).MethodsThe study utilized a regulated process of cross-cultural adaptation to produce the VSS?-?SF?-?CK. We examined its psychometric properties by using a cross-sectional survey. Owing to a non-normal distribution, both principal axis factoring and polychoric correlation were used to examine the structure. The internal consistency of the scales was evaluated using Cronbach's alpha coefficient (?) and composite reliability. The discriminant validity was evaluated using the heterotrait-monotrait ratio of correlations (HTMT.85) and the Fornell-Larcker criterion. To assess convergent validity, the instrument was correlated with two comparators.ResultsThe participants (n =?195) were composed of 165 patients with vestibular symptoms (mean?-?age 45?±?15.8, range 61?years; 56.4% women) and 30 healthy participants (mean?-?age 35?±?18.6; range 52?years; 60% women). Based on the scree plot, along with other criteria such as Horn's parallel analysis and minimum average partial, two factors were extracted: vestibular (VSS?-?V) and autonomic-anxiety (VSS?-?AA). Both constructs showed a robust structure in terms of adequate loadings and weak cross-loadings. The scales' ?s were 0.81, 0.81, and 0.87 for VSS-V, VSS-AA, and the total scale (VSS?-?T), respectively. Discriminant validity was established with a value of 0.71 for HTMT (<?0.85). Spearman's correlation supported the study's hypotheses and confirmed the convergent validity. Intraclass correlation coefficients revealed high external reliability: test-retest results were 0.93, 0.94, and 0.97 for VSS-V, VSS?-?AA, and VSS?-?T, respectively.ConclusionGiven a critical shortage in PROMs for the vestibular field, the psychometric properties of VSS?-?SF?-?CK were evaluated. The results were promising, as they revealed external consistency and construct validity. The goodness of fit indices showed that the VSS?-?SF?-?CK is a reliable and validated PROM that can be used by clinicians and researchers in the Kurdish-speaking population.

Dataset Information

Reliability and validity of a Central Kurdish version of the Dizziness Handicap Inventory.

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Reliability and validity of a Central Kurdish version of the Dizziness Handicap Inventory.

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