The social impact of dizziness in London and Siena
The social impact of dizziness in London and Siena
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DOI：
10.1007/s00415-009-5287-z
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发表时间：
2010-02-01
影响因子：
6
通讯作者：
Silove, Yvonne
中科院分区：
文献类型：
--
作者：
Bronstein, Adolfo M.;Golding, John F.;Silove, Yvonne
虽然头晕是普通和医院实践中常见的表现症状，但其社会成本尚不清楚。我们在锡耶纳和伦敦这两个截然不同的欧洲城市评估了眩晕对患者的社交和工作生活的影响。首先，我们编制了《眩晕对社会生活和工作的影响问卷》(SWID)，对43名头晕患者和45名正常对照进行了验证，并将结果与EQ-5D(欧洲生活质量)问卷进行了相关分析。患者的SWID和EQ-5D得分均低于对照组(P<；0.001)，且两者呈显著正相关(r=0.50p<；0.001)。然后，SWID对每个城市的200名连续前往三级专科患者诊所的患者进行了调查，其中伦敦的一名患者由神经科医生领导，锡耶纳的一名患者由耳鼻喉科专家(ENT)领导。在400名患者中，27%的人报告说由于头晕而换了工作，21%的人放弃了工作。超过50%的患者感到自己的工作效率大幅下降。前6个月因头晕而导致的平均休工天数为7.15天。在所有400名患者中，57%的人社交生活受到干扰。因素分析发现，对工作、旅行、社交和家庭生活的有害影响加在一起，形成了一个单一因素，占了头晕总体影响的很大一部分。伦敦和锡耶纳在某些障碍指标上出现了显著差异，伦敦患者的情况往往更糟。这些地区差异的原因包括，正如预期的那样，伦敦的神经科患者比例高于锡耶纳。然而，与城市人口统计和社会凝聚力相关的因素也可能对生活质量和工作实践产生影响。无论城市之间的差异如何，这些发现都突显了头晕对社会和经济的高度影响。
Although dizziness is a common presenting symptom in general and hospital practice, its social cost is not known. We assessed the social and work life impact of dizziness on patients in two contrasting European cities, Siena and London. First, we developed the 'Social life & Work Impact of Dizziness questionnaire' (SWID), which was validated by administering it to 43 patients with dizziness and 45 normal controls and by correlating the results with the EQ-5D (Europe quality of life) questionnaire. The SWID and EQ-5D scores were worse in patients than controls (p < 0.001) and the two correlated significantly (r = 0.50 p < 0.001). Then two hundred consecutive patients per city attending tertiary specialised 'dizzy patient' clinics, one in London led by a neurologist, one in Siena led by an ear, nose and throat specialist (ENT), were investigated with SWID. Amongst the 400 patients, 27% reported changing their jobs and 21% giving up work as a result of the dizziness. Over 50% of patients felt that their efficiency at work had dropped considerably. The mean number of days off work attributed to the dizziness in the previous 6 months was 7.15 days. Social life was disrupted in 57% of all 400 patients. Factor analysis identified that detrimental effects on work, travel, social and family life combine to create a single factor accounting for much of the overall impact of their dizziness. Significant differences in some measures of handicap between London and Siena emerged, with London patients often faring worse. Reasons for these location differences include, as expected, a higher proportion of neurological patients in London than in Siena. However, factors related to city demographics and social cohesion may also modulate the impact on quality of life and working practice. Regardless of inter-city differences, these findings highlight the high social and economic impact of dizziness.