Fighting for control in an unpredictable life – a qualitative study of older persons’ experiences of living with chronic dizziness

Möller, Ulrika; Hansson, Eva Ekvall; Ekdahl, Charlotte; Midlöv, Patrik; Jakobsson, Ulf; Kristensson, Jimmie

doi:10.1186/1471-2318-14-97

Cited by 16 publications

(20 citation statements)

References 36 publications

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“…The underlying causes of falls are multifaceted [ 2 ] and the informants identified known risk factors like aging [ 4 ], muscle and neurological diseases [ 3 ], and environmental factors like furniture, carpets and slippery surface [ 2 ] as risk factors for falls. To not consider themselves susceptible to falls and to mainly recognize exterior factors to cause falls [ 12 ] and to fight for a normal life style when occasionally feeling dizzy have also been found by others [ 10 ]. This is in line with the finding that some of our informants downplayed their fall risk [ 13 ] or dizziness [ 8 ] since they were eager to emphasize what they still managed in everyday life.…”

Section: Discussionmentioning

confidence: 99%

“…Prevalence of dizziness has been reported by 17.5% for the age group 60–80 years and 31.0% for those above 80, with a higher prevalence in women [ 9 ]. Studies of elderly’s experiences of living with dizziness found that they fought to live a normal life [ 10 ], to understand the causes [ 8 ] and also to get accurate information in order to handle or control the dizziness [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use – a qualitative study

Bell

Steinsbekk

Granås

2017

Scandinavian Journal of Primary Health Care

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ObjectiveThe aim of the study was to explore how home-dwelling elderly who use fall-risk-increasing drugs (FRIDs) perceive their fall risk and how they relate this to their drug use.Design, setting and subjectsA qualitative study with 14 home-dwelling elderly FRID users between 65 and 97 years in Central Norway participating in semi-structured individual interviews. The data were analyzed thematically by using systematic text condensation.ResultsThe main finding was that the informants did not necessarily perceive the use of FRIDs to be a prominent risk factor for falls. Some informants said they did not reflect upon drug use whatsoever and said they fully trusted their physician’s choices. When either experiencing dizziness, fall episodes or by reading the patient information leaflet the informants said to either adjust their drug use or to contact their physician. Some felt rejected due to not getting their point across or their wish to alter the drug was not granted by the physician.ConclusionsElderly FRID users did not necessarily relate their drug use to fall risk or struggled to present their perceived drug-related problems. Physicians need to regularly inform, monitor and assess the drug treatment when treating elderly with FRIDs.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use – a qualitative study

Bell

Steinsbekk

Granås

2017

Scandinavian Journal of Primary Health Care

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“…Dizziness can refer to several sensations including a giddy or rotational sensation, a loss of balance, a faint feeling, light-headedness, instability or unsteadiness, a tendency to fall, or a feeling of everything turning black [ 7 ]. It is well-known that dizziness strongly affects daily living of older people [ 8 – 11 ]. Dizziness has moderate or severe impact on daily living of more than 60 % of older people with dizziness in primary care [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Dizziness in older people: at risk of shared therapeutic nihilism between patient and physician. A qualitative study

et al. 2016

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BackgroundDizziness-related impairment is a strong predictor for an unfavourable course of dizziness in older people. In this study we explored the experiences of older patients with significant dizziness-related impairment and their wishes and expectations regarding general practitioner (GP) care. Knowing the expectations and priorities of people with dizziness may enable the GP to provide tailor-made care, which in turn may substantially increase the quality of life and decrease the use and costs of health care.MethodsWe conducted a qualitative study with semi-structured interviews. We selected patients from ten Dutch general practices. Patients were invited to participate in the study if they were ≥ 65 years, visited their GP because of dizziness and were significantly impaired due to dizziness (Dizziness Handicap Inventory ≥ 30). We applied content analysis to the semi-structured interviews.ResultsThirteen participants participated, seven were female. Analysis of the interviews resulted in the overall theme “Dizziness in older people: at risk of shared therapeutic nihilism by the patient and the GP”. Firstly, this can explained by the fact that participants frequently presented dizziness as a secondary complaint when they visited the GP for another complaint. Secondly, participants reported that the GP often could not help them with any treatment. Despite a poor therapeutic outcome, the vast majority of participants was satisfied how the GP handled their dizziness. Yet, understanding the cause of dizziness seems important for dizzy older patients.ConclusionsDespite significant dizziness-related impairment, older dizzy patients may not present dizziness as main reason for encounter. Presenting dizziness as a secondary complaint may give GPs the - wrong - impression that the dizziness-related impairment is only mild. GPs need to be aware of this potential underreporting. Knowing the cause of dizziness seems important for older patients. Yet, GPs regularly did not succeed in identifying the underlying cause of dizziness. Therefore, GPs should manage the expectations of older dizzy patients regarding diagnosis and successful treatment, by informing them about the uncertainty and unpredictability of dizziness. We also recommend GPs to focus on improving functional ability; this is the key to escape from therapeutic nihilism by the GP.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0474-3) contains supplementary material, which is available to authorized users.

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“… 2 Qualitative studies have highlighted the impact of dizziness on everyday life, often leading to poor function and disability. 3 4 Dizziness is more common in older people, but it is estimated that 1 in 10 working-age adults suffer some degree of disability due to dizziness. 5 Significant disability, medication use and medical consultations due to dizziness have been found in more than 20% of people over the age of 60, 6 with 24% of dizziness being attributed to vestibular disorder.…”

Section: Introductionmentioning

confidence: 99%

“…11 15 Furthermore, many patients with chronic dizziness have unmet healthcare needs. 3 Vestibular rehabilitation (VR) is now the recommended treatment for dizziness. 15 16 The central component of VR is a programme of graded exercises consisting of eye, head and body movements designed to stimulate the vestibular system and promote neurological adaptation.…”

Section: Introductionmentioning

confidence: 99%

Understanding patient experiences of self-managing chronic dizziness: a qualitative study of booklet-based vestibular rehabilitation, with or without remote support

2015

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ObjectiveThis study explores participants’ experience of self-management of dizziness using booklet-based vestibular rehabilitation (VR), with or without expert telephone support.DesignSemistructured qualitative interviews were conducted.SettingParticipants were recruited from primary care practices as part of a large RCT.ParticipantsInterviews were carried out with 33 people (10 men and 23 women; age 27–84) self-managing chronic dizziness using booklet-based vestibular rehabilitation, with or without expert telephone support.ResultsData were analysed using inductive thematic analysis. The majority of participants in both groups reported a positive experience of VR therapy, with many participants reporting an improvement in their dizziness symptoms since undertaking the therapy. Participants in the telephone support group felt that a genuine relationship developed between them and their therapist within three short sessions, and described their therapy sessions as reassuring, encouraging and motivational.ConclusionsThe VR treatment booklet appears to be a valued tool for self-managing chronic dizziness and people appreciate receiving remote telephone support.Trial registration numberNCT00732797.

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Fighting for control in an unpredictable life – a qualitative study of older persons’ experiences of living with chronic dizziness

Cited by 16 publications

References 36 publications

Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use – a qualitative study

Elderly users of fall-risk-increasing drug perceptions of fall risk and the relation to their drug use – a qualitative study

Dizziness in older people: at risk of shared therapeutic nihilism between patient and physician. A qualitative study

Understanding patient experiences of self-managing chronic dizziness: a qualitative study of booklet-based vestibular rehabilitation, with or without remote support

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