Exploratory factor analysis of the Dizziness Handicap Inventory (German version)

Area of Science:

• Vestibular Disorders
• Psychometrics
• Rehabilitation

Background:

• The Dizziness Handicap Inventory (DHI) is a standard self-report measure for assessing dizziness impact.
• Previous research questioned the DHI's original subscale structure, suggesting multidimensionality.
• This study aimed to validate the DHI's dimensions in a German version.

Purpose of the Study:

• To explore the underlying dimensions of the Dizziness Handicap Inventory - German version.
• To investigate the associations between DHI factors, functional disability, and anxiety/depression.
• To examine DHI factor relationships with the International Classification of Functioning, Disability and Health (ICF).

Main Methods:

• Principal component analysis (PCA) was used to determine the DHI's factor structure.
• 194 patients with vestibular disorders completed the DHI, Hospital Anxiety and Depression Scale (HADS), and a UCLA-Dizziness Questionnaire item.
• Spearman correlation coefficients were calculated to assess associations.

Main Results:

• A 3-factor solution emerged, explaining 49.2% of the variance and showing clinical relevance.
• Factor 1 related to emotional/participation impact, Factor 2 to activity-provoking factors, and Factor 3 to walking ability.
• Factor 1 correlated moderately with disability and HADS scores; Factor 2 aligned with the original DHI physical subscale.

Conclusions:

• The original DHI subscale structure was not supported by this study's findings.
• The study recommends using the DHI total score and discusses potential restructuring.
• The identified factors offer insights aligned with the ICF framework.