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THE DEVELOPMENT AND VALIDATION OF THE VESTIBULAR ACTIVITIES AVOIDANCE INSTRUMENT FOR PEOPLE WITH VESTIBULAR AND BALANCE DISORDERS

Alshebber, Kefah (2018) THE DEVELOPMENT AND VALIDATION OF THE VESTIBULAR ACTIVITIES AVOIDANCE INSTRUMENT FOR PEOPLE WITH VESTIBULAR AND BALANCE DISORDERS. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Background: Vestibular disorders result in physical and psychological consequences that have significant impact on individuals’ activities of daily living (ADL) and their overall quality of life (QOL). As a result of these negative consequences, many people with vestibular disorders tend to avoid activities, limit their movement and avoid specific circumstances because of their fear of provoking symptoms and unanticipated dizziness or unsteadiness attacks. These activities are very important in facilitating compensation, and avoiding them contributes to disability. However, specialized outcome measures that identify those people who may avoid activities do not exist.
Purpose: To develop and validate a new self-report measure that identifies those with vestibular and balance disorders who may avoid activities.
Methods: A list of 111 candidate items were generated and included in a survey. The survey was then sent to a panel of clinicians and researchers specializing in vestibular disorders and agreement was obtained on the items to include in the Vestibular Activities Avoidance instrument using the Delphi technique. The psychometric properties of the new outcome self-report measure were established including test-retest reliability; minimum detectable change at 95% confidence level (MDC95), and internal and external validity. The test-retest reliability of the Activities Avoidance total score was estimated using the Intra Class Correlation Coefficient (ICC). Validity was examined using the SF-12, and 2-question disability questionnaire.
Results: Of the 111 vestibular activities avoidance items, 34 of them had 70% or greater agreement for inclusion in the Vestibular Activities Avoidance Instrument. The test-retest reliability of the Vestibular Activities Avoidance Instrument total score was excellent (ICC=.97; confidence interval, 0.95-0.98). Weighted kappa for the VAAI agreement per-item was poor to excellent (0.1-0.8). The SEM of the VAAI was 13.2 and the minimum detectable change (MDC) for the VAAI total score was 36.5. The Vestibular Activities Avoidance Instrument had strong correlation with both mental and physical composite scores of the SF-12.
Conclusion: The Vestibular Activities Avoidance Instrument was developed to determine which factors predict avoidance of activities and thus may negatively influence outcomes. The Activities Avoidance demonstrated excellent reliability and was validated with the SF-12, disability questionnaire.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Alshebber, Kefahkma49@pitt.edukma49
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairWhitney, Susanwhitney@pitt.edu
Committee MemberSparto, Patrickpsparto@pitt.edu
Committee MemberFurman, Josephfurmanjm@upmc.edu
Committee MemberMarchetti, Gregorymarchetti@duq.edu
Committee MemberStaab, Jeffreystaab.jeffrey@mayo.edu
Date: 25 May 2018
Date Type: Publication
Defense Date: 22 January 2018
Approval Date: 25 May 2018
Submission Date: 4 April 2018
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 137
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Health Information Management
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Avoidance, Delphi technique, Dizziness, Kinesiophobia, Psychometrics, Vestibular disorders
Date Deposited: 25 May 2018 13:23
Last Modified: 25 May 2018 13:23
URI: http://d-scholarship.pitt.edu/id/eprint/34068

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