Abstract
BackgroundThe aim of the study was to examine the psychometric properties of the Vertigo symptom scale – short form (VSS-SF), a condition-specific measure of dizziness, following translation of the scale into Norwegian.MethodsA cross-sectional survey design was used to examine the factor structure, internal consistency and discriminative ability (sample I, n = 503). A cross-sectional pre-intervention design was used to examine the construct validity (sample II, n = 36) of the measure and a test-retest design was used to examine reliability (sub-sample of sample II, n = 28).ResultsThe scree plot indicated a two factor structure accounting respectively for 41% and 12% of the variance prior to rotation. The factors were related to vertigo-balance (VSS-V) and autonomic-anxiety (VSS-A). Twelve of the items loaded clearly on either of the two dimensions, while three items cross-loaded. Internal consistency of the VSS-SF was high (alpha = 0.90). Construct validity was indicated by correlation between path length registered by platform posturography and the VSS-V (r = 0.52), but not with the VSS-A. The ability to discriminate between dizzy and not dizzy patients was excellent for the VSS-SF and sub-dimension VSS-V (area under the curve 0.87 and 0.91, respectively), and acceptable for the sub-dimension VSS-A (area under the curve 0.77). High test-retest reliability was demonstrated (ICC VSS-SF: 0.88, VSS-V: 0.90, VSS-A: 0.90) and no systematic change was observed in the scores from test to retest after 2 days.ConclusionUsing a Norwegian translated version of the VSS-SF, this is the first study to provide evidence of the construct validity of this instrument demonstrating a stable two factor structure of the scale, and the identified sub-dimensions of dizziness were related to vertigo-balance and autonomic-anxiety, respectively. Evidence regarding a physical construct underlying the vertigo-balance sub-scale was provided. Satisfactory internal consistency was indicated, and the discriminative ability of the instruments was demonstrated. The instrument showed satisfactory test-retest reliability.
Highlights
The aim of the study was to examine the psychometric properties of the Vertigo symptom scale – short form (VSS-SF), a condition-specific measure of dizziness, following translation of the scale into Norwegian
Translation The VSS-SF was translated from English into Norwegian through a process of review and modification recommended by the World Health Organisation [13]
As principal component analysis (PCA) does not take latent variables into consideration, the approach is not recommended for exploration of factor structures [15] and exploratory factor analysis (EFA) was used to examine the instrument's underlying structure [15]
Summary
The aim of the study was to examine the psychometric properties of the Vertigo symptom scale – short form (VSS-SF), a condition-specific measure of dizziness, following translation of the scale into Norwegian. Due to its subjective nature, dizziness remains a continuous clinical challenge It has been sub-classified into vertigo – a false sensation of movement of self or environment, presyncope – sensations of light-headedness and impending fainting, disequilibrium – a sensation of imbalance and/or postural instability, and "other types of dizziness" – a vague and floating sensation often accompanied by somatic symptoms [1]. This classification was introduced 30 years ago, and is still in use [1,2]. The autonomic-anxiety sub-scale of the VSS correlated with objective measures of psycho-physiological arousal in patients with vestibular disorders [7]
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