Translation of Dizziness Handicap Inventory Scale Into Local Languages of Pakistan

Study Overview
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Brief Summary
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The aim of the present study is to translate the Dizziness Handicap Inventory Scale into Urdu, Pashto, Punjabi, Sindhi and Balochi languages. Along with validation of the translated versions by evaluating their validity and reliability in the people of Pakistan, speaking respective languages and suffering from vertigo and dizziness. No such study has been previously conducted in the Pakistan region which translates the scale and follows the proper cross-culture adaptation.

Detailed Description
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Dizziness is one of the most common symptoms of many diseases that not only affects the daily activities of the patient but also negatively alters their jobs and functions. Moreover, mostly the patients having dizziness due to vestibular causes are known to face more problems as compared to the others. A precisely valid and reliable tool has been already designed for the measurement of dizziness while keeping the common complaints of patients in mind. The dizziness handicap inventory (DHI) was introduced in 1990 by Jacobson and Newman. The mentioned questionnaire comprises 25 questions that categorize the dizziness effects in three main areas namely; functional (9 questions, 36 points), emotional (9 questions, 36 points) and physical (7 questions, 28 points). The maximum score is 100 and the minimum is 0. The higher the score, the greater handicap is considered. It has high internal consistency. This tool is widely used in clinical setups to evaluate the condition of the patients and determine the levels to which their quality of life has been affected by dizziness. Additionally, it is very easy to be filled and hardly takes 10 minutes at maximum. The DHI is highly compatible with the international classification of functioning, disability and health tool, which was standardized by WHO in 2001 for measuring the effects of various diseases. The aim of DHI is to evaluate the self-perceived handicap effects of dizziness. The target population are the patients suffering from dizziness due to brain injuries, multiple sclerosis and vestibular disorders. Since 1990, the DHI has been translated into various languages in order to make its application better. Some examples of the translated languages include Arabic, Brazilian, Spanish, Chinese, Italian, Dutch, French, Norwegian, and German. All of these translated versions have been proved to be very useful, with high validity, reliability and internal consistency. Thus, The DHI is considered the most beneficial questionnaire for the evaluation of dizziness and unsteadiness, especially related to vestibular rehabilitation. However, this questionnaire does not have any versions that can be utilized in Pakistan such as Urdu, Pushto, Punjabi, Sindhi and Balochi. The purpose of this study is to translate the DHI into Urdu, Pushto, Punjabi, Sindhi and Balochi languages and then evaluating the validity and reliability of these versions in order to make this questionnaire available for research and clinics for the population of Pakistan.

Official Title
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Translation of Dizziness Handicap Inventory Scale Into Local Languages of Pakistan

Conditions
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Vertigo, Dizziness

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The patient suffering from vertigo and dizziness for at least 1 month and The ability to walk independently or do their routine tasks will be included in the study. Patients should be capable to complete the questionnaire without any help. Exclusion Criteria: Patients suffering from blindness, musculoskeletal abnormalities, neurologic disorder, or paralysis in ENT or neurologic evaluation by ENT and neurologist will be excluded from the study. Also, if the patients are unable to cooperate then, they will also be excluded.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cross-Cultural Translation of Dizziness Handicap Inventory Scale into the local languages (Punjabi, Pashto, Sindhi, Balochi and Urdu) | The Dizziness Handicap Inventory Scale is a first-hand measure of disability for patients with vertigo and dizziness. The mentioned questionnaire comprises 25 questions that categorize the dizziness effects in three main areas namely; functional (9 questions, 36 points), emotional (9 questions, 36 points) and physical (7 questions, 28 points). The maximum score is 100 and the minimum is 0. The higher the score, the greater handicap is considered. It distinguishes itself from other published scales as it has an approach that deals with the concepts of disability and its assessment. Its translation is to be done in the local languages of Pakistan through a rigorous and approved process. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reliability of translated versions | To determine the reliability of cross-culturally adapted and the translated Dizziness Handicap Inventory versions in patients with vertigo and dizziness of respective languages۔ Reliability or reproducibility refers to the ability of a measure to produce the same results when administered at two or more interval between different visits of the patient. Thus this will be measured through test re-test reliability. | 6 months | 
| Validity of translated versions | To determine the validity of cross-culturally adapted and the translated Dizziness Handicap Inventory versions in patients with vertigo and dizziness of respective languages۔ Validity is how accurate the results are. Thus this will be measured through various parameters to validate the translated versions as appropriate and applicable. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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vertigo, dizziness, dizziness handicap inventory