Working-age adults' perspectives on living with persistent postural-perceptual dizziness: a qualitative exploratory study

BMJ Open. 2019 Apr 1;9(4):e024326. doi: 10.1136/bmjopen-2018-024326.

Abstract

Objectives: To (a) explore the experiences of persistent postural-perceptual dizziness (PPPD), formerly chronic subjective dizziness on the personal, work and social lives of working-age adults; (b) enhance current understandings of the condition and its impact on the lives of working-age adults and (c) highlight points for consideration and importance to clinical practice.

Methods: This qualitative exploratory study drew on interpretive descriptive methodology. Working-age adults (n=8) diagnosed with PPPD were recruited from a single New Zealand community-based specialist clinic. Data from interviews (n=8) and postinterview reflections (n=2) were analysed using thematic analysis.

Results: Three themes were constructed: (1) It sounds like I'm crazy-referring to the lack of medical, social and self-validation associated with PPPD; (2) I'm a shadow of my former self-representing the impact of the condition on sense of self and life trajectory and (3) How will I survive?- highlighting individual coping processes.

Conclusion: This study contributed to the existing body of knowledge by highlighting the complexity and fluidity of experiencing PPPD. It also drew attention to the tension between the acute illness framework that forms the basis of many therapeutic interactions and the enduring psychosocial support needs of the person experiencing PPPD. The findings highlighted that contextual factors need to be taken into account and that a person-centred and biopsychosocial approach, rather than a condition-specific biomedical approach, is needed for care to be perceived as meaningful and satisfactory.

Keywords: CSD; PPPD; chronic subjective dizziness; persistent postural-perceptual dizziness; qualitative.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Attitude to Health
  • Dizziness / physiopathology*
  • Dizziness / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postural Balance*
  • Qualitative Research
  • Quality of Life*
  • Self Concept
  • Social Identification
  • Work