Abstract
To evaluate the effects of the modified Epley maneuver during Posterior Canal Benign Paroxysmal Positional Vertigo (BPPV) on patients’ anxiety and comfort levels. The study, organized as a prospective, worked with 72 patients who were diagnosed with Posterior Canal BPPV through Dix-Hallpike maneuver. The data for the study was collected through Descriptive Characteristics Form, General Comfort Questionnaire Short Form, and Beck Anxiety Inventory. It was found that that 63.9% of the patients experienced average-level anxiety before the implementation of the Epley maneuver and received a total of 3.07 ± .37 (1–6) from the General Comfort Questionnaire. Before applying the modified Epley maneuver and I and IV When the score changes after the week were examined, it was determined that there was a statistically significant difference in all scale scores, as comfort levels increased, anxiety levels decreased. Anxiety was identified as the most important predictor of patients’ comfort level before and after the implementation of the modified Epley maneuver. In light of these findings, it can be said that modified Epley maneuver can safely be used to increase the comfort of patients with Posterior Canal BPPV. Considering that patients with BPPV can consult to emergency rooms, family clinics along with polyclinics, it is recommended to organize regular trainings on BPPV and the implementation of the Epley maneuver. It is believed that evaluation of BPPV patients for their anxiety and offer support when needed is important for the prognosis and patients’ comfort.
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References
Bhattacharyya N, Gubbels SP, Schwartz SR, Edlow JA, El-Kashlan H, Fife T, Holmberg JM, Mahoney K, Hollingsworth DB, Roberts R (2017) Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg 156(3_suppl):S1–S47. https://doi.org/10.1177/0194599816689667
Chen Z-J, Chang C-H, Hu L-Y, Tu M-S, Lu T, Chen P-M, Shen C-C (2016) Increased risk of benign paroxysmal positional vertigo in patients with anxiety disorders: a nationwide population-based retrospective cohort study. BMC Psychiatry 16(1):238. https://doi.org/10.1186/s12888-016-0950-2
Kim J-S, Zee DS (2014) Benign paroxysmal positional vertigo. N Engl J Med 370(12):1138–1147. https://doi.org/10.1056/NEJMcp1309481
van der Zaag-Loonen HV, Van Leeuwen R, Bruintjes TD, Van Munster B (2015) Prevalence of unrecognized benign paroxysmal positional vertigo in older patients. Eur Archives Oto-Rhino-Laryngol 272(6):1521–1524. https://doi.org/10.1007/s00405-014-3409-4
Von Brevern M, Radtke A, Lezius F, Feldmann M, Ziese T, Lempert T, Neuhauser H (2007) Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry 78(7):710–715. https://doi.org/10.1136/jnnp.2006.100420
Wensley C, Botti M, McKillop A, Merry AF (2017) A framework of comfort for practice: an integrative review identifying the multiple influences on patients’ experience of comfort in healthcare settings. Int J Qual Health Care 29(2):151–162. https://doi.org/10.1093/intqhc/mzw158
Kolcaba K, Tilton C, Drouin C (2006) Comfort theory: a unifying framework to enhance the practice environment. J Nur Adm 36(11):538–544
Iachini T, Ruggiero G, Ruotolo F, di Cola AS, Senese VP (2015) The influence of anxiety and personality factors on comfort and reachability space: a correlational study. Cogn Process 16(1):255–258. https://doi.org/10.1007/s10339-015-0717-6
Dros J, Maarsingh OR, Beem L, van der Horst HE, Gt R, Schellevis FG, van Weert HC (2012) Functional prognosis of dizziness in older adults in primary care: a prospective cohort study. J Am Geriatr Soc 60(12):2263–2269. https://doi.org/10.1111/jgs.12031
Hilton MP, Pinder DK (2014) The epley (canalith repositioning) manoeuvre for benign paroxysmal positional vertigo. Cochrane Database Systematic Rev. https://doi.org/10.1002/14651858.CD003162.pub3
Celis-Aguilar EM, Medina-Cabrera CA, Torrontegui-Zazueta LA, Núñez-Millán BX, Castro-Bórquez KM, Obeso-Pereda A, García-Valle CG, Ochoa-Miranda CA (2021) Short-term effect of epley maneuver as treatment for subjective benign paroxysmal positional vertigo. Indian J Otolaryngol Head Neck Surg :1–5. https://doi.org/10.1007/s12070-020-02320-y
Sachdeva K, Sao T (2020) The Clinical Response time of Epley maneuvers for treatment of BPPV: a hospital based study. Indian J Otolaryngol Head Neck Surg 72(4):503–507
Reinink H, Wegner I, Stegeman I, Grolman W (2014) Rapid systematic review of repeated application of the epley maneuver for treating posterior BPPV. Otolaryngol Head Neck Surg 151(3):399–406
van Duijn JG, Isfordink LM, Nij Bijvank JA, Stapper CW, van Vuren AJ, Wegner I, Kortekaas MF, Grolman W (2014) Rapid systematic review of the Epley maneuver for treating posterior canal benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 150(6):925–932. https://doi.org/10.1177/0194599814527732
Gupta AK, Sharma KG, Sharma P (2019) Effect of Epley, semont maneuvers and brandt-daroff exercise on quality of life in patients with posterior semicircular canal benign paroxysmal positional vertigo (PSCBPPV). Indian J Otolaryngol Head Neck Surg 71(1):99–103. https://doi.org/10.1007/s12070-018-1322-7
Prokopakis E, Vlastos I, Tsagournisakis M, Christodoulou P, Kawauchi H, Velegrakis G (2013) Canalith repositioning procedures among 965 patients with benign paroxysmal positional vertigo. Audiol Neurotol 18(2):83–88. https://doi.org/10.1159/000343579
Richard W, Bruintjes TD, Oostenbrink P, van Leeuwen RB (2005) Efficacy of the Epley maneuver for posterior canal BPPV: a long-term, controlled study of 81 patients. Ear Nose Throat J 84(1):22–25
Saberi A, Nemati S, Sabnan S, Mollahoseini F, Kazemnejad E (2017) A safe-repositioning maneuver for the management of benign paroxysmal positional vertigo: Gans vs. Epley maneuver a randomized comparative clinical trial. Eur Arch Otorhinolaryngol 274(8):2973–2979. https://doi.org/10.1007/s00405-016-4406-6
Panuganti A, Loka SR, Tati S, Punga AK (2019) Comparative study of management of BPPV (Benign Paroxysmal Positional Vertigo) with only drugs versus drugs plus Epley manoeuvre. Indian J Otolaryngol Head Neck Surg 71(2):1183–1186. https://doi.org/10.1007/s12070-018-1255-1
Uz U, Uz D, Akdal G, Çelik O (2019) Efficacy of Epley maneuver on quality of life of elderly patients with subjective BPPV. J Int Adv Otol 15(3):420. https://doi.org/10.5152/iao.2019.6483
Gunes A, Yuzbasioglu Y (2019) Effects of treatment on anxiety levels among patients with benign paroxysmal positional vertigo. Eur Arch Otorhinolaryngol 276(3):711–718. https://doi.org/10.1007/s00405-019-05297-9
Wei W, Sayyid ZN, Ma X, Wang T, Dong Y (2018) Presence of anxiety and depression symptoms affects the first time treatment efficacy and recurrence of benign paroxysmal positional vertigo. Front Neurol 9:178. https://doi.org/10.3389/fneur.2018.00178
Çitlik Saritaş S, Çevik S, Özden G (2018) Genel konfor ölçeği kisa formunun türkçe geçerlik ve güvenirlik çalişması. Diyabet Obezite ve Hipertansiyonda Hemşirelik Forumu Dergisi 10(2):17
Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J consult clin Psychol 56(6):893
Ulusoy M, Sahin NH, Erkmen H (1998) The Beck anxiety inventory: psychometric properties. J Cogn Psychother 12(2):163–172
Dağkıran M, Sürmelioğlu Ö, Ay Ö (2015) Benign paroksismal pozisyonel vertigoda tani ve tedavi yöntemleri. Arşiv Kaynak Tarama Dergisi 24(4):555–564
Ciorba A, Bianchini C, Scanelli G, Pala M, Zurlo A, Aimoni C (2017) The impact of dizziness on quality-of-life in the elderly. Eur Arch Otorhinolaryngol 274(3):1245–1250. https://doi.org/10.1007/s00405-016-4222-z
Muñoz RC, Moreno JLB, Balboa IV, Matos YR, Puertolas OC, Ortega JA, Perez ER, Curto XM, Ripollès CR, Farres NM (2019) Disability perceived by primary care patients with posterior canal benign paroxysmal positional vertigo. BMC Fam Pract 20(1):156. https://doi.org/10.1186/s12875-019-1035-3
Bigelow RT, Semenov YR, du Lac S, Hoffman HJ, Agrawal Y (2016) Vestibular vertigo and comorbid cognitive and psychiatric impairment: the 2008 national health interview survey. J Neurol Neurosurg Psychiatry 87(4):367–372. https://doi.org/10.1136/jnnp-2015-310319
Yuan Q, Yu L, Shi D, Ke X, Zhang H (2015) Anxiety and depression among patients with different types of vestibular peripheral vertigo. Medicine 94(5):e453
Xu Z, Zhao P, Yang X, Liu X, Chen X, Zhang S, Wu Z (2015) The hearing and vestibular evoked myogenic potentials test in patients with primary benign paroxysmal positional vertigo. Lin chuang er bi yan hou tou jing wai ke za zhi= J Clinical Otorhinol Head Neck Surg 29(1):20–23
Oliveira Miranda D, Soares de Lima TA, Ribeiro Azevedo L, Feres O, Ribeiro da Rocha JJ, Pereira-da-Silva G (2014) Proinflammatory cytokines correlate with depression and anxiety in colorectal cancer patients. Biomed Res Int. https://doi.org/10.1155/2014/739650
Kolcaba K (2015) Katherine Kolcaba’s comfort theory. In: Smith MC, Parker ME (eds) Nursing theories and nursing practice, Philadelphia: F.A. Davis, pp 381–392
Gül AI, Özkiris M, Aydin R, Simsek G, Saydam L (2014) Benign paroksismal pozisyonel vertigo ve anksiyete arasindaki iliski/the relationship between benign paroxysmal positional vertigo and anxiety. Türkiye Klinikleri Tip Bilimleri Dergisi 34(4):378. https://doi.org/10.5336/medsci.2014-39518
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The ethics board approval for the study was collected from Akdeniz University Clinical Research Ethics Board (Decision No: KAEK-361). Patients’ written and oral consent was collected after informing them.
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Kar, M., Özkan, İ. & Taylan, S. The Effect of Modified Epley Maneuver Implementation on the Anxiety and Comfort Levels of Patients with Posterior Canal Bening Paroxysmal Positional Vertigo: A Prospective Study. Indian J Otolaryngol Head Neck Surg 74 (Suppl 3), 3764–3772 (2022). https://doi.org/10.1007/s12070-021-02547-3
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DOI: https://doi.org/10.1007/s12070-021-02547-3