چکیده (انگلیسی):

Background:Dizziness-related impairment is a strong predictor for an unfavourable course of dizziness in older
people. In this study we explored the experiences of older patients with significant dizziness-related impairment
and their wishes and expectations regarding general practitioner (GP) care. Knowing the expectations and priorities
of people with dizziness may enable the GP to provide tailor-made care, which in turn may substantially increase
the quality of life and decrease the use and costs of health care.
Methods:We conducted a qualitative study with semi-structured interviews. We selected patients from ten Dutch
general practices. Patients were invited to participate in the study if they were≥65 years, visited their GP because
of dizziness and were significantly impaired due to dizziness (Dizziness Handicap Inventory≥30). We applied
content analysis to the semi-structured interviews.
Results:Thirteen participants participated, seven were female. Analysis of the interviews resulted in the overall
theme“Dizziness in older people: at risk of shared therapeutic nihilism by the patient and the GP”. Firstly, this can
explained by the fact that participants frequently presented dizziness as a secondary complaint when they visited
the GP for another complaint. Secondly, participants reported that the GP often could not help them with any
treatment. Despite a poor therapeutic outcome, the vast majority of participants was satisfied how the GP handled
their dizziness. Yet, understanding the cause of dizziness seems important for dizzy older patients.
Conclusions:Despite significant dizziness-related impairment, older dizzy patients may not present dizziness as
main reason for encounter. Presenting dizziness as a secondary complaint may give GPs the - wrong - impression
that the dizziness-related impairment is only mild. GPs need to be aware of this potential underreporting. Knowing
the cause of dizziness seems important for older patients. Yet, GPs regularly did not succeed in identifying the
underlying cause of dizziness. Therefore, GPs should manage the expectations of older dizzy patients regarding
diagnosis and successful treatment, by informing them about the uncertainty and unpredictability of dizziness. We
also recommend GPs to focus on improving functional ability; this is the key to escape from therapeutic nihilism by
the GP.