Health education intervention and its impact on patients with unilateral vestibular dysfunction: An information-motivation-behavioral model approach

Abstract

Unilateral vestibular dysfunction is a one-sided impairment of vestibular function in one ear. Incorporating health education in treatment and rehabilitation plans can improve vestibular function, keep negative emotions at bay, and reduce the extent of the condition. This letter investigates the impact of the information-motivation-behavioral skills model as a medium for health education on patient outcomes. While offering encouraging observations, there are certain limitations, such as the study’s retrospective design, small sample size, use of subjective measures, and lack of longer follow-ups that challenge the cogency of the study. The study is a step toward transforming vestibular dysfunction treatment through health education.

Key Words: Vestibular dysfunction; Health education; Information-motivation-behavioral skills model; Vestibular rehabilitation; Self efficacy

Core Tip: Health education has been proved to have positive effects on patients of Unilateral vestibular dysfunction. The study investigates this through the information-motivation-behavioral skills model and highlights its importance in treatment plans. This approach appears promising however, limitations such as study’s retrospective design, small sample size, use of subjective measures and lack of longer follow-ups should be considered when interpreting the findings.

INTRODUCTION

Unilateral vestibular hypofunction (UVH) is a heterogeneous condition characterized by partial or total impairment of one of the vestibular organs or nerves[1,2]. The condition presents with a web of vexatious symptoms including vertigo that instigates a profound whirling sensation, which may be short-lived or extend over a longer period, and nystagmus. These symptoms worsen with changes in head position or eye closure[3]. Other prevalent symptoms associated with vestibular dysfunction include sweating, nausea, vomiting, and/or tachycardia. The dysfunction is associated with conditions like peripheral neuritis, vestibular otosclerosis, benign paroxysmal positional vertigo, Ménière’s disease, trauma of the inner ear, or neoplasms of the inner ear among many others. It has been estimated that 30% to 50% of all cases of vertigo are a result of peripheral vestibular dysfunction[4-6]. Moreover, besides the apparent manifestations of the condition, many patients are impinged with mental disturbances such as anxiety and depression[7].

INTEGRATING THE IMB MODEL IN VESTIBULAR DYSFUNCTION CARE

Integrating health education and psychological care in the treatment can alleviate these emotions, enhance balance function, and demote the extent of vestibular dysfunction[8]. The information-motivation-behavioral skills (IMB) model can be employed to facilitate this health education. It is a frequently utilized model that seeks to facilitate health behavior change by emphasizing essential elements related to information, motivation, and behavioral skills. The information component of it alludes to educating the patient about the disease, its possible consequences, and the treatment choices at hand. Enlightening the patient about the disease can allow them to make informed choices regarding the management of their condition. Motivation is a critical component of the model as it encourages behavior change. Boosting motivation entails empowering the patient and emphasizing the advantages associated with behavior change. Behavior skills involve imparting practical skills and strategies to the patients to expedite behavior change[9,10]. As an all-encompassing framework, the IMB model presents a targeted strategy for health education styled to the needs of unilateral vestibular dysfunction (UVH) patients. We aim to highlight the urgent need for effective management strategies for UVH patients. By reviewing the findings of studies like Shi et al[11], we intend to probe into the efficacy of health education, particularly using the IMB model, to enhance patient outcomes. By providing both patients and healthcare professionals with understanding of impactful interventions, its objective is to improve patient care and enhance quality of life in managing UVH.

Shi et al[11] puts forth a retrospective cohort study, investigating the influence of health education based on the IMB model on patients with UVH. The study was composed of 80 subjects, which were categorized equally into a comparison group and an observation group based on the type of care provided. Their diagnosis was established via video nystagmus imaging. In conformity with the IMB model, the patients were equipped with knowledge of the condition, the appropriate treatments and rehabilitation strategies, behavioral guidance, and vestibular rehabilitation exercises. The Self-Efficacy Scale, Dizziness Handicap Inventory, and the Hospital Anxiety and Depression Scale (HADS) were used to analyze the findings. The results demonstrated that the IMB-based education group showed enhanced self-efficacy, reduced anxiety and depression, and improved quality of life as compared to the contrasting group. The findings corroborate the efficacy of the IMB model in ameliorating the outcome for patients with UVH. However, certain elements of the study scale down its robustness. The study employs a retrospective study design that relies on existing data, making it more cost and time efficient as compared to other study designs. However, it may be more prone to recall bias in patients and provide no control over the variables. A randomized control design would have been a superior approach as the absence of a prospective design limits the study’s ability to efficaciously establish a relationship between health education and patient outcomes, given that other variables might have influenced the findings. The study incorporates 80 patients, which are further divided, making the patients in the observed group only 40. This volume of the sample is considered relatively small in clinical research. The small sample size neglects the representation of a diverse and broader patient population, narrowing down the generalizability of the findings to this neglected population. Additionally, it cuts back on the statistical power of the results, increasing the probability of unreliable results. The study uses subjective outcome measures as it is heavily dependent on self-reported scales such as the HADS. The potential of response bias becomes a major challenge and factors beyond intervention such as the patient's expectations or social appeal, may exert influence on subjective measures. Using objective measures could strengthen the findings. The study does not provide information regarding the follow-up details therefore it becomes difficult to understand the long-term impact of health education on patients with UVH. Understanding its long-term effects can guide treatment and rehabilitation plans for these patients. A longer follow-up duration is essential to determine the sustainability of behavioral changes and treatment impact.

Lastly, the study invites patients to communicate through WeChat or phone numbers for added support, introducing a potential bias, as actively engaging patients, or those familiar with technology might deviate from those that do not engage as much or are unfamiliar with technology thereby affecting the results.

CONCLUSION

The study sheds light on a crucial element of treatment and rehabilitation in UVH patients. It provides valuable insights into the impact of health education using the IMB model on these patients by demonstrating how it improves self-efficacy, eases mental health, and enhances quality of life. While the study provides valuable insights, it also allows further investigation. For the future, a larger-scale prospective study could create clear-cut findings. Adding objective outcome measures to the subjective scales would further reinforce the validity of the findings. In addition to the IMB model, alternative approaches for delivering health education can be looked into, such as utilizing digital platforms or group sessions, further potentiating patient engagement and accessibility. Finally, future research can address the potential biases, such as those introduced by patient communication methods, strengthening the study's findings and advancing the development of more comprehensive treatment strategies for UVH. Nevertheless, these findings can bring a revolutionary change to the way health education is incorporated into treatments. However, certain factors, such as the study's retrospective design, small sample size, use of subjective measures, and lack of longer follow-ups limit its robustness. Nevertheless, it contributes meaningfully to the world of treatment and rehabilitation.