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Original article
The perception of family members regarding patient's vertigo and imbalance
Percepción de los familiares del vértigo y el desequilibrio del paciente
Sadegh Jafarzadeha,
Corresponding author
jafarzadehs@mums.ac.ir

Corresponding author.
, Fatemeh Maharatib, Jamshid Jamalic
a Department of Audiology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
b Department of Audiology, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
c Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Many vestibular disorders such as benign paroxysmal positional vertigo&#44; Meniere&#39;s disease&#44; vestibular neuritis&#44; and vestibular migraine are prevalent in adults<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">1&#44;2</span></a> and children<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">3</span></a>&#59; vertigo and imbalance are very common symptoms&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">1&#44;4</span></a> These symptoms could have a range from mild to severe&#44; stable to unstable&#44; and could greatly affect the patient&#39;s quality of life&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">5&#8211;8</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Case history plays a main role in the assessment of patients with vertigo and imbalance&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">9</span></a> however&#44; different factors may affect its validity&#46; It is difficult to obtain a valid and reliable case history in some cases&#46; For instance&#44; patients may describe their symptoms vaguely or even forget some of them&#46; Usually on these occasions&#44; clinicians count on the perception and opinions of family members &#40;who accompany the patient&#41; about their symptoms&#46; The perception of family members is important&#44; not only for achieving a case history&#44; but in the entire process of diagnosis and treatments&#46; They are present from beginning to end&#44; support the patient and understand how they are suffering&#46; Family members can also consult the patient about assessment and treatment&#44; help them take medications and encourage the patient to undergo treatments like vestibular rehabilitation&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">It was reported that patients and their spouses have a relatively congruent perception about vertigo and imbalance&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a> but many patients are accompanied by their children or other relatives and symptoms like vertigo are subjective&#46; All aspects are understood and experienced only by the patient&#44; and in many cases&#44; family members can only judge the presence and severity of symptoms based on their own observations&#46; Therefore&#44; their perceptions depend on many internal and external factors&#44; such as the quality of time that they spend with the patient and their ability and accuracy to observe&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Dizziness Handicap Inventory &#40;DHI&#41; was used for evaluating the symptoms of patients&#59; therefore&#44; separate forms of DHI were completed by patients and their family members&#46; The goal of the present study was to evaluate how much the perceptions of family members could be trusted regarding vertigo and imbalance experienced by patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Participants</span><p id="par0025" class="elsevierStylePara elsevierViewall">This cross-sectional study was conducted from April 2018 to September 2019 among 110 patients and 110 family members who were referred to the Central Vestibular Clinic in Mashhad&#46; Patients had vertigo and imbalance and were all diagnosed with vestibular origins for vertigo and imbalance by otolaryngologists and neurologists&#46; They were referred for further assessment and were selected by simple random sampling method&#46; Their family members who accompanied them were spouses&#44; children&#44; and other relatives&#46; All of the spouses were living with patients&#46; Most children frequently visited their parents and most members of &#8220;other relatives&#8221; also had a close relationship with patients&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The Farsi language version of DHI was completed separately by patients and their family members&#46; Family members were instructed to put themselves in the patient&#39;s shoes and complete the forms with precision&#46; Patients and family members were completely unaware of each other&#39;s answers&#44; and completed the forms by the paper and pencil method&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Participants were informed and consented to this procedure&#46; This study was approved by the ethics committee of Mashhad University of Medical Sciences &#40;IR&#46;MUMS&#46;REC&#46;1397&#46;016&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Material</span><p id="par0040" class="elsevierStylePara elsevierViewall">The DHI created by Newman and Jacobson in 1990<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> is one of the most popular questionnaires for the assessment of vertigo and imbalance&#46; It is fast and easy to administer and has high reliability&#44; validity and internal consistency features&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">11</span></a> Furthermore&#44; the DHI complies with the international classification of functioning&#44; disability&#44; and health &#40;ICF&#41; from the World Health Organization&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">12</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">This questionnaire has been translated into many languages&#46; It showed that DHI has high reliability&#44; validity and internal consistency in different languages including Farsi&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">13</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">DHI has three sub scales&#59; evaluating the physical&#44; functional&#44; and emotional consequences of vertigo and imbalance&#46; It has 25 items that are graded with a score of 0 &#40;for answer &#8220;no&#8221;&#41;&#44; 2 &#40;&#8220;sometimes&#8221;&#41;&#44; or 4 &#40;&#8220;yes&#8221;&#41;&#46; The minimum score is 0 &#40;no disability&#41; while the maximum score is 100 &#40;The worst possible perceived disability&#41;&#46; Physical&#44; functional and emotional sub scales have 7&#44; 9&#44; 9 questions&#44; respectively&#44; however&#44; a score below 12 represents no perceived handicap&#46; The scores between 14&#8211;26&#44; 28&#8211;44 and 46&#8211;100 show mild&#44; moderate and severe disability&#44; respectively&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">DHI relate to the patient&#39;s view about their handicap because of vertigo and imbalance&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a> It is also related to the physical and functional tests of balance&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">14</span></a> The higher DHI scores show more physical disabilities that include difficulties in standing and walking&#46; Patients with a score higher than 60 in DHI are considered functionally impaired and they are at risk of falling&#46; Furthermore&#44; DHI scores correlate to anxiety and depression in patients&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Data analysis</span><p id="par0060" class="elsevierStylePara elsevierViewall">Continuous variables were expressed as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41;&#59; discrete variables were reported as frequency and percentage&#46; The normality condition of the quantitative variables was investigated by using the Shapiro-Wilks test&#46; The mean DHI scores were compared for patients and family members with the Paired <span class="elsevierStyleItalic">t</span>-test and the Pearson coefficient of correlation&#46; The comparison between mean DHI scores in gender and duration of symptoms &#40;acute&#47;chronic&#41; were assessed by an independent <span class="elsevierStyleItalic">t</span>-test&#46; The difference in scores between patients and family members in dimensions of the questionnaire was calculated&#46; Multivariate regression was used to assess the relation between age&#44; sex&#44; duration of the disorder&#44; and the patient&#39;s diagnosis the dimensions of the questionnaire&#46; The assumptions required for multivariate regression were reviewed and confirmed&#46; <span class="elsevierStyleItalic">p</span>-Value of less than 0&#46;05 was considered as significant&#46; Data were analyzed by using SPSS 25&#46;0 software&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0065" class="elsevierStylePara elsevierViewall">The mean age of patients and their family members were 51&#46;25<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#46;53 and 44&#46;22<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;48 years&#44; respectively&#46; Of the 220 participants&#44; 77 &#40;70&#37;&#41; patients and 59 &#40;54&#37;&#41; family members were female&#46; The duration of symptoms was acute in 60&#37; of them&#46; The patients had BPPV&#44; vestibular neuritis&#44; Meniere&#39;s disease&#44; Bilateral Vestibular Dysfunction &#40;BVD&#41; and other disorders for 26 &#40;23&#46;6&#37;&#41;&#44; 18 &#40;16&#46;4&#37;&#41;&#44; 16 &#40;14&#46;5&#37;&#41;&#44; 16 &#40;14&#46;5&#37;&#41;&#44; and 34 &#40;30&#46;9&#37;&#41; cases&#44; respectively&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The mean DHI scores of patients and their family members were 45&#46;35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&#46;24 and 42&#46;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>22&#46;83&#44; respectively&#46; The DHI scores in patients showed no significant difference based on the gender of patients &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#44; but for family members&#44; the mean DHI scores showed significant differences in the total DHI score and two functional and physical dimensions &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> and <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The DHI scores in patients had no significant difference based on duration &#40;acute and chronic&#41; of symptoms &#40;<span class="elsevierStyleItalic">p</span>-value<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The findings showed a significant correlation between the scores of patients and their family members in all sub scales based on the DHI &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Detailed information is provided in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">A difference larger than 10 points between total scores of patients and family members was considered as under or overestimation&#46; The 30&#37;&#44; 47&#37; and 33&#37; family members had underestimation&#44; correct estimation&#44; and overestimation&#44; respectively&#46; By using the criteria of 19 scores &#40;Smallest Detectable Change for DHI&#41; these numbers were 16&#37;&#44; 69&#37;&#44; and 25&#37;&#44; respectively&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Different factors may affect the correlation between the scores of patients and family members&#46; The effect of age &#40;patients and family members&#41;&#44; sex &#40;patients and family members&#41;&#44; duration of the disorder&#44; and the patient&#39;s diagnosis is reported in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; None of these factors had a significant effect&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">The results of this study showed that spouses and other relatives&#44; except their children&#44; have a relatively congruent perception with patients&#46; A similar study also showed similar results between patients and their spouses&#44; although some spouses overestimated the symptoms&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a> The perception of relatives in other symptoms such as pain is frequently reported in the literature&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">15&#8211;18</span></a> These studies also showed a congruent perception between patients and their spouses or significant others&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">In this study&#44; there were no significant relationships between the perception of patients and their children and their perceptions were incongruent&#44; which may result due to their poor communication&#46; In different groups such as couples&#44; poor communication is related to incongruent perception&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">16</span></a> Furthermore&#44; in the case of the children group accompanying patients in their evaluation session it did not mean that they had close relationships&#46; In one of the cases&#44; the difference between the total DHI score of a patient and her son was 82&#46; This result could be due to the patients&#8217; exaggerations about her symptoms or the child&#39;s unawareness about the problems of his mother&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">In this study&#44; most of the patients &#40;79&#46;0&#37;&#41; came with their spouses or children&#46; Although&#44; if they came with other relatives&#44; it showed that they have stronger relationships and also in some circumstances their perceptions were even closer to patients in comparison to their spouses&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Results showed that the functional and physical aspects of symptoms are more noticeable by family members&#44; because they could observe and perceive these objective aspects more than other participants&#46; Therefore&#44; subjective &#40;emotional&#41; aspects seem to be more ignored even by spouses&#46; Although this kind of incongruent perception could also be observed in other disorders&#44; for instance in patients who have cancer&#44; their spouses also showed more attention to objective effects&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">19</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The perception of the patient about vertigo is important and it is related to their degree of handicap&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">20</span></a> Although&#44; the congruent perception between patient and family members is also important and it may lead to more support for patients&#44; it could affect the treatment process and the patient&#39;s recovery&#46; A similar effect was reported for the mental health of stroke survivors&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">21</span></a> It also showed that in fibromyalgia patients&#44; congruent perception affects their coping&#44; decision making skill&#44; and adjustment&#46; However&#44; incongruent perception could negatively affect their quality of life and well-being&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">16</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">In addition to family members&#44; the clinicians may also have a different perception in some aspects and underestimate the patient&#39;s problems&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">22&#44;23</span></a> Although&#44; the clinicians had more congruent perception with patients in more physical aspects&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">23</span></a> in some cases the patient is the only one that can report the emotional consequences of their own symptoms&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">In this study&#44; different factors such as age&#44; sex&#44; duration of the disorder&#44; and the patient&#39;s diagnosis did not affect the correlation between perception of the patients and family members &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; We may expect more disability in bilateral vestibular dysfunction than BPPV but our results showed the patient&#39;s diagnosis didn&#8217;t affect the conjugate perception of patients and their family members&#46; However&#44; anxiety and depression affect DHI scores<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">24&#44;25</span></a> and the congruence between the perception of patients and their spouses&#44;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a> but these factors were not evaluated in these patients&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">There is a relatively congruent perception of vertigo and imbalance between patients and their family members&#59; excluding children&#46; Therefore&#44; their perception could be helpful in the assessment and treatment of patients&#46; They are also more observant in the physical&#44; rather than the emotional&#44; aspects of vertigo and imbalance&#46; Furthermore&#44; it might have been better to ask the family members about their relationship with the patient before using their perception&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Our study has some limitations&#59; anxiety and depression may affect DHI score but these factors were not evaluated in our patients&#46; Also&#44; The DHI score may relate to the acute and chronic stages of symptoms&#46; In acute symptoms&#44; some patients may need more time to notice the effect of symptoms on different aspects&#46; These patients may have different DHI scores later&#44; but the perception of family members also may change during this period&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conclusion</span><p id="par0140" class="elsevierStylePara elsevierViewall">There was a relatively weak to moderate relationship between the perception of patients and their family members&#44; except children&#46; They were more observant of the physical aspects of vertigo and imbalance in comparison with emotional ones&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of interest</span><p id="par0145" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Family members play a major role in the assessment and final result of the treatments of patients&#46; The goal of the present study was to evaluate how much the perception of patients&#8217; family members could be trusted regarding the vertigo and imbalance which they experienced&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A cross-sectional study was conducted on 110 patients and their family members who were referred to the Central Vestibular Clinic in Mashhad from April 2018 to September 2019&#46; Family members were categorized as spouses&#44; children&#44; and other relatives of patients&#46; Patients and their family members separately completed the Dizziness Handicap Inventory &#40;DHI&#41; by the paper and pencil method&#46; DHI has a high reliability&#44; validity&#44; and internal consistency&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Mean DHI scores of patients and their family members were 45&#46;35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&#46;24 and 42&#46;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>22&#46;83&#44; respectively&#46; The correlation between DHI scores of patients and family members&#44; except children&#44; were significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A relatively weak to moderate relationship between the perception of patients and their family members&#44; except children&#44; was found&#46; They were more aware of the physical aspects of vertigo and imbalance than the emotional ones&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Los familiares juegan un papel principal en la evaluaci&#243;n y resultado final de los tratamientos de los pacientes&#46; El objetivo del presente estudio fue evaluar cu&#225;nta percepci&#243;n de los familiares del paciente merece confianza en cuanto al v&#233;rtigo y el desequilibrio que experimentan los pacientes&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; un estudio transversal en 110 pacientes y sus familiares&#44; que fueron derivados a la Cl&#237;nica Vestibular Central de Mashhad de abril de 2018 a septiembre de 2019&#46; Los familiares fueron categorizados como esposos&#44; hijos&#44; y otros familiares de los pacientes&#46; Los pacientes y sus familiares completaron separadamente el Dizziness Handicap Inventory con l&#225;piz y papel&#46; Dicho inventario tiene una gran fiabilidad&#44; validez y consistencia interna&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Las puntuaciones medias del Dizziness Handicap Inventory de los pacientes y sus familiares fueron de 45&#44;35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>20&#44;24 y 42&#44;01<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>22&#44;83&#44; respectivamente&#46; La correlaci&#243;n entre las puntuaciones de Dizziness Handicap Inventory de los pacientes y sus familiares&#44; exceptuando los hijos&#44; fue significativa &#40;p&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se encontr&#243; una relaci&#243;n de relativamente d&#233;bil a moderada entre la percepci&#243;n de los pacientes y sus familiares&#44; exceptuando los hijos&#46; Ellos fueron m&#225;s observadores de los aspectos f&#237;sicos del v&#233;rtigo y el desequilibrio&#44; en comparaci&#243;n con los aspectos emocionales&#46;</p></span>"
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        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean &#40;SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">t</span> Statistic&#40;<span class="elsevierStyleItalic">P</span>-value&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Patients</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Emotional</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;88 &#40;7&#46;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;461 &#40;0&#46;147&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#46;29 &#40;8&#46;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;56 &#40;7&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Functional</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;85 &#40;8&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;604 &#40;0&#46;547&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;87 &#40;7&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;16 &#40;7&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Physical</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;21 &#40;8&#46;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;324 &#40;0&#46;747&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;77 &#40;7&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;60 &#40;8&#46;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Total score</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;20&#46;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;455 &#40;0&#46;650&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#46;92 &#40;20&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#46;35 &#40;20&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Family members</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Emotional</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;61 &#40;8&#46;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;433 &#40;0&#46;155&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;93 &#40;8&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;85 &#40;8&#46;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Functional</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">2&#46;315 &#40;0&#46;023<a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">42&#46;01 &#40;22&#46;83&#41;&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean &#40;SD&#41; deference between patients and family members&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;409 &#40;&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Functional&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;417 &#40;&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Physical&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;433 &#40;&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total score&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;433 &#40;&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t">0&#46;387 &#40;0&#46;006<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Functional&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;08 &#40;6&#46;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;577 &#40;&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Physical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;96 &#40;7&#46;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;573 &#40;&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total score&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total score&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Functional&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;3 &#40;8&#46;63&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;743 &#40;&#60;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total score&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;57 &#40;20&#46;44&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;664 &#40;0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;</a>&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">E difference<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">F difference<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">P difference<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">F difference<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">P difference<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">E difference<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&#46;433&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#46;512&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F difference<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos