 Vaughan’s very best performances". Text by WikipediaThe Balance Center at Cleveland Clinic Abu Dhabi helps patients suffering from dizziness and vertigo.
Dizziness is a general term that encompasses loss of balance, lightheadedness, a spinning sensation or an inability to walk straight, among other symptoms. It can be caused by problems in the inner ear, brain, eyes, or neck, and sometimes involves multiple causes. For patients affected by dizziness, receiving an accurate diagnosis that identifies the cause of the symptoms is vital to be able to return to their normal lives.
The multidisciplinary team at the Balance Center consists of experienced audiologists, otologists, and physical therapists, who are experts in the assessment and treatment of patients with a variety of diseases causing dizziness. The specialist team also work closely with caregivers from other specialties across Cleveland Clinic Abu Dhabi, including neurology, neurosurgery, cardiology, and spine surgery.
An accurate diagnosis of the cause of dizziness is key to successful treatment, and to returning to a normal life quickly. When you visit the Balance Center, you will initially be assessed by our otologists, who will obtain a detailed history of your symptoms and conduct a thorough physical examination. Based on this, they will then order tests that assess the hearing and balance functions of the inner ear.
Electrocochleography (EchoG): A specific test that measures small electrical waves within the inner ear in response to sounds. It is easy to administer and can give good indications about the presence of Meniere’s disease.
In addition to Balance Tests, your doctor may request imaging tests, such as an MRI of the inner ear, brain, or spine. Following a thorough assessment and discussion by the whole team, a treatment plan will be offered to you. This may include a combination of medical treatment and vestibular rehabilitation therapy, a specialized form of physical therapy focused on improving your balance.
Watch as our experts talk about their roles at the Balance Center and how they help patients with dizziness.
Shidu is the Chinese transliteration for ‘losing an only child,’ which indicates the death of the only child in the family. Shidu is a unique social phenomenon resulting from the One-Child Policy implemented in China for several decades. Shiduers are parents who have lost their only child. The grief research scholar Neimeyer (2012) argued that grief research should consider the role of different cultures in the grieving process. Familism culture is a collectivist culture that has a profound effect on Chinese society and is likely to produce a significant effect on the grieving process of shiduers; however, this effect has not yet received systematic attention in research. To explore the effect of familism culture on the grief of shiduers, we conducted semi-structured personal interviews in Beijing, China, with seven shiduers. The study results show that the effect of familism culture on the grief of shiduers includes three levels: cognition, emotion, and behavior. These levels are reflected in a variety of relationships, including relationships with ancestors, the deceased child, the spouse, relatives, Tong Ming Ren (the Chinese transliteration of ‘people who share the same fate’), and the country. The first four types of relationships are reflections of ‘direct familism culture,’ and the latter two types of relationships are reflections of ‘extended familism culture’. The relationships with the deceased child, relatives, and Tong Ming Ren are mainly supportive; the relationship with ancestors is mainly stressful; the relationship with the spouse has a dual nature; and the relationship with the country is contradictory. Over time, shiduers have abandoned the concept of familism culture and have moved toward reducing stress and increasing supportiveness. Psychological professionals, social workers, and government staff may refer to the results of this study to help shiduers obtain support and reduce stress from the described relationships. Specific suggestions are provided in the text.
Previous studies examining the grief of parents who lose their child have primarily addressed two aspects. First, the grief expressed by them has been studied. For example, Michon et al. (2003) used a scale to measure the intensity of grief, whereas Olivas (2013) used a form of textual data to illustrate their state of grief through qualitative research. Second, researchers have continuously attempted to explore the factors that influence the grieving process among them. For example, Rando (1983) found that a previous loss tended to be associated with poorer bereavement outcomes among those who lose their child to cancer, whereas Ronen et al. (2010) interviewed parents who lose their child and found that continuing bonds could promote their grief adjustment. Because of language differences and other barriers, however, the state of grief among Chinese shiduers has rarely received scholarly attention.
Losing a child causes the most painful and lasting grief (Gorer, 1965). China’s One-Child Policy was maintained for approximately 30 years to control the population. This policy ended only recently in 2015. During the several decades of the One-Child Policy, losing an only child became a unique social phenomenon in China. Parents who lose their only child are called ‘shiduers.’ Using census data from 1990, 2000, and 2010 as a basis, Wang estimated that as of 2010, the cumulative number of deceased only children exceeded one million, which corresponds to more than one million families that lost their only child (Wang, 2013). Wang also noted that although the One-Child Policy has ended, the number of future families that will lose an only child will continue to increase for a considerable period of time (Wang, 2016). The results of several studies have suggested that the state of grief of Chinese shiduers is more severe than that of other parents who lose their child. A survey of 226 Chinese women who became shiduers due to earthquakes found that the state of prolonged grief amongst the 116 women who did not give birth again was more severe than that amongst the 110 women who had given birth again (Xu et al., 2014). Furthermore, a cross-cultural study of shiduers in China and parents who lost their child in Switzerland found that those in China scored significantly higher on the prolonged grief scale (Xiu et al., 2016). Therefore, the grief state of shiduers is deserving of research.
A Chinese saying states that ‘losing one’s parent(s) in one’s youth, losing one’s spouse in middle-age, and losing one’s child in old age’ are the three great tragedies in life. The shiduers population undoubtedly experiences an unforgettable grieving process. Grief refers to ‘a primarily emotional reaction to the loss of a loved one through death. It incorporates diverse psychological (cognitive, social-behavioral) and physical (physiological-somatic) manifestations’ (Stroebe et al., 2001). Qualitative studies have found that most shiduers develop an intense grief response in terms of cognition, emotion, behavior, and physiology (He et al., 2014). If this type of intense grief response persists in the long term, prolonged grief can easily develop. Prolonged grief is also called complicated grief, which is a long-lasting and permeating grief response characterized by longing for or persistent preoccupation with the deceased and accompanied by intense emotional pain (World Health Organisation, 2017). According to another survey, the proportion of shiduers who suffered from prolonged grief was approximately 30% (Shang, 2016). Many factors affect shiduers with regard to the suffering they experience from prolonged grief or from the slow recovery process. The effect of culture on this grieving process has been stressed by scholars. For example, the well-known grief research scholar Neimeyer (2012) argued that ‘exporting’ the grief model primarily generated in the United States to other cultures might be inappropriate and that grief research should consider the role of different cultures in the grieving process.
Studies on the relation between the grief of shiduers and their culture are rare because shidu is a unique social phenomenon in China. Recently, relevant studies have discussed the effect of culture. For example, in Chinese culture, participants in funeral rites are usually a group formed by ties of blood and geography (Jia, 2010). The grieving process for shiduers is affected by the negative influence of ‘stigmatization’ from traditional Chinese culture (Xu, 2014; Zheng and Lawson, 2014). The ritualistic behavior of grieving for shiduers has unique Chinese cultural connotations. For example, according to traditional Chinese customs, some shiduers hold a sacrificial ceremony for the child every 7 days for 49 days after the child’s passing (He et al., 2017). However, the objectives of these studies were not to systematically examine the effect of culture. These studies provided only partial information to understand the grief of shiduers from a cultural perspective and lacked in-depth studies of a particular effect of culture. Therefore, the question remains: for shiduers in China, which type of traditional Chinese culture has the most profound effect on their grieving process?
China is a country deeply affected by the collectivist culture. Among the numerous types of collectivist cultures, familism culture has an especially profound effect on Chinese society. Familism culture refers to a type of ‘ingroup collectivism’ in which family members attach primary importance to the family (Schwartz, 1990). In China, however, the word ‘family’ refers not only to close relatives, such as parents, spouses, and children, but also to a social organization formed by ties of blood or marriage that encompasses nephews, aunts, and other relatives (Chinese Academy of Social Sciences, 2012). The famous Chinese social psychologist Guoshu Yang generalized the social orientation of Chinese people into four characteristics: family orientation (the most important characteristic), relationship orientation, authority orientation, and other orientation (