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Quantification of dyspnoea using descriptors: development and initial testing of the Dyspnoea-12

Yorke, J, Moosavi, SH, Shuldham, C and Jones, PW 2010, 'Quantification of dyspnoea using descriptors: development and initial testing of the Dyspnoea-12' , Thorax, 65 (1) , pp. 21-26.

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Abstract

Rationale: Dyspnoea is a debilitating and distressing symptom that is reflected in different verbal descriptors. Evidence suggests that dyspnoea, like pain perception, consists of sensory quality and affective components. The objective of this study was to develop an instrument that measures overall dyspnoea severity using descriptors that reflect its different aspects. Methods: 81 dyspnoea descriptors were administered to 123 patients with chronic obstructive pulmonary disease (COPD), 129 with interstitial lung disease and 106 with chronic heart failure. These were reduced to 34 items using hierarchical methods. Rasch analysis informed decisions regarding further item removal and fit to the unidimensional model. Principal component analysis (PCA) explored the underlying structure of the final item set. Validity and reliability of the new instrument were further assessed in a separate group of 53 patients with COPD. Results: After removal of items with hierarchical methods (n=47) and items that failed to fit the Rasch model (n=22), 12 were retained. The ‘‘Dyspnoea-12’’ had good internal reliability (Cronbach’s alpha=0.9) and fit to the Rasch model (x2 p=0.08). Items patterned into two groups called ‘‘physical’’(n=7) and ‘‘affective’’( n=5). In the separate validation study, Dyspnoea-12 correlated with the Hospital Anxiety and Depression Scale (anxiety r=0.51; depression r=0.44, p,0.001, respectively), 6-minute walk distance (r=20.38, p,0.01) and MRC (Medical Research Council) grade (r=0.48, p,0.01), and had good stability over time (intraclass correlation coefficient=0.9, p,0.001). Conclusion: Dyspnoea-12 fulfills modern psychometric requirements for measurement. It provides a global score of breathlessness severity that incorporates both ‘‘physical’’ and ‘‘affective’’ aspects, and can measure dyspnoea in a variety of diseases.

Item Type: Article
Contributors: (Author)
Themes: Subjects / Themes > R Medicine > RT Nursing
Subjects / Themes > R Medicine > R Medicine (General)
Health and Wellbeing
Schools: Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences > Centre for Nursing, Midwifery & Social Work Research
Colleges and Schools > College of Health & Social Care
Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences
Journal or Publication Title: Thorax
Publisher: BMJ Publishing Group
Refereed: Yes
ISSN: 0040-6376
Depositing User: Users 29196 not found.
Date Deposited: 22 Feb 2010 14:01
Last Modified: 20 Aug 2013 16:04
URI: http://usir.salford.ac.uk/id/eprint/3098

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