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Clinical validation of the Swedish version of Dyspnoea-12 instrument in outpatients with cardiorespiratory disease

Sundh, Josefin; Bornefalk, Hans; Sköld, Carl Magnus; Janson, Christer; Blomberg, Anders; Sandberg, Jacob LU ; Bornefalk-Hermansson, Anna; Igelström, Helena and Ekström, Magnus LU (2019) In BMJ Open Respiratory Research 6(1).
Abstract

Introduction Breathlessness is the cardinal symptom in both cardiac and respiratory diseases, and includes multiple dimensions. The multidimensional instrument Dyspnoea-12 has been developed to assess both physical and affective components of breathlessness. This study aimed to perform a clinical validation of the Swedish version of Dyspnoea-12 in outpatients with cardiorespiratory disease. Methods Stable outpatients with cardiorespiratory disease and self-reported breathlessness in daily life were recruited from five Swedish centres. Assessments of Dyspnoea-12 were performed at baseline, after 30-90 min and after 2 weeks. Factor structure was tested using confirmatory factor analysis and internal consistency using Cronbach's alpha.... (More)

Introduction Breathlessness is the cardinal symptom in both cardiac and respiratory diseases, and includes multiple dimensions. The multidimensional instrument Dyspnoea-12 has been developed to assess both physical and affective components of breathlessness. This study aimed to perform a clinical validation of the Swedish version of Dyspnoea-12 in outpatients with cardiorespiratory disease. Methods Stable outpatients with cardiorespiratory disease and self-reported breathlessness in daily life were recruited from five Swedish centres. Assessments of Dyspnoea-12 were performed at baseline, after 30-90 min and after 2 weeks. Factor structure was tested using confirmatory factor analysis and internal consistency using Cronbach's alpha. Test-retest reliability was analysed using intraclass correlation coefficients (ICCs). Concurrent validity at baseline was evaluated by examining correlations with lung function and several instruments for the assessment of symptoms and health status. Results In total, 182 patients were included: with the mean age of 69 years and 53% women. The main causes of breathlessness were chronic obstructive pulmonary disease (COPD; 25%), asthma (21%), heart failure (19%) and idiopathic pulmonary fibrosis (19%). Factor analysis confirmed the expected underlying two-component structure with two subdomains. The Dyspnoea-12 total score, physical subdomain score and affective subdomain scores showed high internal consistency (Cronbach's alpha 0.94, 0.84 and 0.80, respectively) and acceptable reliability after 2 weeks (ICC total scores 0.81, 0.79 and 0.73). Dyspnoea-12 showed concurrent validity with the instruments modified Medical Research Council scale, COPD Assessment Test, European Quality of Life-Five Dimensions-Five levels, the Functional Assessment of Chronic Illness Therapy-Fatigue, the Hospital Anxiety and Depression Scale, and with forced expiratory volume in 1 s in percentage of predicted value. The results were consistent across different cardiorespiratory conditions. Conclusion The Dyspnoea-12 is a valid instrument for multidimensional assessment of breathlessness in Swedish patients with cardiorespiratory diseases.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
asthma, breathlessness, COPD, dyspnoea, heart failure, idiopathic pulmonary fibrosis, internal consistency, reliability, concurrent validity, multidimensional
in
BMJ Open Respiratory Research
volume
6
issue
1
publisher
BMJ Publishing Group
external identifiers
  • scopus:85072574511
ISSN
2052-4439
DOI
10.1136/bmjresp-2019-000418
language
English
LU publication?
yes
id
99d228cd-731c-40c9-815f-a557acef3be3
date added to LUP
2019-10-04 12:43:34
date last changed
2019-11-13 05:41:33
@article{99d228cd-731c-40c9-815f-a557acef3be3,
  abstract     = {<p>Introduction Breathlessness is the cardinal symptom in both cardiac and respiratory diseases, and includes multiple dimensions. The multidimensional instrument Dyspnoea-12 has been developed to assess both physical and affective components of breathlessness. This study aimed to perform a clinical validation of the Swedish version of Dyspnoea-12 in outpatients with cardiorespiratory disease. Methods Stable outpatients with cardiorespiratory disease and self-reported breathlessness in daily life were recruited from five Swedish centres. Assessments of Dyspnoea-12 were performed at baseline, after 30-90 min and after 2 weeks. Factor structure was tested using confirmatory factor analysis and internal consistency using Cronbach's alpha. Test-retest reliability was analysed using intraclass correlation coefficients (ICCs). Concurrent validity at baseline was evaluated by examining correlations with lung function and several instruments for the assessment of symptoms and health status. Results In total, 182 patients were included: with the mean age of 69 years and 53% women. The main causes of breathlessness were chronic obstructive pulmonary disease (COPD; 25%), asthma (21%), heart failure (19%) and idiopathic pulmonary fibrosis (19%). Factor analysis confirmed the expected underlying two-component structure with two subdomains. The Dyspnoea-12 total score, physical subdomain score and affective subdomain scores showed high internal consistency (Cronbach's alpha 0.94, 0.84 and 0.80, respectively) and acceptable reliability after 2 weeks (ICC total scores 0.81, 0.79 and 0.73). Dyspnoea-12 showed concurrent validity with the instruments modified Medical Research Council scale, COPD Assessment Test, European Quality of Life-Five Dimensions-Five levels, the Functional Assessment of Chronic Illness Therapy-Fatigue, the Hospital Anxiety and Depression Scale, and with forced expiratory volume in 1 s in percentage of predicted value. The results were consistent across different cardiorespiratory conditions. Conclusion The Dyspnoea-12 is a valid instrument for multidimensional assessment of breathlessness in Swedish patients with cardiorespiratory diseases.</p>},
  articleno    = {e000418},
  author       = {Sundh, Josefin and Bornefalk, Hans and Sköld, Carl Magnus and Janson, Christer and Blomberg, Anders and Sandberg, Jacob and Bornefalk-Hermansson, Anna and Igelström, Helena and Ekström, Magnus},
  issn         = {2052-4439},
  keyword      = {asthma,breathlessness,COPD,dyspnoea,heart failure,idiopathic pulmonary fibrosis,internal consistency, reliability, concurrent validity,multidimensional},
  language     = {eng},
  number       = {1},
  publisher    = {BMJ Publishing Group},
  series       = {BMJ Open Respiratory Research},
  title        = {Clinical validation of the Swedish version of Dyspnoea-12 instrument in outpatients with cardiorespiratory disease},
  url          = {http://dx.doi.org/10.1136/bmjresp-2019-000418},
  volume       = {6},
  year         = {2019},
}