Barr J T, Schumacher G E, Freeman S, LeMoine M, Bakst A W, Jones P W
National Education and Research Center for Outcomes Assessment, School of Pharmacy, Northeastern University, Boston, MA 02115, USA.
Clin Ther. 2000 Sep;22(9):1121-45. doi: 10.1016/S0149-2918(00)80089-2.
The St. George's Respiratory Questionnaire (SGRQ) is a 50-item health status survey specific for chronic obstructive pulmonary disease (COPD) and other respiratory diseases that is available in British English but not American English. The SGRQ's symptom-reporting component requires a 1-year reporting period, which may be too long for reliable and accurate patient recall.
The objectives of the present study were to translate the SGRQ from British to American English, modify the reporting period of the symptom-reporting component from 1 year to 1 month, and assess the reliability, validity, and sensitivity to change of this translated modified version in a sample of patients with COPD.
Based on input from American patients with COPD and health professionals, the SGRQ was translated into American English (SGRQ-A) and then translated back to British English. For SGRQ-A reliability and validity studies, patients were asked to report symptoms experienced over 1 year (reporting period in the original SGRQ) and 1 month (modification made to SGRQ-A). We evaluated 102 patients with COPD (50% female; mean age, 68 years; mean forced expiratory volume in 1 second [FEV1], 1.01 L) at an administrative session before and after completion of a pulmonary rehabilitation program. The SGRQ-A, Chronic Respiratory Disease Questionnaire (CRQ), 36-Item Short Form Health Survey (SF-36), 6-minute walk (6MW), Medical Research Council (MRC) Dyspnea scale, and pulmonary function tests (FEV1 and % predicted FEV1) were used in the assessment battery.
The SGRQ-A showed good agreement with the original SGRQ when translated back to British English. Internal reliability (Cronbach alpha) was > 0.70 for all SGRQ-A components except the 1-year symptom-reporting component. Test-retest intraclass correlations were 0.795 to 0.900. Construct validity was strengthened when all SGRQ-A components (except 1-year symptoms and most 1-month symptoms) correlated (P < or = 0.01) with the MRC Dyspnea scale, 6MW, all SF-36 concept scores, and 80% of CRQ domains (r = 0.30-0.72). Discriminate validity was demonstrated when all components of the SGRQ-A with the modified 1-month symptom-reporting period were shown to discriminate better between disease-severity groups (based on patient self-reports of disease severity) than did pulmonary function tests and the 6MW. Responsiveness of the SGRQ-A to change in health status was demonstrated when scores on the Symptoms-1 month and Total-1 month components detected significant improvements in patients' health status (P = 0.02 and P = 0.04, respectively).
The SGRQ-A with a modified 1-month symptom-reporting period demonstrated reliability and validity in this sample of patients with COPD. Key words: chronic obstructive pulmonary disease, St. George's Respiratory Questionnaire, American translation, reliability, validity, symptom recall.
圣乔治呼吸问卷（SGRQ）是一项针对慢性阻塞性肺疾病（COPD）及其他呼吸系统疾病的包含50个条目的健康状况调查问卷，现有英式英语版本，但没有美式英语版本。SGRQ的症状报告部分要求报告期为1年，对于患者可靠且准确的回忆来说可能太长。
本研究的目的是将SGRQ从英式英语翻译成美式英语，将症状报告部分的报告期从1年改为1个月，并在一组COPD患者样本中评估此翻译修改版本的信度、效度及对变化的敏感性。
根据美国COPD患者和健康专业人员的意见，将SGRQ翻译成美式英语（SGRQ-A），然后再翻译回英式英语。对于SGRQ-A的信度和效度研究，要求患者报告1年（原始SGRQ的报告期）和1个月（对SGRQ-A所做的修改）内经历的症状。在一项肺康复计划完成前后的管理环节中，我们评估了102例COPD患者（50%为女性；平均年龄68岁；平均第1秒用力呼气量[FEV1]为1.01L）。评估项目包括SGRQ-A、慢性呼吸系统疾病问卷（CRQ）、36项简短健康调查（SF-36）、6分钟步行试验（6MW）、医学研究委员会（MRC）呼吸困难量表以及肺功能测试（FEV1和FEV1预测值百分比）。
当SGRQ-A再翻译回英式英语时，与原始SGRQ显示出良好的一致性。除1年症状报告部分外，所有SGRQ-A分量表的内部信度（Cronbachα）均>0.70。重测组内相关系数为0.795至0.900。当所有SGRQ-A分量表（除1年症状和大多数1个月症状外）与MRC呼吸困难量表、6MW、所有SF-36概念得分以及80%的CRQ领域相关（P≤0.01）时（r=0.30 - 0.72），结构效度得到加强。当显示SGRQ-A修改后的1个月症状报告期的所有分量表在疾病严重程度组（基于患者对疾病严重程度的自我报告）之间的区分度优于肺功能测试和6MW时，证明了区分效度。当症状-1个月和总分-1个月分量表的得分检测到患者健康状况有显著改善时（分别为P=0.02和P=0.04），证明了SGRQ-A对健康状况变化的反应性。
症状报告期修改为1个月的SGRQ-A在该组COPD患者样本中显示出信度和效度。关键词：慢性阻塞性肺疾病，圣乔治呼吸问卷，美式翻译，信度，效度，症状回忆
