Campbell Margaret L
Center for Health Research, Wayne State University, Detroit, Michigan 48202, USA.
J Palliat Med. 2008 Jan-Feb;11(1):44-50. doi: 10.1089/jpm.2007.0090.
The purpose of this study was to establish the reliability and construct validity of a new behavioral instrument to measure the presence and intensity of respiratory distress for patients who are unable to self-report about dyspnea. Patient reports about dyspnea were compared to displayed behaviors in three groups of 70 patients (n = 210). Pulmonary rehabilitation patients were assessed with the respiratory distress observation scale (RDOS) after controlled exercise while hypoxemic and subsequently asked to report current dyspnea on a dyspnea visual analog scale (DVAS). Patients with postoperative orthopedic pain were evaluated with the RDOS and asked to report current pain and dyspnea. Healthy volunteers were assessed with the RDOS at rest and asked to report current dyspnea. The internal consistency (alpha) of this seven variable scale is 0.78. A positive correlation between the RDOS and DVAS (p = 0.001) was found in dyspneic patients indicating convergent validity. Significant differences were found when RDOS scores were compared between groups indicating discriminant validity. The instrument is reliable and has convergent and discriminant validity. There are clinical and research applications for this scale for assessment of patients who are unable to self-report about distress from dyspnea.
本研究的目的是建立一种新的行为工具的信度和结构效度，以测量无法自我报告呼吸困难的患者呼吸窘迫的存在情况和严重程度。将三组各70名患者（n = 210）的呼吸困难患者报告与所表现出的行为进行比较。对肺康复患者在控制性运动后低氧血症状态下使用呼吸窘迫观察量表（RDOS）进行评估，随后要求他们在呼吸困难视觉模拟量表（DVAS）上报告当前的呼吸困难情况。对骨科术后疼痛患者使用RDOS进行评估，并要求他们报告当前的疼痛和呼吸困难情况。对健康志愿者在静息状态下使用RDOS进行评估，并要求他们报告当前的呼吸困难情况。这个包含七个变量的量表的内部一致性（α）为0.78。在呼吸困难患者中发现RDOS与DVAS之间存在正相关（p = 0.001），表明具有收敛效度。在比较各组的RDOS评分时发现了显著差异，表明具有区分效度。该工具具有可靠性，且具有收敛效度和区分效度。该量表在评估无法自我报告呼吸困难所致窘迫的患者方面具有临床和研究应用价值。
