Department of Pulmonology/Center for Home Mechanical Ventilation, University Medical Center Groningen UMCG, University of Groningen, Groningen, The Netherlands.
J Clin Epidemiol. 2013 Oct;66(10):1166-74. doi: 10.1016/j.jclinepi.2013.04.013. Epub 2013 Jul 5.
There are limited data on health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD) patients with chronic hypercapnic respiratory failure during an admission requiring ventilatory support. The aim was to assess and compare the reliability and validity of the Clinical COPD Questionnaire (CCQ), Chronic Respiratory Questionnaire (CRQ), Maugeri Respiratory Failure-28 (MRF-28) Questionnaire, and Severe Respiratory Insufficiency (SRI) Questionnaire in patients with very severe COPD.
One hundred eighty hospitalized patients filled out the CCQ, CRQ, MRF-28, SRI, Groningen Activity Restriction Scale (GARS), Hospital Anxiety and Depression Scale (HADS), and the Medical Research Council Dyspnea Scale (MRC). Reliability was examined by assessing distribution of total scores, floor and ceiling effects, and internal consistency (using Cronbach α coefficient). Construct validity between questionnaires and also the other measurements were tested with Spearman ρ.
All four questionnaires were feasible in this setting and had reasonable characteristics for distribution of total scores, floor and ceiling effects, internal consistency, and construct validity. On balance, the SRI scored best. Additionally, the SRI had a remarkable high explained variance by HADS, GARS, and MRC (73%).
The SRI performed slightly better than the CCQ, CRQ, and MRF-28, which renders it the preferred questionnaire for scoring HRQL in patients with very severe COPD.
在需要通气支持的住院患者中,慢性阻塞性肺疾病(COPD)合并慢性高碳酸血症呼吸衰竭患者的健康相关生活质量(HRQL)数据有限。本研究旨在评估和比较临床 COPD 问卷(CCQ)、慢性呼吸问卷(CRQ)、Maugeri 呼吸衰竭 28 项问卷(MRF-28)和严重呼吸衰竭问卷(SRI)在极重度 COPD 患者中的可靠性和有效性。
180 名住院患者填写了 CCQ、CRQ、MRF-28、SRI、格罗宁根活动限制量表(GARS)、医院焦虑抑郁量表(HADS)和医学研究委员会呼吸困难量表(MRC)。通过评估总分分布、地板效应和天花板效应以及内部一致性(使用 Cronbach α 系数)来评估可靠性。通过 Spearman ρ 检验来测试问卷之间以及与其他测量方法之间的结构有效性。
在这种情况下,所有四个问卷都是可行的,并且具有总分分布、地板效应和天花板效应、内部一致性和结构有效性的合理特征。总的来说,SRI 的得分最高。此外,SRI 对 HADS、GARS 和 MRC 的解释方差具有显著的高值(73%)。
SRI 的表现略优于 CCQ、CRQ 和 MRF-28,这使得它成为极重度 COPD 患者评分 HRQL 的首选问卷。