Department of Psychology, Southern Methodist University, Dallas, TX, USA.
Department of Health Psychology, KU Leuven, Leuven, Belgium.
Respirology. 2019 Jan;24(1):48-54. doi: 10.1111/resp.13368. Epub 2018 Jul 13.
Prevention of exacerbations in chronic obstructive pulmonary disease (COPD) is important to decrease overall declines in functioning and improve quality of life. The present study sought to develop a psychometrically valid measure of perceived triggers of exacerbations in COPD patients, the COPD Exacerbation Trigger Inventory (CETI).
Participants (n = 192) were recruited through local clinics and online to complete surveys of the CETI, demographic information, disease-specific information and the COPD Assessment Test (CAT). The CETI included a free response section on patients' individual top triggers, combined with ratings of their controllability.
Exploratory principal component analyses identified a stable 5-factor structure (33 items), from which trigger subscales for weather/climate, air pollution/irritants, exercise, infection/illness and psychological factors were formed (internal consistency Cronbach's α = 0.90-0.94). Trigger factors were associated with COPD functional status, exacerbation frequency and healthcare utilization. Participants found personal triggers related to dust, air pollution, smoking and physical activity to be the most easily controlled, whereas those related to psychological factors, climate, infection, respiratory symptoms and sleep to be more difficult to control. Greater perceived controllability of triggers was associated with lower CAT scores, indicating better health status and less impact of the disease on functioning.
The CETI is a psychometrically valid measure of perceived exacerbation triggers in patients with COPD. Perceived triggers are associated with clinical outcomes. Assessment of trigger classes and their controllability may prove useful in both research and clinical settings with COPD patients and to further our knowledge in prevention and disease management.
预防慢性阻塞性肺疾病（COPD）加重对于降低整体功能下降和改善生活质量非常重要。本研究旨在开发一种具有心理测量学效度的 COPD 患者加重感知触发因素的测量工具，即 COPD 加重触发因素清单（CETI）。
通过当地诊所和在线渠道招募了 192 名参与者，要求他们完成 CETI、人口统计学信息、疾病特异性信息和 COPD 评估测试（CAT）的调查。CETI 包括患者个人触发因素的自由反应部分，以及对其可控性的评分。
探索性主成分分析确定了一个稳定的 5 因素结构（33 项），从中形成了天气/气候、空气污染/刺激物、运动、感染/疾病和心理因素的触发子量表（内部一致性 Cronbach's α=0.90-0.94）。触发因素与 COPD 功能状态、加重频率和医疗保健利用有关。参与者认为与灰尘、空气污染、吸烟和体力活动相关的个人触发因素最容易控制，而与心理因素、气候、感染、呼吸症状和睡眠相关的触发因素则更难控制。对触发因素的感知可控性越高，CAT 评分越低，表明健康状况越好，疾病对功能的影响越小。
CETI 是一种具有心理测量学效度的 COPD 患者加重感知触发因素的测量工具。感知触发因素与临床结果相关。评估触发因素类别及其可控性可能在 COPD 患者的研究和临床环境中证明有用，并进一步加深我们对预防和疾病管理的认识。
