Hegendörfer Eralda, Doukhopelnikoff Alexander, Degryse Jean-Marie
Dept of Public Health and Primary Care, Katholieke Universiteit Leuven (KU Leuven), Belgium.
Institute of Health and Society, Université Catholique de Louvain (UC Louvain), Belgium.
ERJ Open Res. 2021 Apr 12;7(2). doi: 10.1183/23120541.00606-2020. eCollection 2021 Apr.
Breathlessness is a common and distressing symptom in older adults and an independent predictor of adverse outcomes and yet its multidimensional assessment has not been validated in older adults. We apply and validate the Multidimensional Dyspnoea Profile (MDP) in a sample of adults 75 years and older in Belgium. Breathlessness was rated with the MDP, the modified Borg Dyspnoea Scale (mBDS), the Short Physical Performance Battery (SPPB, a numerical rating scale for intensity and unpleasantness both before and after exertion), as well as with the Medical Research Council (MRC) Dyspnoea Scale. The Hospital Anxiety and Depression Scale (HADS) assessed the affective status. Factor structure was analysed with exploratory principal components analysis, internal consistency with Cronbach's alpha and concurrent validity with Spearman's correlation coefficients with other breathlessness scales, HADS and SPPB scores. In 96 participants (mean age 85 years; 34% men) who rated breathlessness at both assessment points, exploratory principal components analysis identified two components: Immediate Perception (IP) and Emotional Reaction (ER), explaining most of the MDP item variance (65.37% before and 71.32% after exertion). Internal consistency was moderate to high for MDP-IP (Cronbach's alpha = 0.86 before and 0.89 after exertion) and MDP-ER (Cronbach's alpha = 0.89 before and 0.91 after exertion). The correlation patterns of MDP-IP and MDP-ER with other tests confirmed concurrent validity. The domain structure, reliability and concurrent validity of MDP for breathlessness before and after exertion were confirmed in a sample of adults 75 years and older, supporting its use and further research for the multidimensional profiling of breathlessness in older adults.
呼吸困难是老年人常见且令人痛苦的症状，也是不良后果的独立预测因素，然而其多维评估在老年人中尚未得到验证。我们在比利时75岁及以上的成年人样本中应用并验证了多维呼吸困难量表（MDP）。使用MDP、改良的博格呼吸困难量表（mBDS）、简短体能测试电池（SPPB，一种用于评估运动前后强度和不适程度的数字评分量表）以及医学研究委员会（MRC）呼吸困难量表对呼吸困难进行评分。医院焦虑抑郁量表（HADS）评估情感状态。通过探索性主成分分析分析因子结构，用克朗巴赫α系数分析内部一致性，用与其他呼吸困难量表、HADS和SPPB评分的斯皮尔曼相关系数分析同时效度。在两个评估点都对呼吸困难进行评分的96名参与者（平均年龄85岁；34%为男性）中，探索性主成分分析确定了两个成分：即时感知（IP）和情绪反应（ER），解释了大部分MDP项目方差（运动前为65.37%，运动后为71.32%）。MDP-IP（运动前克朗巴赫α系数=0.86，运动后=0.89）和MDP-ER（运动前克朗巴赫α系数=0.89，运动后=0.91）的内部一致性从中度到高度。MDP-IP和MDP-ER与其他测试的相关模式证实了同时效度。在75岁及以上的成年人样本中，证实了MDP在运动前后呼吸困难方面的领域结构、可靠性和同时效度，支持其在老年人呼吸困难多维分析中的应用和进一步研究。
