Tinti Stefania, Parati Monica, De Maria Beatrice, Urbano Nicla, Sardo Vivian, Falcone Graziella, Terzoni Stefano, Alberti Annalisa, Destrebecq Anne
Department of Biomedicine and Prevention (S.T.), University of Rome ''Tor Vergata'', Rome, Italy.
Department of Electronics, Information and Bioengineering, Neuroengineering and Medical Robotics Laboratory (M.P.), Politecnico di Milano, Milan, Italy; IRCCS Istituti Clinici Scientifici Maugeri (M.P., B.D.M.), Milan, Italy.
J Pain Symptom Manage. 2022 Jan;63(1):e46-e58. doi: 10.1016/j.jpainsymman.2021.07.011. Epub 2021 Aug 3.
In order to examine the multi-dimensional nature of dyspnea and its impact on the activities of daily living (ADLs) in patients with cardio-respiratory and cancer diseases, validated measures are needed.
Our aim was to identify all the multi-dimensional clinical scales assessing dyspnea and its impact on ADLs in patients with cardio-respiratory and cancer diseases, and to critically appraise their psychometric properties.
Five databases were systematically searched up to July 2020. Eligible criteria were: the examination of at least one psychometric property, and the recruitment of adults with a cardio-respiratory or cancer disease in non-emergency settings. The characteristics and psychometric properties of the studies included were presented through a narrative synthesis. The methodological quality of the studies and evidence synthesis were rated using the "COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN)" criteria.
Forty-three studies, for which eight assessment scales had been identified, were included in the review. At the time of the review, three multi-dimensional assessment scales were available for assessing dyspnea symptoms, and five multi-dimensional scales were available to examine the impact of dyspnea on ADLs. Although the use of these scales has rapidly grown, evidence of psychometric properties has been reported as limited in most of the scales.
Despite the potential of the identified scales, further studies are needed to strength evidence on the validity and reliability of the multi-dimensional dyspnea scales. Furthermore, more studies appraising the content validity and responsiveness of the scales are specifically recommended.
为了研究呼吸困难的多维度特性及其对心肺疾病和癌症患者日常生活活动（ADL）的影响，需要经过验证的测量方法。
我们的目的是识别所有评估呼吸困难及其对心肺疾病和癌症患者ADL影响的多维度临床量表，并严格评估其心理测量特性。
截至2020年7月，系统检索了五个数据库。纳入标准为：至少检查一项心理测量特性，且在非紧急情况下招募患有心肺疾病或癌症的成年人。通过叙述性综合分析呈现所纳入研究的特征和心理测量特性。使用“基于共识的健康测量工具选择标准（COSMIN）”标准对研究的方法学质量和证据综合进行评分。
该综述纳入了43项研究，从中识别出了8种评估量表。在综述时，有三种多维度评估量表可用于评估呼吸困难症状，有五种多维度量表可用于研究呼吸困难对ADL的影响。尽管这些量表的使用迅速增加，但大多数量表的心理测量特性证据有限。
尽管已识别出的量表具有潜力，但仍需要进一步研究以加强多维度呼吸困难量表有效性和可靠性的证据。此外，特别建议开展更多评估量表内容效度和反应度的研究。
