Liao Yingxue, Zhou Haofeng, Liu Meifeng, Zhang Guolin, Wang Ting, Xu Mingyu, Deng Jiawei, Guo Lan, Ma Huan, Geng Qingshan
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 510000 Guangzhou, Guangdong, China.
Department of Cardiac Rehabilitation, Huizhou Third People's Hospital, Guangzhou Medical University, 516000 Huizhou, Guangdong, China.
Rev Cardiovasc Med. 2024 Jan 29;25(2):45. doi: 10.31083/j.rcm2502045. eCollection 2024 Feb.
Exercise capacity serves as a direct representation of cardiac function. The Duke Activity Status Index (DASI), a self-administered 12-item questionnaire, covers aspects of daily living, household tasks, sexual function, and physical activity. Although widely used to evaluate exercise capacity, its validation in Chinese cardiovascular disease (CVD) patients has not been thoroughly explored. Considering the significant cultural and lifestyle differences between China and Western countries, which may influence Chinese patients' comprehension and responses to DASI, our objective is to culturally adapt DASI for Chinese patients with CVD to ensure its precision in assessing exercise capacity.
The cultural adaptation of the original DASI questionnaire into Chinese followed a rigorous process to ensure its validity, reliability, and sensitivity to Chinese CVD patients. The study included 107 outpatients diagnosed with CVD who completed the DASI and cardiopulmonary exercise testing (CPET). Cronbach's alpha, Spearman correlation, and factor analysis were utilized to test reliability and validity. Receiver operating characteristic (ROC) curve analysis was employed to assess the prognostic utility of the DASI.
Participants had a mean DASI score of 39.40 10.75 and a peak oxygen uptake (Peak ) of 19.53 5.89 mL/min/kg. The Chinese version of the DASI exhibited satisfactory reliability and validity in CVD patients, with a Chronbach's alpha coefficient of 0.706. The DASI score demonstrated a moderate correlation with Peak measured by CPET (r = 0.67, 0.001). Factor analysis yielded three factors, accounting for 56.76% of the total variance, with factor 1 contributing to 26.38% of the variance. ROC curve analysis demonstrated that the DASI exhibited discriminative utility in the identification of patients with improved long-term prognosis ( 0.001). The ROC curve had an area of 0.788 [95% confidence interval (CI) = 0.704-0.871]. The DASI score 36.85 served as the optimal threshold for enhanced long-term prognosis, exhibiting a sensitivity of 0.80 and a specificity of 0.69.
The culturally adapted DASI questionnaire is a straightforward and efficient tool for reasonably evaluating exercise capacity in Chinese CVD patients.
运动能力是心功能的直接体现。杜克活动状态指数（DASI）是一份包含12个条目的自填式问卷，涵盖日常生活、家务劳动、性功能和体育活动等方面。尽管DASI被广泛用于评估运动能力，但其在中国心血管疾病（CVD）患者中的有效性尚未得到充分研究。考虑到中国与西方国家在文化和生活方式上存在显著差异，这可能会影响中国患者对DASI的理解和回答，我们的目标是对DASI进行文化调适，使其适用于中国CVD患者，以确保其在评估运动能力方面的准确性。
将原始DASI问卷文化调适为中文版遵循了严格的流程，以确保其对中国CVD患者的有效性、可靠性和敏感性。该研究纳入了107名被诊断为CVD的门诊患者，他们完成了DASI和心肺运动试验（CPET）。采用克朗巴哈系数、斯皮尔曼相关性分析和因子分析来检验可靠性和有效性。采用受试者工作特征（ROC）曲线分析来评估DASI的预后效用。
参与者的DASI平均得分为（39.40±10.75）分，峰值摄氧量（Peak VO₂）为（19.53±5.89）ml/min/kg。中文版DASI在CVD患者中表现出令人满意的可靠性和有效性，克朗巴哈系数为0.706。DASI得分与CPET测量的Peak VO₂呈中度相关（r = 0.67，P < 0.001）。因子分析产生了三个因子，占总方差的56.76%，其中因子1贡献了26.38%的方差。ROC曲线分析表明，DASI在识别长期预后改善的患者方面具有判别效用（P < 0.001）。ROC曲线的面积为0.788 [95%置信区间（CI）= 0.704 - 0.871]。DASI得分≤36.85作为长期预后改善的最佳阈值，敏感性为0.80，特异性为0.69。
经过文化调适的DASI问卷是合理评估中国CVD患者运动能力的一种简单有效的工具。
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