Lareau S C, Meek P M, Roos P J
Jerry L. Pettis Veterans Administration Medical Center, Department of Medicine, Loma Linda University, Calif 92357, USA.
Heart Lung. 1998 May-Jun;27(3):159-68. doi: 10.1016/s0147-9563(98)90003-6.
Describe the process of development and testing to reduce the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ) from 164 items to a modified questionnaire (the PFSDQ-M) consisting of 40 items.
Instrument development and testing for reliability, validity, and practicality.
Hospital-based outpatients.
Testing was done on three groups of clinically stable patients with chronic obstructive pulmonary disease: a secondary analysis of 131 subjects for item selection, reliability, and validity; 50 additional subjects evaluating the PFSDQ-M for internal consistency, test-retest correlations, and construct validity; and 34 subjects from a longitudinal study for responsiveness.
PFSDQ, PFSDQ-M, and spirometry.
The practicality of the PFSDQ-M was supported by its sixth- to seventh-grade reading level, ease of reading (Flesch-Kincaid 69.5), self-administration, brief period for testing (7 minutes initially, 6 minutes on repeated testing), and limited missing data (< 8%). Reliability of the three components was supported by internal consistency alpha = 0.93 for change experienced by the patient with activities (CA), 0.95 for dyspnea with activities (DA), and 0.95 for fatigue with activities (FA). Good stability of the PFSDQ-M was demonstrated on test-retest; r = 0.70 for change, 0.83 for dyspnea, and 0.79 for fatigue (with activities). The usefulness of the PFSDQ-M in discriminating between dyspnea scores in patients based on their rate of deterioration in lung function was demonstrated.
The PFSDQ was modified by reducing the number of activities evaluated, standardizing scaling formats, and adding a fatigue component. Findings suggest that the PFSDQ-M demonstrates initial reliability; good validity estimates, as seen with the factor analysis, and the dyspnea and activity scores appear responsive to physiologic changes in lung function over time.
描述将肺功能状态与呼吸困难问卷（PFSDQ）从164项精简为包含40项的修订问卷（PFSDQ-M）的开发和测试过程。
进行工具开发并测试其信度、效度和实用性。
医院门诊。
对三组临床稳定的慢性阻塞性肺疾病患者进行测试：对131名受试者进行二次分析以进行项目选择、信度和效度评估；另外50名受试者评估PFSDQ-M的内部一致性、重测相关性和结构效度；34名来自纵向研究的受试者评估其反应性。
PFSDQ、PFSDQ-M和肺量计。
PFSDQ-M的实用性体现在其六年级到七年级的阅读水平、易读性（弗莱什-金凯德可读性指数为69.5）、可自行填写、测试时间短（初始7分钟，重复测试6分钟）以及缺失数据有限（<8%）。三个分量表的信度通过内部一致性得到支持，患者活动时经历的变化（CA）的α系数为0.93，活动时呼吸困难（DA）的α系数为0.95，活动时疲劳（FA）的α系数为0.95。PFSDQ-M在重测中显示出良好的稳定性；变化的重测相关系数r = 0.70，呼吸困难的r = 0.83，疲劳的r = （活动时）0.79。PFSDQ-M在根据患者肺功能恶化率区分呼吸困难评分方面的有用性得到了证明。
通过减少评估的活动数量、标准化评分格式和增加疲劳分量表对PFSDQ进行了修订。研究结果表明，PFSDQ-M显示出初步的信度；如因子分析所示，具有良好的效度估计，并且呼吸困难和活动评分似乎随时间对肺功能的生理变化有反应。
