Turhan KAHRAMAN,
Sema SAVCI,
Buse ÖZCAN KAHRAMAN,
Serap ACAR,
İsmail ÖZSOY,
Aylin TANRIVERDİ,
Karya POLAT,
Aslı PAPURCU,
Nazenin Hande SEZGİN,
Aylin ÖZGEN ALPAYDIN,
Can SEVİNÇ
7154
Validity and reliability of the Turkish version of the Multidimensional Dyspnea Profile in outpatients with respiratory disease
Validity and reliability of the Turkish version of the Multidimensional Dyspnea Profile in outpatients with respiratory disease
Background/aim: Dyspnea is the subjective feeling of breathing discomfort, which is a significant problem for patients with heart and respiratory disease and also an important determinant of exercise tolerance, quality of life, and mortality in various diseases. Most of the scales are not enough to investigate the multidimensional effects of dyspnea; therefore, the Multidimensional Dyspnea Profile (MDP) was developed and validated in many languages. This study aimed to translate and culturally adapt the MDP into Turkish and investigate the psychometric properties of this adapted version in outpatients with respiratory disease. Materials and methods: The MDP was translated and culturally adapted into Turkish following published guidelines. A total of 170 outpatients with respiratory disease were included to assess psychometric properties. The factorial structure was investigated using a principal component analysis. Two situations were used in this study evaluating dyspnea in activity-related and resting conditions. We formulated 17 hypotheses for each MDP domain (in total 68) to assess construct validity, and correlations were investigated between the MDP and measures of body mass index, pulmonary function test, other dyspnea assessments, anxiety, depression, and health-related quality of life. To investigate the test-retest reliability, the MDP was administered again after 1-h and 1 week. Results: Internal consistency of the MDP was excellent (Cronbach’s alpha coefficients ranged from 0.89 to 0.93). The exploratory factor analysis revealed 2 components explaining a 70% and 76% variance. Overall, 64 of the 68 predetermined hypotheses (94%) were confirmed to test construct validity. The MDP showed excellent test-retest reliability for a 1-hperiod (intraclass correlation coefficient values ranged from 0.98 to 0.99). However, test-retest reliability decreased moderate-to-high after 1 week (0.53–0.80). Conclusion: The MDP was successfully translated and culturally adapted into Turkish and this version showed good psychometric properties including the factorial structure, internal consistency, test-retest reliability, and construct validity to assess multidimensional aspects of dyspnea.
___
- 1. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. American Journal of Respiratory and Critical Care Medicine 2012; 185: 435-452. doi: 10.1164/ rccm.201111-2042ST
- 2. Laviolette L, Laveneziana P. Dyspnoea: a multidimensional and multidisciplinary approach. European Respiratory Journal 2014; 43: 1750-1762. doi: 10.1183/09031936.00092613
- 3. Lansing RW, Gracely RH, Banzett RB. The multiple dimensions of dyspnea: review and hypotheses. Respiratory Physiology & Neurobiology 2009; 167: 53-60. doi: 10.1016/j.resp.2008.07.012
- 4. Banzett RB, Pedersen SH, Schwartzstein RM, Lansing RW. The affective dimension of laboratory dyspnea: air hunger is more unpleasant than work/effort. American Journal of Respiratory and Critical Care Medicine 2008; 177: 1384-1390. doi: 10.1164/ rccm.200711-1675OC
- 5. Meek PM, Banzett R, Parsall MB, Gracely RH, Schwartzstein RM, Lansing R. Reliability and validity of the multidimensional dyspnea profile. Chest 2012; 141: 1546-1553. doi: 10.1378/ chest.11-1087
- 6. Williams M, Cafarella P, Olds T, Petkov J, Frith P. Affective descriptors of the sensation of breathlessness are more highly associated with severity of impairment than physical descriptors in people with COPD. Chest 2010; 138: 315-322. doi: 10.1378/chest.09-2498
- 7. Mahler DA, Ward J, Waterman LA, McCusker C, ZuWallack R, Baird JC. Patient-reported dyspnea in COPD reliability and association with stage of disease. Chest 2009; 136: 1473-1479. doi: 10.1378/chest.09-0934
- 8. Dorman S, Jolley C, Abernethy A, Currow D, Johnson M et al. Researching breathlessness in palliative care: consensus statement of the National Cancer Research Institute Palliative Care Breathlessness Subgroup. Palliative Medicine 2009; 23: 213-227. doi: 10.1177/0269216309102520
- 9. Yorke J, Russell AM, Swigris J, Shuldham C, Haigh C et al. Assessment of dyspnea in asthma: validation of The Dyspnea-12. The Journal of Asthma 2011; 48: 602-608. doi: 10.3109/02770903.2011.585412
- 10. Tanaka K, Akechi T, Okuyama T, Nishiwaki Y, Uchitomi Y. Development and validation of the Cancer Dyspnoea Scale: a multidimensional, brief, self-rating scale. British Journal of Cancer 2000; 82: 800-805. doi: 10.1054/bjoc.1999.1002
- 11. Parshall MB, Meek PM, Sklar D, Alcock J, Bittner P. Test-retest reliability of multidimensional dyspnea profile recall ratings in the emergency department: a prospective, longitudinal study. BMC Emergency Medicine 2012; 12: 6. doi: 10.1186/1471- 227x-12-6
- 12. Banzett RB, O’Donnell CR, Guilfoyle TE, Parshall MB, Schwartzstein RM, et al. Multidimensional Dyspnea Profile: an instrument for clinical and laboratory research. European Respiratory Journal 2015; 45: 1681-1691. doi: 10.1183/09031936.00038914
- 13. Morélot-Panzini C, Gilet H, Aguilaniu B, Devillier P, Didier A et al. Real-life assessment of the multidimensional nature of dyspnoea in COPD outpatients. European Respiratory Journal 2016; 47: 1668-1679. doi: 10.1183/13993003.01998-2015
- 14. Ekstrom M, Sundh J. Swedish translation and linguistic validation of the multidimensional dyspnoea profile. European Clinical Respiratory Journal 2016; 3: 32665. doi: 10.3402/ecrj. v3.32665
- 15. Belo LF, Rodrigues A, Vicentin AP, Paes T, de Castro LA et al. A breath of fresh air: validity and reliability of a Portuguese version of the Multidimensional Dyspnea Profile for patients with COPD. PLoS One 2019; 14: e0215544. doi: 10.1371/ journal.pone.0215544
- 16. Ekström M, Bornefalk H, Sköld M, Janson C, Blomberg A et al. Validation of the Swedish Multidimensional Dyspnea Profile (MDP) in outpatients with cardiorespiratory disease. BMJ Open Respiratory Research 2019; 6: e000381. doi: 10.1136/ bmjresp-2018-000381
- 17. Stump A, Schröder M, Domanski U, Franke KJ, Nilius G. German translation and linguistic validation of the Multidimensional Dyspnea Profile (MDP). Pneumologie 2019; 73: 470-473 (in German). doi: 10.1055/a-0861-1516
- 18. Williams MT, John D, Frith P. Comparison of the Dyspnoea-12 and Multidimensional Dyspnoea Profile in people with COPD. European Respiratory Journal 2017; 49: 1600773. doi: 10.1183/13993003.00773-2016
- 19. Anthoine E, Moret L, Regnault A, Sébille V, Hardouin JB. Sample size used to validate a scale: a review of publications on newly-developed patient reported outcomes measures. Health and Quality of Life Outcomes 2014; 12: 2. doi: 10.1186/s12955- 014-0176-2
- 20. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine 2000; 25: 3186-3191. doi: 10.1097/00007632- 200012150-00014
- 21. Stenton C. The MRC breathlessness scale. Occupational Medicine 2008; 58: 226-227. doi: 10.1093/occmed/kqm162
- 22. Mahler DA, Horowitz MB. Clinical evaluation of exertional dyspnea. Clinics in Chest Medicine 1994; 15: 259-269.
- 23. Borg GA. Psychophysical bases of perceived exertion. Medicine & Science in Sports & Exercise 1982.
- 24. Aydemir Ö. Validity and reliability of Turkish version of Hospital Anxiety and Depression Scale. Türk Psikiyatri Dergisi 1997; 8: 187-280 (in Turkish).
- 25. Kücükdeveci AA, McKenna SP, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. International Journal of Rehabilitation Research. 2000; 23: 31- 38. doi: 10.1097/00004356-200023010-00004
- 26. Andresen EM. Criteria for assessing the tools of disability outcomes research. Archives of Physical Medicine and Rehabilitation 2000; 81: S15-20. doi: 10.1053/apmr.2000.20619
- 27. Munro BH. Statistical methods for health care research. Pennsylvania, PA, USA: Lippincott Williams & Wilkins, 2005.
- 28. Gruenberger JB, Vietri J, Keininger DL, Mahler DA. Greater dyspnea is associated with lower health-related quality of life among European patients with COPD. International Journal of Chronic Obstructive Pulmonary Disease 2017; 12: 937-944. doi: 10.2147/copd.S123744
- 29. Banzett RB, Adams L, O’Donnell CR, Gilman SA, Lansing RW, Schwartzstein RM. Using laboratory models to test treatment: morphine reduces dyspnea and hypercapnic ventilatory response. American Journal of Respiratory and Critical Care Medicine 2011; 184: 920-927. doi: 10.1164/rccm.201101- 0005OC
- 30. O’Donnell CR, Schwartzstein RM, Lansing RW, Guilfoyle T, Elkin D, Banzett RB. Dyspnea affective response: comparing COPD patients with healthy volunteers and laboratory model with activities of daily living. BMC Pulmonary Medicine 2013; 13: 27-27. doi: 10.1186/1471-2466-13-27
- 31. Nunnally J, Bernstein D. Psychometric theory. 3rd edition. New York: McGraw-Hill, 1994.