Dyspnea Outcome Instrument for COPD Research

描述(申请人提供)：随着人口老龄化，预计患有慢性阻塞性肺疾病(COPD)的成年人人数将大幅上升。呼吸困难是COPD导致残疾的最常见症状。呼吸困难是指在多种生理、心理、社会和环境因素的影响下，对劳累的、不舒服的呼吸的感知和体验。多维呼吸困难评估是呼吸困难管理的重要组成部分。 本研究旨在开发并测试呼吸困难管理问卷(DMQ)的计算机适应性测验(CAT)版本。CAT测量方法的优势包括其比传统的固定形式的秤更高的精度、效率和实用性。本项目拟开发的100个项目的多维DMQ-CAT将包括呼吸困难强度、呼吸困难相关焦虑、恐惧活动回避和活动自我效能感的测量。它将解决现有COPD专用量表在有效衡量呼吸困难功能的不同方面的变化方面的不足，特别是在医疗和康复干预后的情感、认知和行为维度。国际功能、残疾和健康分类(ICF)和呼吸困难理论模型将构成DMQ-CAT的理论基础。 将使用横断面设计来校准和现场测试用于建立DMQ-CAT的题库，目标样本为200名在两个医院招募的患有COPD的成年人。使用验证性因素分析和项目反应理论模型对项目池的多维性进行评估。还将评估其因素结构、内部一致性信度、同时效度和区分效度。并与UCSD气短问卷、慢性呼吸系统疾病问卷(CRQ)、医院焦虑抑郁量表(HADS)、COPD自我效能量表进行比较。DMQ-CAT分数估计的准确性和精确度将通过将它们与管理总共100个题库的分数进行比较来评估。 传播和未来的研究将集中在医疗、康复和社区环境中的多点临床试验中使用和进一步测试DMQ-CAT。与公共卫生的相关性：这项研究解决了改进结果测量的重要需要，用于评估传统和新开发的医疗和康复干预措施的影响，这些干预措施旨在改善患有COPD的成年人的呼吸困难、功能和生活质量。授精和未来的研究将集中在医疗、康复和社区环境中的多点临床试验中使用和进一步测试DMQ-CAT。与公共卫生的相关性：这项研究解决了改善结果测量的重要需要，用于评估传统和新开发的医疗和康复干预的影响，这些干预旨在改善成人COPD患者的呼吸困难、功能和生活质量。

DESCRIPTION (provided by applicant): With the aging of the population, the number of adults living with chronic obstructive pulmonary disease (COPD) is expected to rise significantly. Dyspnea is the most prevalent symptom of COPD contributing to disability. Dyspnea is the perception and experience of labored, uncomfortable breathing influenced by multiple physiological, psychological, social, and environmental factors. Multidimensional dyspnea assessment is an important part of dyspnea management. This study aims to develop and test a prototype computer adaptive test (CAT) version of the Dyspnea Management Questionnaire (DMQ). Advantages of CAT measurement methodology include its greater precision, efficiency and practicality over traditional, fixed-form scales. The 100 item multidimensional DMQ- CAT to be developed in this project will consist of measures of dyspnea intensity, dyspnea-related anxiety, fearful activity avoidance, and self-efficacy for activity. It will address inadequacies in existing COPD-specific scales in efficiently measuring change in the different facets of dyspnea functioning, especially affective, cognitive, and behavioral dimensions, following medical and rehabilitation interventions. The International Classification of Functioning, Disability and Health (ICF) and the Dyspnea Theoretical Model will form the theoretical base of the DMQ-CAT. A cross-sectional design will be used to calibrate and field-test the item pool to be used to build the DMQ-CAT in a target sample of 200 adults with COPD recruited across two hospital settings. The multidimensionality of the item pool will be evaluated using confirmatory factor analysis and item response theory modeling. Its factor structure, internal consistency reliability, and concurrent and discriminate validity will also be evaluated. It will be compared with the UCSD Shortness of Breath Questionnaire, the Chronic Respiratory Disease Questionnaire (CRQ), the Hospital Anxiety and Depression Scale (HADS), and the COPD Self-Efficacy Scale. The accuracy and precision of DMQ-CAT score estimates will be evaluated by comparing them to scores derived from administering the total 100 item pool. Dissemination and future research will focus on using and further testing the DMQ-CAT in multi-site clinical trials in medical, rehabilitation, and community settings. Relevance to Public Health: This study addresses an important need for improved outcome measurement to be used to evaluate the impact of traditional and newly developed medical and rehabilitation interventions that purport to improve dyspnea, function, and quality of life of adults with COPD.Dissemination and future research will focus on using and further testing the DMQ-CAT in multi-site clinical trials in medical, rehabilitation, and community settings. Relevance to Public Health: This study addresses an important need for improved outcome measurement to be used to evaluate the impact of traditional and newly developed medical and rehabilitation interventions that purport to improve dyspnea, function, and quality of life of adults with COPD.