Dyspnea Outcome Instrument for COPD Research

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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.