Article

OBJECTIVES: To develop and test a prototype dyspnea computer adaptive test (CAT).
DESIGN: Prospective study. SETTING: Two outpatient medical facilities.
PARTICIPANTS: A convenience sample of adults (N=292) with chronic obstructive
pulmonary disease (COPD). INTERVENTIONS: Not applicable. We developed a modified and expanded item bank and CAT for the Dyspnea Management
Questionnaire (DMQ), an outcome measure consisting of 4 dyspnea dimensions:
dyspnea intensity, dyspnea anxiety, activity avoidance, and activity
self-efficacy. RESULTS: Factor analyses supported a 4-dimensional model
underlying the 71 DMQ items. The DMQ item bank achieved acceptable Rasch model
fit statistics, good measurement breadth with minimal floor and ceiling effects,
and evidence of high internal consistency reliability (alpha=.92-.98). With the
use of CAT simulation analyses, the DMQ-CAT showed high measurement accuracy
compared with the total item pool (r=.83-.97, P<.0001) and evidence of good to
excellent concurrent validity (r=-.61 to -.80, P<.0001). All DMQ-CAT domains
showed evidence for known-groups validity (P</=.001). CONCLUSIONS: The DMQ-CAT
reliably and validly captured 4 distinct dyspnea domains. Multidimensional
dyspnea assessment in COPD is needed to better measure the effectiveness of
pharmacologic, pulmonary rehabilitation, and psychosocial interventions in not
only alleviating the somatic sensation of dyspnea but also reducing dysfunctional
emotions, cognitions, and behaviors associated with dyspnea, especially for
anxious patients.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS