Test–retest reliability of multidimensional dyspnea profile recall ratings in the emergency department: a prospective, longitudinal study

BMC Emergency Medicine - Tập 12 - Trang 1-10 - 2012
Mark B Parshall1, Paula M Meek2, David Sklar3, Joe Alcock3,4, Paula Bittner1
1University of New Mexico College of Nursing, MSC 09–5350, 1 University of New Mexico, Albuquerque, USA
2College of Nursing, University of Colorado College of Nursing Denver, Aurora, USA
3University of New Mexico School of Medicine, Department of Emergency Medicine, MSC 10 5560, 1 University of New Mexico, Albuquerque, USA
4Emergency Medicine Service, Raymond G. Murphy VA Medical Center, Albuquerque, USA

Tóm tắt

Dyspnea is among the most common reasons for emergency department (ED) visits by patients with cardiopulmonary disease who are commonly asked to recall the symptoms that prompted them to come to the ED. The reliability of recalled dyspnea has not been systematically investigated in ED patients. Patients with chronic or acute cardiopulmonary conditions who came to the ED with dyspnea (N = 154) completed the Multidimensional Dyspnea Profile (MDP) several times during the visit and in a follow-up visit 4 to 6 weeks later (n = 68). The MDP has 12 items with numerical ratings of intensity, unpleasantness, sensory qualities, and emotions associated with how breathing felt when participants decided to come to the ED (recall MDP) or at the time of administration (“now” MDP). The recall MDP was administered twice in the ED and once during the follow-up visit. Principal components analysis (PCA) with varimax rotation was used to assess domain structure of the recall MDP. Internal consistency reliability was assessed with Cronbach’s alpha. Test–retest reliability was assessed with intraclass correlation coefficients (ICCs) for absolute agreement for individual items and domains. PCA of the recall MDP was consistent with two domains (Immediate Perception, 7 items, Cronbach’s alpha = .89 to .94; Emotional Response, 5 items; Cronbach’s alpha = .81 to .85). Test–retest ICCs for the recall MDP during the ED visit ranged from .70 to .87 for individual items and were .93 and .94 for the Immediate Perception and Emotional Response domains. ICCs were much lower for the interval between the ED visit and follow-up, both for individual items (.28 to .66) and for the Immediate Perception and Emotional Response domains (.72 and .78, respectively). During an ED visit, recall MDP ratings of dyspnea at the time participants decided to seek care in the ED are reliable and sufficiently stable, both for individual items and the two domains, that a time lag between arrival and questionnaire administration does not critically affect recall of perceptual and emotional characteristics immediately prior to the visit. However, test–retest reliability of recall over a 4- to 6-week interval is poor for individual items and significantly attenuated for the two domains.

Tài liệu tham khảo

Gallagher EJ, Bijur PE, Latimer C, Silver W: Reliability and validity of a visual analog scale for acute abdominal pain in the ED. Am J Emerg Med. 2002, 20 (4): 287-290. 10.1053/ajem.2002.33778. Bailey B, Daoust R, Doyon-Trottier E, Dauphin-Pierre S, Gravel J: Validation and properties of the verbal numeric scale in children with acute pain. Pain. 2010, 149 (2): 216-221. 10.1016/j.pain.2009.12.008. Newman-Toker DE, Cannon LM, Stofferahn ME, Rothman RE, Hsieh Y-H, Zee DS: Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting. Mayo Clin Proc. 2007, 82 (11): 1329-1340. 10.4065/82.11.1329. Diaz M, Braude D, Skipper B: Concordance of historical questions used in risk-stratifying patients with headache. Am J Emerg Med. 2007, 25 (8): 907-910. 10.1016/j.ajem.2007.02.003. Broderick JE, Stone AA, Calvanese P, Schwartz JE, Turk DC: Recalled pain ratings: a complex and poorly defined task. J Pain. 2006, 7 (2): 142-149. 10.1016/j.jpain.2005.09.012. Meek PM, Lareau SC, Anderson D: Memory for symptoms in COPD patients: how accurate are their reports?. Eur Respir J. 2001, 18 (3): 474-481. 10.1183/09031936.01.00083501. American Thoracic Society: Dyspnea. Mechanisms, assessment, and management: a consensus statement. Am J Respir Crit Care Med. 1999, 159 (1): 321-340. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, Calverley PM, Gift AG, Harver A, Lareau SC, et al: An Official ATS Statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012, 185 (4): 435-452. 10.1164/rccm.201111-2042ST. Aaron SD, Vandemheen KL, Clinch JJ, Ahuja J, Brison RJ, Dickinson G, Hébert PC: Measurement of short-term changes in dyspnea and disease-specific quality of life following an acute COPD exacerbation. Chest. 2002, 121 (3): 688-696. 10.1378/chest.121.3.688. Tsai C-L, Hodder RV, Page JH, Cydulka RK, Rowe BH, Camargo CA: The short-form Chronic Respiratory Disease Questionnaire was a valid, reliable, and responsive quality-of-life instrument in acute exacerbations of chronic obstructive pulmonary disease. J Clin Epidemiol. 2008, 61 (5): 489-497. 10.1016/j.jclinepi.2007.07.003. Kendrick KR, Baxi SC, Smith RM: Usefulness of the modified 0–10 Borg scale in assessing the degree of dyspnea in patients with COPD and asthma. J Emerg Nurs. 2000, 26 (3): 216-222. Saracino A: Validation of a verbal dyspnoea rating scale in the emergency department. Emerg Med Australas. 2008, 20 (6): 475-481. 10.1111/j.1742-6723.2008.01132.x. Mebazaa A, Pang PS, Tavares M, Collins SP, Storrow AB, Laribi S, Andre S, Mark Courtney D, Hasa J, Spinar J, et al: The impact of early standard therapy on dyspnoea in patients with acute heart failure: the URGENT-dyspnoea study. Eur Heart J. 2010, 31 (7): 832-841. 10.1093/eurheartj/ehp458. Saracino A, Weiland TJ, Jolly B, Dent AW: Verbal dyspnoea score predicts emergency department departure status in patients with shortness of breath. Emerg Med Australas. 2010, 22 (1): 21-29. 10.1111/j.1742-6723.2009.01254.x. Camargo CA, Tsai C-L, Clark S, Kenney PA, Radeos MS: Spirometric correlates of dyspnea improvement among emergency department patients with chronic obstructive pulmonary disease exacerbation. Respir Care. 2008, 53 (7): 892-896. Clark WC, Yang JC, Tsui S-L, Ng K-F, Bennett Clark S: Unidimensional pain rating scales: a multidimensional affect and pain survey (MAPS) analysis of what they really measure. Pain. 2002, 98 (3): 241-247. 10.1016/S0304-3959(01)00474-2. DeVellis RF: Scale Development: Theory and Applications 3rd edition. 2012, Sage, Thousand Oaks Streiner DL, Norman GR: Health Measurement Scales: A Practical Guide to Their Development and Use. 2008, Oxford University Press, Oxford, 4 Parshall MB: Psychometric characteristics of dyspnea descriptor ratings in emergency department patients with exacerbated chronic obstructive pulmonary disease. Res Nurs Health. 2002, 25 (5): 331-344. 10.1002/nur.10051. Shrout PE, Fleiss JL: Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979, 86 (2): 420-428. McGraw KO, Wong SP: Forming inferences about some intraclass correlation coefficients. Psychol Methods. 1996, 1 (1): 30-46. Weir JP: Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005, 19 (1): 231-240. Parshall MB, Carle AC, Ice U, Taylor R, Powers J: Validation of a 3-factor measurement model of dyspnea in hospitalized adults with heart failure. Heart Lung. 2012, 41 (1): 44-56. 10.1016/j.hrtlng.2011.05.003. Moy ML, Lantin ML, Harver A, Schwartzstein RM: Language of dyspnea in assessment of patients with acute asthma treated with nebulized albuterol. Am J Respir Crit Care Med. 1998, 158 (3): 749-753. Ekman I, Granger B, Swedberg K, Stenlund H, Boman K: Measuring shortness of breath in heart failure (SOB-HF): development and validation of a new dyspnoea assessment tool. Eur J Heart Fail. 2011, 13 (8): 838-845. 10.1093/eurjhf/hfr062. Banzett RB, Pedersen SH, Schwartzstein RM, Lansing RW: The affective dimension of laboratory dyspnea: air hunger is more unpleasant than work/effort. Am J Respir Crit Care Med. 2008, 177 (12): 1384-1390. 10.1164/rccm.200711-1675OC. 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. Am J Respir Crit Care Med. 2011, 184 (8): 920-927. 10.1164/rccm.201101-0005OC. Meek PM, Banzett RB, Parshall MB, Gracely RH, Schwartzstein RM, Lansing R: Reliability and validity of the multidimensional dyspnea profile (MDP). Chest. January 19, 2012 Lansing RW, Gracely RH, Banzett RB: The multiple dimensions of dyspnea: review and hypotheses. Respir Physiol Neurobiol. 2009, 167 (1): 53-60. 10.1016/j.resp.2008.07.012. Wade JB, Price DD, Hamer RM, Schwartz SM, Hart RP: An emotional component analysis of chronic pain. Pain. 1990, 40 (3): 303-310. 10.1016/0304-3959(90)91127-5. Gracely RH: Evaluation of multi-dimensional pain scales. Pain. 1992, 48 (3): 297-300. 10.1016/0304-3959(92)90076-N. Gracely RH: Affective dimensions of pain: how many and how measured?. Am Pain Soc J. 1992, 1 (4): 243-247. Price DD, Harkins SW: The affective-motivational dimension of pain: a two-stage model. Am Pain Soc J. 1992, 1 (4): 229-239. Wade JB, Dougherty LM, Archer CR, Price DD: Assessing the stages of pain processing: a multivariate analytical approach. Pain. 1996, 68 (1): 157-167. 10.1016/S0304-3959(96)03162-4. Price DD: Psychological and neural mechanisms of the affective dimension of pain. Science. 2000, 288 (5472): 1769-1772. 10.1126/science.288.5472.1769. Price DD: Central neural mechanisms that interrelate sensory and affective dimensions of pain. Mol Interv. 2002, 2 (6): 392-403. 10.1124/mi.2.6.392. Wilson RC, Jones PW: Differentiation between the intensity of breathlessness and the distress it evokes in normal subjects during exercise. Clin Sci. 1991, 80 (1): 65-70. Carrieri-Kohlman V, Gormley JM, Douglas MK, Paul SM, Stulbarg MS: Differentiation between dyspnea and its affective components. West J Nurs Res. 1996, 18 (6): 626-642. 10.1177/019394599601800602. Carrieri-Kohlman V, Gormley JM, Eiser S, Demir-Deviren S, Nguyen H, Paul SM, Stulbarg MS: Dyspnea and the affective response during exercise training in obstructive pulmonary disease. Nurs Res. 2001, 50 (3): 136-146. 10.1097/00006199-200105000-00002. Carrieri-Kohlman V, Donesky-Cuenco D, Park SK, Mackin L, Nguyen HQ, Paul SM: Additional evidence for the affective dimension of dyspnea in patients with COPD. Res Nurs Health. 2010, 23 (1): 4-19. Swigris JJ, Yorke J, Sprunger DB, Swearingen C, Pincus T, du Bois RM, Brown KK, Fischer A: Assessing dyspnea and its impact on patients with connective tissue disease-related interstitial lung disease. Respir Med. 2010, 104 (9): 1350-1355. 10.1016/j.rmed.2010.03.027. Yorke J, Moosavi SH, Shuldham C, Jones PW: Quantification of dyspnoea using descriptors: development and initial testing of the Dyspnoea-12. Thorax. 2010, 65 (1): 21-26. 10.1136/thx.2009.118521. Yorke J, Russell A-M, Swigris J, Shuldham C, Haigh C, Rochnia N, Hoyle J, Jones PW: Assessment of dyspnea in asthma: validation of the Dyspnea-12. J Asthma. 2011, 48 (6): 602-608. 10.3109/02770903.2011.585412. Yorke J, Swigris J, Russell A-M, Moosavi SH, Ng Man Kwong G, Longshaw M, Jones PW: Dyspnea-12 is a valid and reliable measure of breathlessness in patients with interstitial lung disease. Chest. 2011, 139 (1): 159-164. 10.1378/chest.10-0693. von Leupoldt A, Sommer T, Kegat S, Baumann HJ, Klose H, Dahme B, Buchel C: The unpleasantness of perceived dyspnea is processed in the anterior insula and amygdala. Am J Respir Crit Care Med. 2008, 177: 1026-1032. 10.1164/rccm.200712-1821OC. Wan L, Van Diest I, De Peuter S, Bogaerts K, Van den Bergh O: Repeated breathlessness experiences induced by hypercapnia: differential effects on intensity and unpleasantness. Chest. 2009, 135 (2): 455-461. 10.1378/chest.08-1226. Simon PM, Schwartzstein RM, Weiss JW, Lahive K, Fencl V, Teghtsoonian M, Weinberger SE: Distinguishable sensations of breathlessness induced in normal volunteers. Am Rev Respir Dis. 1989, 140 (4): 1021-1027. Simon PM, Schwartzstein RM, Weiss JW, Fencl V, Teghtsoonian M, Weinberger SE: Distinguishable types of dyspnea in patients with shortness of breath. Am Rev Respir Dis. 1990, 142 (5): 1009-1014. Elliott MW, Adams L, Cockcroft A, MacRae KD, Murphy K, Guz A: The language of breathlessness. Use of verbal descriptors by patients with cardiopulmonary disease. Am Rev Respir Dis. 1991, 144 (4): 826-832. Mahler DA, Harver A, Lentine T, Scott JA, Beck K, Schwartzstein RM: Descriptors of breathlessness in cardiorespiratory diseases. Am J Respir Crit Care Med. 1996, 154 (5): 1357-1363. Hardie GE, Janson S, Gold WM, Carrieri-Kohlman V, Boushey HA: Ethnic differences: word descriptors used by African-American and white asthma patients during induced bronchoconstriction. Chest. 2000, 117 (4): 935-943. 10.1378/chest.117.4.935. Harver A, Mahler DA, Schwartzstein RM, Baird JC: Descriptors of breathlessness in healthy individuals: distinct and separable constructs. Chest. 2000, 118 (3): 679-690. 10.1378/chest.118.3.679. Parshall MB, Welsh JD, Brockopp DY, Heiser RM, Schooler MP, Cassidy KB: Reliability and validity of dyspnea sensory quality descriptors in heart failure patients treated in an emergency department. Heart Lung. 2001, 30 (1): 57-65. 10.1067/mhl.2001.112499. Wilcock A, Crosby V, Hughes A, Fielding K, Corcoran R, Tattersfield AE: Descriptors of breathlessness in patients with cancer and other cardiorespiratory diseases. J Pain Symptom Manage. 2002, 23 (3): 182-189. 10.1016/S0885-3924(01)00417-1. Williams M, Garrard A, Cafarella P, Petkov J, Frith P: Quality of recalled dyspnoea is different from exercise-induced dyspnoea: an experimental study. Aust J Physiother. 2009, 55 (3): 177-183. 10.1016/S0004-9514(09)70078-9. 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 (2): 315-322. 10.1378/chest.09-2498. Bianchi R, Gigliotti F, Romagnoli I, Lanini B, Castellani C, Binazzi B, Stendardi L, Bruni GI, Scano G: Impact of a rehabilitation program on dyspnea intensity and quality in patients with chronic obstructive pulmonary disease. Respiration. 2011, 81 (3): 186-195. 10.1159/000273675. Harver A, Schwartzstein RM, Kotses H, Humphries CT, Schmaling KB, Mullin ML: Descriptors of breathlessness in children with persistent asthma. Chest. 2011, 139 (4): 832-838. 10.1378/chest.10-2388. Hodges JL, Lehmann EL: Estimates of location based on ranks. Ann Math Stat. 1963, 34: 598-611. 10.1214/aoms/1177704172. Hunter M, Philips C, Rachman S: Memory for pain. Pain. 1979, 6 (1): 35-46. 10.1016/0304-3959(79)90138-6. Beese A, Morley S: Memory for acute pain experience is specifically inaccurate but generally reliable. Pain. 1993, 53 (2): 183-189. 10.1016/0304-3959(93)90079-5. Norman GR, Streiner DL: Biostatistics: The Bare Essentials. 2007, People’s Medical Publishing House, Shelton, CT Nunnally JC, Bernstein IH: Psychometric Theory. 1994, McGraw-Hill, New York, 3 Tabachnick BG, Fidell LS: Using Multivariate Statistics. 2007, Pearson, Boston, 5 The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-227X/12/6/prepub