Cited by 369Chronic Obstructive Pulmonary Disease (COPD) ResearchHealth Education and ValidationPsychometric Methodologies and Testing

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Quantification of dyspnoea using descriptors: development and initial testing of the Dyspnoea-12

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Yorke, J, Moosavi, S H, Shuldham, C, Jones, P W·2010·Thorax

DOI 10.1136/thx.2009.118521PMC PMC2795166

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Abstract

RATIONALE: Dyspnoea is a debilitating and distressing symptom that is reflected in different verbal descriptors. Evidence suggests that dyspnoea, like pain perception, consists of sensory quality and affective components. The objective of this study was to develop an instrument that measures overall dyspnoea severity using descriptors that reflect its different aspects. METHODS: 81 dyspnoea descriptors were administered to 123 patients with chronic obstructive pulmonary disease (COPD), 129 with interstitial lung disease and 106 with chronic heart failure. These were reduced to 34 items using hierarchical methods. Rasch analysis informed decisions regarding further item removal and fit to the unidimensional model. Principal component analysis (PCA) explored the underlying structure of the final item set. Validity and reliability of the new instrument were further assessed in a separate group of 53 patients with COPD. RESULTS: After removal of items with hierarchical methods (n = 47) and items that failed to fit the Rasch model (n = 22), 12 were retained. The "Dyspnoea-12" had good internal reliability (Cronbach's alpha = 0.9) and fit to the Rasch model (chi(2) p = 0.08). Items patterned into two groups called "physical"(n = 7) and "affective"(n = 5). In the separate validation study, Dyspnoea-12 correlated with the Hospital Anxiety and Depression Scale (anxiety r = 0.51; depression r = 0.44, p<0.001, respectively), 6-minute walk distance (r = -0.38, p<0.01) and MRC (Medical Research Council) grade (r = 0.48, p<0.01), and had good stability over time (intraclass correlation coefficient = 0.9, p<0.001). CONCLUSION: Dyspnoea-12 fulfills modern psychometric requirements for measurement. It provides a global score of breathlessness severity that incorporates both "physical" and "affective" aspects, and can measure dyspnoea in a variety of diseases.

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Authors: Yorke, J., Moosavi, S. H., Shuldham, C., & Jones, P. W.
Affiliations: University of Salford (GB)
Charing Cross Hospital (GB)
Royal Brompton & Harefield NHS Foundation Trust (GB)
St George's, University of London (GB)
Corresponding author: Yorke, J
ORCID: Yorke, J
Moosavi, S H
Jones, P W
Venue: Thorax
Publisher: BMJ
Published: 2009-12-08
Volume: 65
Issue: 1
Pages: 21-26
ISSN: 0040-6376 (ISSN-L)
DOI: 10.1136/thx.2009.118521
PMC: PMC2795166
OpenAlex: W2101443745
Cited by: 369
References: 36
Citations by year: 2026: 30 · 2025: 38 · 2024: 26 · 2023: 34 · 2022: 36 · 2021: 41 · 2020: 17 · 2019: 22 · 2018: 20 · 2017: 16 · 2016: 20 · 2015: 18 · 2014: 7 · 2013: 10 · 2012: 12
FWCI: 9.29
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Thorax (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
St George's Online Research Archive (St George's University of London) (acceptedVersion)
Research Explorer (The University of Manchester) (submittedVersion)
University of Salford Institutional Repository (University of Salford) (submittedVersion, cc-by)
HighWire Press Open Archive (submittedVersion)
Funders: Royal Brompton and Harefield NHS Foundation Trust
Action Medical Research
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Health Sciences › Nursing › Research and Theory › Health Education and Validation
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords: dyspnea, symptom assessment, chronic obstructive pulmonary disease, interstitial lung disease, chronic heart failure, Rasch analysis, psychometric validation, anxiety and depression
MeSH terms: Aged, Anxiety Disorders, Chronic Disease, Depressive Disorder, Disability Evaluation, Dyspnea, Epidemiologic Methods, Female, Heart Failure, Humans, Male, Terminology as Topic, Psychometrics, Lung Diseases, Interstitial, Pulmonary Disease, Chronic Obstructive

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Quantification of dyspnoea using descriptors: development and initial testing of the Dyspnoea-12

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