Assessment of Dyspnea in Asthma: Validation of the Dyspnea-12
Open accessAbstract
BACKGROUND: Dyspnea is a prominent symptom in asthma. The Dyspnea-12 (D-12), an instrument that quantifies breathlessness using 12 descriptors that tap the physical and affective aspects, has shown promise for the measurement of dyspnea in cardiorespiratory disease. OBJECTIVE: We report the results of a study designed to test the validity and reliability of the D-12 in a population of patients with asthma. METHODS: This cross-sectional study included 102 patients with asthma. Subjects completed the D-12, Hospital Anxiety and Depression scale, St. George's Respiratory Questionnaire (SGRQ), and Medical Research Council scale. Confirmatory factor analysis confirmed the two-component structure of the D-12 (i.e., seven items that tap the physical aspects of breathlessness and five items that tap the affective aspects). RESULTS: The D-12 subscales had excellent internal reliability (Cronbach's alpha for the "physical" score was 0.94 and the affective score was 0.95). The D-12 physical component was more strongly correlated with SGRQ Symptoms (r = 0.648), SGRQ Activities (r = 0.635) and Medical Research Council grade (r = 0.636), while the affective component was more strongly correlated with SGRQ Impacts (r = 0.765) and Hospital Anxiety and Depression scale scores (anxiety r = 0.641 and depression r = 0.602). CONCLUSION: This study supports validity of the D-12 for use in the assessment of dyspnea of patients with asthma. It assesses one of the most pertinent symptoms of asthma from two viewpoints-physical and affective.
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Breathlessness is an important outcome in asthma because it provides the patient with an alarm signal and is a vital component of self-monitoring.
“Breathlessness is an important outcome in asthma since it provides the patient with an alarm signal, making a vital component of self-monitoring [1,23].”
From A randomised controlled feasibility trial of Group Cognitive Behavioural Therapy for people with severe asthma (2017) · cites this paper as [23]
In the Dyspnoea-12 asthma validation study, Yorke et al. reported that the affective component had stronger correlations with the HAD questionnaire than the physical component.
“In the Dyspnoea-12 asthma validation study, Yorke et al. reported that the affective component had stronger correlations with the HAD questionnaire than the physical component [23].”
From A randomised controlled feasibility trial of Group Cognitive Behavioural Therapy for people with severe asthma (2017) · cites this paper as [23]
The D-12 allows assessment of the sensory and emotional components of dyspnoea, which is recommended by international scientific societies for dyspnoea evaluation.
“D-12,46,58 used in our study, allows the assessment of the sensory and emotional components of dyspnoea, which is recommended by international scientific societies for dyspnea evaluation.59”
From Physiotherapy Education and Breathing Retraining for Patients With Hyperventilation Syndrome: An Observational Study (2026) · cites this paper as [46]
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References 29 · Cited by 79
Research works printed but not linked: 4
- [6]Simon PM Schwartzstein RM Woodrow J Fencl V Teghtsoonian M Weinberger SE Distinguishable sensations of breathlessness in patients with shortness of breath Am J Resp Crit Care Med 1990 142 1009 1014 2240820
- [18]Yorke J Swigirs J Russell AM Moosavi SH Kwong G Ng Man Longshaw M Jones PW Dyspnoea-12 is a valid and reliable measure of breathlessness in patients with ILD Chest 2011 139 1 159 64 20595454 PMC3035488
- [24]ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories ATS statement: guidelines for the six-minute walk test Am J Respir Crit Care Med 2002 166 111e17 12091180
- [26]Suhr DD Exploratory or confirmatory factor analysis? 2006 Paper #200-31, 31st SAS users group international conference San Francisco
- Authors
- Yorke, J., Russell, A.-M., Swigris, J., Shuldham, C., Haigh, C., Rochnia, N., Hoyle, J., & Jones, P. W.
- Affiliations
- University of Salford (GB)
- Royal Brompton & Harefield NHS Foundation Trust (GB)
- Manchester Metropolitan University (GB)
- North Manchester General Hospital (GB)
- St George's, University of London (GB)
- Corresponding author
- Yorke, Janelle
- Venue
- Journal of Asthma
- Publisher
- Informa UK Limited
- Published
- 2011-06-02
- Volume
- 48
- Issue
- 6
- Pages
- 602-608
- ISSN
- 0277-0903 (ISSN-L)
- 1532-4303
- PMC
- PMC3149863
- OpenAlex
- W2139616518
- Cited by
- 79
- References
- 29
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 6 · 2023: 4 · 2022: 4 · 2021: 9 · 2020: 5 · 2019: 3 · 2018: 4 · 2017: 7 · 2016: 11 · 2015: 4 · 2014: 6 · 2013: 1 · 2012: 5
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Asthma (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- PubMed Central (acceptedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Funders
- Medical Research Council
- National Heart, Lung, and Blood Institute (K23HL092227)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- asthma, dyspnea, symptom assessment, psychometric validation, St George's Respiratory Questionnaire, anxiety and depression, Medical Research Council scale, internal consistency
- MeSH terms
- Adult, Asthma, Cross-Sectional Studies, Data Interpretation, Statistical, Dyspnea, Exercise Test, Female, Forced Expiratory Volume, Health Status, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Surveys and Questionnaires, Severity of Illness Index, Vital Capacity, Reproducibility of Results, Walking
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