Comparative analysis of the psychometric parameters of two quality-of-life questionnaires, the SGRQ and CAT, in the assessment of patients with COPD exacerbations during hospitalization: A multicenter study

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Abstract

The aim of this study was to assess health-related quality of life (HRQL) in patients with chronic obstructive pulmonary disease (COPD) and to discuss the different tools available for its assessment. The most widely used assessments are the St. George respiratory questionnaire (SGRQ) and the COPD assessment test (CAT) questionnaire. Both have a different difficulty in exam completion, calculation, and scoring. No studies exist that analyze the validity and internal consistency of using both questionnaires on patients admitted to the hospital for a COPD exacerbation. A multicenter, cross-sectional analytic observational study of patients admitted to the hospital due to a COPD exacerbation (CIE 491.2). During their hospital stay, they were administered the SGRQ and the CAT questionnaire within the framework of a therapeutic education program (APRENDEPOC). Descriptive and comparative analysis, correlations between the scales (Pearson’s correlation index), consistency and reliability calculations (Cronbach’s α), and a forward stepwise multiple linear regression were performed, with significant correlations in both questionnaires considered p < 0.01 with the total scores. A statistical significance of p < 0.05 was assumed. Altogether, 231 patients were admitted for a COPD exacerbation ( n = 77) at Hospital Clínic of Barcelona (HCB) and ( n = 154) at Hospital Universitario General of Castellón (HUGC). The sample profile was not homogeneous between both centers, with significant differences in HRQL between hospitals. Correlation were noted between both scales ( p < 0.01), along with high levels of internal consistency and reliability (CAT 0.836 vs. SGRQ 0.827). The HRQL is related to dyspnea, wheezing, daytime drowsiness, and edema, as well as to the need to sleep in a sitting position, anxiety, depression, and dependence on others in the execution of daily activities. Our regression analysis showed that the SGRQ questionnaire could predict more changes in HRQL with a higher number of variables.

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Validity and reliability of the St George's Respiratory Questionnaire after adaptation to a different language and culture: the Spanish example.

Abdel Azim A Khalaf, J Anto, R Marrades … (1996)

We describe the adaptation into Spanish of the St George's Respiratory Questionnaire (SGRQ), a self-administered questionnaire developed by Jones et al. (1991) covering three domains of health in airways disease patients: symptoms, activity and impacts. For the adaptation, the forward and back-translation method by bilinguals was used, together with professional committee and lay panel. Once tested for feasibility and comprehension, 318 male chronic obstructive pulmonary disease (COPD) patients with a wide range of disease severity completed the Spanish version of the SGRQ. The clinical status of the patients was evaluated concurrently with the measurement of health status. Lung function was assessed in the 2 months before or after the questionnaire administration. The Spanish version of the SGRQ was acceptable and easy to understand. Cronbach's alpha reliability coefficient was 0.94 for the overall scale and 0.72 for "Symptoms", 0.89 for "Activity", and 0.89 for "Impacts" subscales. Correlation coefficients between the overall score and dyspnoea and % forced expiratory volume in one second (FEV1) were 0.59 and -0.45, respectively, and these correlations were higher than those observed between the clinical variables and the Nottingham Health Profile, a generic measure of health-related quality of life. Results of the study suggest that the Spanish version of the SGRQ is conceptually equivalent to the original, and similarly reliable and valid. Although further studies should complete the adaptation work, results suggest that the SGRQ may already be used in Spain and in international studies involving Spanish respiratory patients. According to the present approach, it appears to be feasible to adapt a specific questionnaire on health-related quality of life in respiratory disease to another language and culture.

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Factors that influence disease-specific quality of life or health status in patients with COPD: a review and meta-analysis of Pearson correlations.

Tsiligianni Ioanna, Janwillem Kocks, Nikolaos Tzanakis … (2011)

A major goal in the management of chronic obstructive pulmonary disease (COPD) is to ensure that the burden of the disease for patients with COPD is limited and that patients will have the best possible quality of life. To explore all the possible factors that could influence disease-specific quality of life and health status in patients with COPD. A systematic review of the literature and a meta-analysis were performed to explore the factors that could have a positive or negative effect on quality of life and/or health status in patients with COPD. Quality of life and health status are determined by certain factors included gender, disease severity indices, lung function parameters, body mass index, smoking, symptoms, co-morbidity, depression, anxiety, and exacerbations. Factors such as dyspnoea, depression, anxiety and exercise tolerance were found to be more correlated with health status than the widely used spirometric values. Forced expiratory volume in one second had a weak to modest Pearson weighted correlation coefficient which ranged from -0.110 to -0.510 depending on the questionnaire used. The broad range of determining factors suggests that, in order to reach the management goals, health status should be measured in addition to lung function in patients with COPD.

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Creating scenarios of the impact of copd and their relationship to copd assessment test (CAT™) scores

Paul W Jones, Margaret Tabberer, Wen-Hung Chen (2011)

Background The COPD Assessment Test (CAT™) is a new short health status measure for routine use. New questionnaires require reference points so that users can understand the scores; descriptive scenarios are one way of doing this. A novel method of creating scenarios is described. Methods A Bland and Altman plot showed a consistent relationship between CAT scores and scores obtained with the St George's Respiratory Questionnaire for COPD (SGRQ-C) permitting a direct mapping process between CAT and SGRQ items. The severity associated with each CAT item was calculated using a probabilistic model and expressed in logits (log odds of a patient of given severity affirming that item 50% of the time). Severity estimates for SGRQ-C items in logits were also available, allowing direct comparisons with CAT items. CAT scores were categorised into Low, Medium, High and Very High Impact. SGRQ items of corresponding severity were used to create scenarios associated with each category. Results Each CAT category was associated with a scenario comprising 12 to 16 SGRQ-C items. A severity 'ladder' associating CAT scores with exemplar health status effects was also created. Items associated with 'Low' and 'Medium' Impact appeared to be subjectively quite severe in terms of their effect on daily life. Conclusions These scenarios provide users of the CAT with a good sense of the health impact associated with different scores. More generally they provide a surprising insight into the severity of the effects of COPD, even in patients with apparently mild-moderate health status impact.

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Author and article information

Journal

Journal ID (nlm-ta): Chron Respir Dis

Journal ID (iso-abbrev): Chron Respir Dis

Journal ID (publisher-id): CRD

Journal ID (hwp): spcrd

Title: Chronic Respiratory Disease

Publisher: SAGE Publications (Sage UK: London, England )

ISSN (Print): 1479-9723

ISSN (Electronic): 1479-9731

Publication date (Electronic): 12 March 2018

Publication date (Print): November 2018

Volume: 15

Issue: 4

Pages: 374-383

Affiliations

[1 ]Universitat Jaume I, Castellón, Spain

[2 ]Universidad de Alicante, Alicante, Spain

[3 ]Hospital Clínic de Barcelona, Barcelona, Spain

Author notes

[*]Ana Folch Ayora, Facultad Ciencias de la Salud, Unidad Predepartamental de enfermería, Universitat Jaume I, Av. de Vicente Sos Baynat, s/n, cp: 12071 Castellón de la Plana, Spain. Email: afolch@ 123456uji.es

Author information

Ana Folch Ayora http://orcid.org/0000-0002-0210-6162

María Isabel Orts-Cortés http://orcid.org/0000-0002-1504-575X

Article

Publisher ID: 10.1177_1479972318761645

DOI: 10.1177/1479972318761645

PMC ID: 6234566

PubMed ID: 29529879

SO-VID: 29001681-4c06-455d-8545-84ffd3266680

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This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 19 July 2017

Date accepted : 21 January 2018

Funding

Funded by: Sociedad Española de Neumología y Cirugía Torácica, https://doi.org/10.13039/501100007509;

Comparative analysis of the psychometric parameters of two quality-of-life questionnaires, the SGRQ and CAT, in the assessment of patients with COPD exacerbations during hospitalization: A multicenter study

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Most cited references 32

Validity and reliability of the St George's Respiratory Questionnaire after adaptation to a different language and culture: the Spanish example.

Factors that influence disease-specific quality of life or health status in patients with COPD: a review and meta-analysis of Pearson correlations.

Creating scenarios of the impact of copd and their relationship to copd assessment test (CAT™) scores

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