Internal Consistency and Validity of the Spanish Version of the St. George' Respiratory Questionnaire for Use in Patients With Clinically Stable Bronchiectasis

Abstract

To analyze the reliability and validity of the St. George's Respiratory Questionnaire (SGRQ) for use in patients with clinically stable bronchiectasis. The SGRQ (50 items on 3 scales--symptoms, activity, and impact) was administered to 102 patients (mean [SD] age, 69.5 [8.7] years; 63% men) with clinically stable bronchiectasis. Disease severity was classified according parameters such as airflow obstruction (forced expiratory volume in 1 second), colonization by Pseudomonas aeruginosa, extent of bronchiectasis, symptoms, daily quantity of sputum, and number of exacerbations. Internal consistency (Cronbach's alpha and correlation between items and between item and scale), concurrent validity (correlation between items and clinical variables), predictive validity (correlation between items and severity), and construct validity (factorial analysis of main components) were assessed. The internal consistency of the SGRQ was excellent (Cronbach's alpha between 0.81 and 0.87 for the different scales, and 0.90 for the overall score). Concurrent validity was high, as correlations between items and clinical variables were significant and followed the expected distribution. The SGRQ differentiated between degrees of disease severity, regardless of the clinical variable used. The factorial analysis showed a construct of 4 factors that were only moderately similar to the original structure of the questionnaire, due mainly to inclusion of a small number of questions with conditioned response and others with low discriminatory capacity. The SGRQ shows excellent concurrent and predictive internal consistency and validity, though restructuring of the original construct would be advisable before use in patients with stable bronchiectasis.