Abstract
BackgroundTo broaden the range of outcomes that we can measure for patients undergoing treatment for oncological and other chronic conditions, we aimed to validate a questionnaire measuring self-reported autonomic regulation (aR), i.e. to characterise a subject's autonomic functioning by questions on sleeping and waking, vertigo, morningness-eveningness, thermoregulation, perspiration, bowel movements and digestion.MethodsWe administered the questionnaire to 440 participants (♀: N = 316, ♂: N = 124): 95 patients with breast cancer, 49 with colorectal cancer, 60 with diabetes mellitus, 39 with coronary heart disease, 28 with rheumatological conditions, 32 with Hashimoto's disease, 22 with multiple morbidities and 115 healthy people. We administered the questionnaire a second time to 50.2% of the participants. External convergence criteria included the German version of the Hospital Anxiety and Depression Scale (HADS-D), a short questionnaire on morningness-eveningness, the Herdecke Quality of Life Questionnaire (HLQ) and a short version questionnaire on self-regulation.ResultsA principal component analysis yielded a three dimensional 18-item inventory of aR. The subscales orthostatic-circulatory, rest/activity and digestive regulation had internal consistency (Cronbach-α: rα = 0.65 – 0.75) and test-retest reliability (rrt = 0.70 – 85). AR was negatively associated with anxiety, depression, and dysmenorrhoea but positively correlated to HLQ, self-regulation and in part to morningness (except digestive aR) (0.49 – 0.13, all p < 0.05).ConclusionAn internal validation of the long-version scale of aR yielded consistent relationships with health versus illness, quality of life and personality. Further studies are required to clarify the issues of external validity, clinical and physiological relevance.
Highlights
To broaden the range of outcomes that we can measure for patients undergoing treatment for oncological and other chronic conditions, we aimed to validate a questionnaire measuring self-reported autonomic regulation, i.e. to characterise a subject's autonomic functioning by questions on sleeping and waking, vertigo, morningness-eveningness, thermoregulation, perspiration, bowel movements and digestion
A loss of nocturnal cardio-respiratory coordination was seen in patients with diabetes mellitus and with breast cancer, where the grade of loss was dependent on the severity of the illness [9]
We invited 475 people to participate in our study; 452 consented (95%) and we had complete data on 440 participants (93%)
Summary
To broaden the range of outcomes that we can measure for patients undergoing treatment for oncological and other chronic conditions, we aimed to validate a questionnaire measuring self-reported autonomic regulation (aR), i.e. to characterise a subject's autonomic functioning by questions on sleeping and waking, vertigo, morningness-eveningness, thermoregulation, perspiration, bowel movements and digestion. General inventories of health-related quality of life (HRQL) have established that patients with psychosomatic symptoms can have greater impairments of HRQL and daily functioning, than severely ill patients suffering from chronic physical conditions [1,2]. We aimed to develop a questionnaire that measures physical symptoms related to autonomic function across a range of chronic conditions and that was sensitive enough to capture both somatic functions and somatic functional loss [4]. Measured circadian rhythm markers have been shown to be relevant for recording health [5] and illness [6]. Reduced heart rate variability (HRV) is a risk factor for increased mortality in various chronic conditions illnesses including diabetes and coronary heart disease [8]. Affective and autonomic disorders have been reported in manifest and latent hypothyroidism [11]
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