Abstract
Background/aimDyspnea is the subjective feeling of breathing discomfort, which is a significant problem for patients with heart and respiratory disease and also an important determinant of exercise tolerance, quality of life, and mortality in various diseases. Most of the scales are not enough to investigate the multidimensional effects of dyspnea; therefore, the Multidimensional Dyspnea Profile (MDP) was developed and validated in many languages. This study aimed to translate and culturally adapt the MDP into Turkish and investigate the psychometric properties of this adapted version in outpatients with respiratory disease.Materials and methodsThe MDP was translated and culturally adapted into Turkish following published guidelines. A total of 170 outpatients with respiratory disease were included to assess psychometric properties. The factorial structure was investigated using a principal component analysis. Two situations were used in this study evaluating dyspnea in activity-related and resting conditions. We formulated 17 hypotheses for each MDP domain (in total 68) to assess construct validity, and correlations were investigated between the MDP and measures of body mass index, pulmonary function test, other dyspnea assessments, anxiety, depression, and health-related quality of life. To investigate the test-retest reliability, the MDP was administered again after 1-h and 1 week.ResultsInternal consistency of the MDP was excellent (Cronbach’s alpha coefficients ranged from 0.89 to 0.93). The exploratory factor analysis revealed 2 components explaining a 70% and 76% variance. Overall, 64 of the 68 predetermined hypotheses (94%) were confirmed to test construct validity. The MDP showed excellent test-retest reliability for a 1-hperiod (intraclass correlation coefficient values ranged from 0.98 to 0.99). However, test-retest reliability decreased moderate-to-high after 1 week (0.53–0.80).ConclusionThe MDP was successfully translated and culturally adapted into Turkish and this version showed good psychometric properties including the factorial structure, internal consistency, test-retest reliability, and construct validity to assess multidimensional aspects of dyspnea.
Highlights
Background/aim: Dyspnea is the subjective feeling of breathing discomfort, which is a significant problem for patients with heart and respiratory disease and an important determinant of exercise tolerance, quality of life, and mortality in various diseases
To further support the divergent validity of the Multidimensional Dyspnea Profile (MDP), we investigated the correlations with body mass index (BMI) and found no significant correlation per Meek et al [5]
We investigated the psychometric properties of the MDP in a quite different population including outpatients with different respiratory diseases, and found similar reliability and validity results
Summary
Dyspnea is the subjective feeling of breathing discomfort, which is a significant problem for patients with heart and respiratory disease [1]. Most of the common dyspnea measurements do not adequately assess the complexity of dyspnea [5] Scales such as the Visual Analogue Scale (VAS) and the Modified Borg. Scale (MBS) are used to measure the severity of dyspnea in unidimensional [6,7], or the Baseline/ Transitional Dyspnea Index (BDI/TDI) and the modified Medical Research Council (mMRC) Scale are used to assess the effects of dyspnea on exercise capacity [8]. Unidimensional scales are specific for a time point (current or recalled) but do not evaluate the quality of unpleasantness, breathing discomfort, or related emotional experiences. These scales are not enough to investigate the multidimensional effects of dyspnea in individuals with chronic pulmonary disease
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