title: The assessment of breathlessness in pulmonary arterial hypertension: reliability and validity of the Dyspnoea-12.
abstract: Breathlessness is a cardinal symptom of pulmonary arterial hypertension (PAH); yet no breathlessness instrument has been previously tested for reliability and validity for this population. Using a cross-sectional design, we tested the psychometric properties of the Dyspnoea-12 (D-12), for the assessment of breathlessness in PAH. Pearson's correlations with World Health Organization functional class (WHO FC), Minnesota Living with Heart failure - pulmonary hypertension modified version (MLHF-PH), Hospital Anxiety and Depression scale (HADS) and 6-minute walk distance test (6MWD) were conducted. Participants (n = 176) were mostly female (70.5%), mean age 54.3±14 years; diagnosed with idiopathic PAH (48.9%), congenital heart disease (27.8%) and connective tissue disease (23.3%); and most were WHO FC II (32.4%) and III (52.3%). The D-12 showed excellent internal consistency for the total and two-component scores for physical and emotional (Cronbach's α 0.95, 0.93 and 0.94, respectively). D-12 total score was significantly associated with MLHF-PH (r = 0.70), HADS (anxiety r = 0.54 and depression r = 0.68), WHO FC (r = 0.49), and 6MWD (r = -0.26). In patients with PAH, the D-12 - a short patient reported measure of breathlessness severity that taps the physical and emotional components, is a reliable and valid instrument.
authors.affiliation: University of Manchester, UK Janelle.Yorke@manchester.ac.uk.
authors.forename: Janelle
authors.initials: J
authors.lastname: Yorke
authors.affiliation: Pulmonary Vascular Unit, Royal Hallamshire Hospital, Sheffield, UK.
authors.forename: Iain
authors.initials: I
authors.lastname: Armstrong
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004417:Dyspnea / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011594:Psychometrics; D015203:Reproducibility of Results; D018570:Risk Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires
keywords: Pulmonary arterial hypertension; breathlessness; dyspnoea; instrument design; patient assessment; patient reported outcome measure; psychometrics