title: Development and psychometric properties of the Pulmonary-specific Quality-of-Life Scale in lung transplant patients.
abstract: BACKGROUND
  The Pulmonary-specific Quality-of-Life Scale (PQLS) was developed to measure quality of life (QoL) among patients awaiting lung transplant. The objective of this study was to determine the psychometric properties of the PQLS, identify empirically derived sub-scales, and examine ability to detect changes in pulmonary-specific QoL scores after lung transplantation.
  
  
  METHODS
  Data were derived from the INSPIRE trial, a dual-site randomized controlled trial of coping skills training in 389 lung transplant candidates (obstructive [48.3%], restrictive [24.2%], cystic fibrosis [13.6%], and other [13.9%]). Cronbach alpha was calculated to assess the internal reliability of the PQLS (n = 388). Test-retest reliability was assessed with correlation coefficients between baseline and 12-week post-baseline scores for the usual care control condition (n = 140). Convergent validity was assessed with correlation coefficients between the PQLS and established measures of QoL and emotional distress, 6-minute walk test distance, forced expiratory volume in 1 second, and use of supplemental oxygen at rest (n = 388). Change from baseline to 6 months post-transplantation was assessed with repeated measures analysis of variance (n = 133).
  
  
  RESULTS
  The PQLS was internally reliable and stable across 12 weeks. The PQLS correlated strongly with QoL measures (e.g., Shortness of Breath Questionnaire, r = 0.78, p < 0.0001), moderately with mood and anxiety (e.g., Beck Depression Inventory-II, r = 0.59, p < 0.0001), and modestly with lung disease severity (e.g., 6-minute walk test, r = -0.41, p < 0.0001). PQLS scores improved by nearly 2 SDs after transplant.
  
  
  CONCLUSIONS
  These results demonstrated the reliability, validity, and sensitivity to change of the PQLS for measuring pulmonary QoL among patients with advanced lung disease and the responsiveness of the PQLS to changes in QoL after lung transplantation.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina. Electronic address: Benson.Hoffman@Duke.edu.
authors.forename: Benson M
authors.initials: BM
authors.lastname: Hoffman
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Stonerock
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Smith
authors.affiliation: Department of Psychiatry, Drexel University College of Medicine, Philadelphia, Pennsylvania.
authors.forename: C Virginia F
authors.initials: CV
authors.lastname: O'Hayer
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: Scott
authors.initials: S
authors.lastname: Palmer
authors.affiliation: Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Davis
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, New York.
authors.forename: Keiko
authors.initials: K
authors.lastname: Kurita
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Carney
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Freeland
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: James A
authors.initials: JA
authors.lastname: Blumenthal
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000523:psychology* / Q000601:surgery*; D016040:Lung Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014850:Waiting Lists; D055815:Young Adult
keywords: COPD; cystic fibrosis; lung transplant; pulmonary fibrosis; quality of life