title: Portuguese validation of the Cambridge pulmonary hypertension outcome review (CAMPHOR) questionnaire.
abstract: BACKGROUND
  Patients with pulmonary arterial hypertension (PAH) and other forms of precapillary pulmonary hypertension (PH) have impaired quality of life (QoL). The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is a PH-specific patient-reported outcome measure that assesses symptoms, activity limitations and QoL. It was originally developed in UK-English. The main objective of this study was to create an adaptation of the CAMPHOR suitable for a Portuguese-speaking population.
  
  
  METHODS
  A multi-step approach was followed: bilingual and lay panel translation; cognitive debriefing interviews; and psychometric testing in repeated postal surveys (2 weeks apart) including assessment of internal consistency, reproducibility and validity. The Nottingham Health Profile (NHP) questionnaire was used as a comparator instrument to test convergent validity.
  
  
  RESULTS
  The CAMPHOR was translated without difficulty by the two panels. Cognitive debriefing interviews showed the questionnaire was easily understood and considered relevant to patients' experience with their illness. Psychometric evaluation was performed with 50 PAH patients (47 ± 14 years, 37 women). Cronbach's alpha coefficients showed good internal consistency for the three CAMPHOR scales [Symptoms = 0.95; Activities = 0.93 and QoL = 0.94]. Test-retest coefficients showed that all scales had excellent reliability (Symptoms = 0.94; Activities = 0.89 and QoL = 0.93), indicating low levels of random measurement error. The CAMPHOR correlated as expected with the NHP. The magnitude of correlations followed a similar pattern to those in the original development study. The CAMPHOR also exhibited evidence of known group validity in its ability to distinguish between self-reported severity and general health groups.
  
  
  CONCLUSIONS
  A valid and reliable version of the CAMPHOR questionnaire for the European Portuguese-speaking population was developed and is recommended for use.
authors.affiliation: Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto-Hospital de Santo António, Largo Professor Abel Salazar, 4099-001, Porto, Portugal. reisabilio@gmail.com.
authors.forename: Abílio
authors.initials: A
authors.lastname: Reis
authors.affiliation: Galen Research Ltd, Manchester, UK.
authors.forename: James
authors.initials: J
authors.lastname: Twiss
authors.affiliation: Department of Health Sciences, University of Aveiro, Aveiro, Portugal.
authors.forename: Margarida
authors.initials: M
authors.lastname: Vicente
authors.affiliation: Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto-Hospital de Santo António, Largo Professor Abel Salazar, 4099-001, Porto, Portugal.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Gonçalves
authors.affiliation: Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto-Hospital de Santo António, Largo Professor Abel Salazar, 4099-001, Porto, Portugal.
authors.forename: Luísa
authors.initials: L
authors.lastname: Carvalho
authors.affiliation: Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto-Hospital de Santo António, Largo Professor Abel Salazar, 4099-001, Porto, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Meireles
authors.affiliation: Pulmonary Vascular Disease Unit, Medicine Department, Centro Hospitalar do Porto-Hospital de Santo António, Largo Professor Abel Salazar, 4099-001, Porto, Portugal.
authors.forename: Alzira
authors.initials: A
authors.lastname: Melo
authors.affiliation: Galen Research Ltd, Manchester, UK.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: McKenna
authors.affiliation: Department of Health Sciences, University of Aveiro, Aveiro, Portugal.|Faculty of Medicine, Department of Pharmacology & Therapeutics, University of Porto, Porto, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Almeida
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D000071066:Patient Reported Outcome Measures; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D014175:Translating; D014177:Translations
keywords: CAMPHOR; Nottingham Health Profile; Portuguese adaptation; Precapillary pulmonary hypertension; Pulmonary arterial hypertension; Pulmonary hypertension; Quality of life