title: Validation of the Japanese Severe Respiratory Insufficiency Questionnaire in hypercapnic patients with noninvasive ventilation.
abstract: BACKGROUND
  The Severe Respiratory Insufficiency (SRI) Questionnaire was originally developed in German to assess health-related quality of life (HRQL) and was validated as a multidimensional instrument with high psychometric properties in chronic hypercapnic respiratory failure (CHRF) patients receiving noninvasive ventilation (NIV). We aimed to investigate the intercultural adaptation of the Japanese SRI Questionnaire and whether it is a reliable and valid HRQL questionnaire to administer to those patients.
  
  
  METHODS
  The SRI Questionnaire was adapted to Japanese using a translation and back-translation procedure, followed by equivalency assessment. It was validated in 56 stable outpatients receiving NIV for CHRF, primarily due to chronic obstructive pulmonary disease (COPD) and/or pulmonary tuberculosis sequelae.
  
  
  RESULTS
  Examination of the frequency distribution of the Japanese SRI Questionnaire showed that the subscales and summary were approximately normally distributed and well balanced. There were no significant differences in SRI scores between patients with COPD and pulmonary tuberculosis sequelae. Cronbach׳s α values representing internal consistency of seven SRI subscales ranged from 0.56 to 0.80; attendant symptoms and sleep had the lowest values. Cronbach׳s α value was 0.92 for the SRI summary. The SRI summary score was significantly related to all eight subscales of the Medical Outcomes Study 36-item short form, with correlation coefficients of 0.41-0.66.
  
  
  CONCLUSIONS
  The Japanese SRI Questionnaire was produced using a standardized procedure and an equivalency study. It has high psychometric properties with internal consistency and concurrent validity. The Japanese SRI Questionnaire can be used to assess HRQL in patients on NIV for CHRF.
authors.affiliation: Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: ogato@kuhp.kyoto-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Oga
authors.affiliation: Department of Respiratory Medicine and Allergy, Tosei General Hospital, Aichi, Japan. Electronic address: taniguchi@tosei.or.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Taniguchi
authors.affiliation: Department of Respiratory Medicine, Takatsuki Red Cross Hospital, Osaka, Japan. Electronic address: hideok@takatsuki.jrc.or.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Kita
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Minami-Kyoto Hospital, Kyoto, Japan. Electronic address: tsuboit@skyoto.hosp.go.jp.
authors.forename: Tomomasa
authors.initials: T
authors.lastname: Tsuboi
authors.affiliation: Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Hyogo, Japan. Electronic address: ktomii@kcho.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tomii
authors.affiliation: Department of Pulmonary Medicine, Ogaki Municipal Hospital, Gifu, Japan. Electronic address: morihide_ando@mac.com.
authors.forename: Morihide
authors.initials: M
authors.lastname: Ando
authors.affiliation: Department of Respiratory Medicine, Komaki City Hospital, Aichi, Japan. Electronic address: e-kojima@komakihp.gr.jp.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kojima
authors.affiliation: Department of Respiratory Medicine, Kobe City Medical Center West Hospital, Hyogo, Japan. Electronic address: htomy@kobe-nishishimin-hospi.jp.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Tomioka
authors.affiliation: Department of Respiratory Medicine, Tenri Hospital, Nara, Japan. Electronic address: ytaguchi@tenriyorozu.jp.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Taguchi
authors.affiliation: Department of Respiratory Medicine, Tenri Hospital, Nara, Japan. Electronic address: yusuke-k@tenriyorozu.jp.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kaji
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Toneyama Hospital, Osaka, Japan. Electronic address: rmaekura@toneyama.go.jp.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Maekura
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Toneyama Hospital, Osaka, Japan. Electronic address: hiragat@hiraga-clinic.com.
authors.forename: Toru
authors.initials: T
authors.lastname: Hiraga
authors.affiliation: Department of Respiratory Medicine, Otsu Red Cross Hospital, Shiga, Japan. Electronic address: nsakai@otsu.jrc.or.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Sakai
authors.affiliation: Department of Respiratory Medicine and Allergy, Tosei General Hospital, Aichi, Japan. Electronic address: lung@tosei.or.jp.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: mishima@kuhp.kyoto-u.ac.jp.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
authors.affiliation: Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine, Cologne, Germany. Electronic address: WindischW@kliniken-koeln.de.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Windisch
authors.affiliation: Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: chink@kuhp.kyoto-u.ac.jp.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chin
mesh_terms: D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000523:psychology* / Q000628:therapy*; D008297:Male; D063087:Noninvasive Ventilation / Q000523:psychology*; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life; D012131:Respiratory Insufficiency / Q000523:psychology* / Q000628:therapy*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Chronic hypercapnic respiratory failure; Health-related quality of life; Noninvasive ventilation; Severe Respiratory Insufficiency Questionnaire