Comparison of Short Form-36 Health Survey and Nottingham Health Profile in moderate to severe patients with COPD

A study on the validity and reliability of the Turkish version of the Clinical Chronic Obstructive Pulmonary Disease Questionnaire

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a progressive disease negatively affecting health-related quality of life. The related scales in Turkish are limited in number and generalizability.

OBJECTIVE

To perform validity and reliability studies of the Turkish version of the Clinical Chronic Obstructive Pulmonary Disease Questionnaire (CCQ).

METHODS

This study was conducted at the Department of Chest Diseases, with 100 volunteer COPD patients with a mean age of 67.72 ± 9.78 years. After obtaining the necessary permission, translation procedures were applied for Turkish cultural adaptation. Finally, a single Turkish translation was created, and this questionnaire was evaluated by linguists. Incomprehensible items were corrected in a pilot study. Baseline and test-retest measurements after two weeks were performed. Internal consistency analysis was made for validity, and correlations were calculated with the 36-Item Short Form Health Survey (SF-36), the modified Medical Research Council (mMRC) Dyspnea Scale and Respiratory Function Tests (RFTs).

RESULTS

Cronbach's alpha value was found to be 0.90 for the first obtained data and 0.91 for the second obtained data. There was similarity at the rate of 0.97 between the first and second measurements in terms of total scores of the CCQ. The questionnaire significantly correlated with the SF-36, mMRC and RFTs (-0.85 ⩽r⩽ 0.69, p< 0.05).

CONCLUSIONS

As a result of this study, the Turkish version of CCQ was determined to be reliable and valid. The CCQ is an easy-to-use questionnaire in terms of application-calculation and can be safely used for the clinical assessment and monitoring of patients.

Assessment of quality of life in haemodialysis patients: a comparison of the Nottingham Health Profile and the Short Form 36

This study aimed to compare the psychometric properties of the Nottingham Health Profile (NHP) and the Medical Outcomes Study Short Form Health Survey (SF-36), which evaluates health-related quality of life in haemodialysis patients. Data were gathered using the NHP and the SF-36. Quality of life scores obtained from the NHP and the SF-36 were compared according to sociodemographic characteristics. It was found that the internal consistency values of the NHP and the SF-36 were similar. The floor effect of the two NHP subscales and the ceiling effect of all the NHP subscales were higher than those pertaining to the. It was observed that the NHP mean subscale scores were higher than those of the SF-36, except for one subscale of the SF-36. There was a significant positive correlation between the similar subscales of the NHP and the SF-36 and between the total scores. These results seem to support the utility of the NHP and the SF-36 in evaluating quality of life in haemodialysis patients.

Health-related quality of life and chronic obstructive pulmonary disease in North Carolina

Background:

Comparisons of health-related quality of life (HRQOL) between persons with chronic obstructive pulmonary disease (COPD) and adults in the general population are not well described.

Aims:

To examine associations between COPD and four measures of HRQOL in a population-based sample.

Patients & Methods:

These relationships were examined using data from 13,887 adults aged >18 years who participated in the 2007 Behavioral Risk Factor Surveillance System (BRFSS) conducted in North Carolina (NC). Logistic regression was used to obtain adjusted relative odds (aOR).

Results:

The age-adjusted prevalence of COPD among NC adults was 5.4% (standard error 0.27). Nearly half of adults with COPD reported fair/poor health compared with 15% of those without the condition (age-aOR, 5.5; 95% confidence interval [ CI] , 4.4 to 6.8). On average, adults with COPD reported twice as many unhealthy days (physical/mental) as those without the condition. The age-adjusted prevalence of >14 unhealthy days during the prior 30 days was 45% for adults with COPD and 17% for those without. The aOR of >14 unhealthy days was 1.7 (95% CI, 1.4 to 2.2) times greater among adults with COPD compared with those without.

Conclusions:

These results suggest COPD is independently associated with lower levels of HRQOL and reinforce the importance of preventing COPD and its complications through health education messages stressing efforts to reduce total personal exposure to tobacco smoke, occupational dusts and chemicals, and other indoor and outdoor air pollutants linked to COPD and early disease recognition. Our findings represent one of the few statewide efforts in the US and provide guidance for disease management and policy decision making.

Sensitivity to environmental irritants and quality of life in COPD

It is a common clinical experience that patients with chronic obstructive pulmonary disease (COPD) complain of airway symptoms provoked by environmental irritants like chemicals and scents, although few studies can confirm such connections. The aim was to study the prevalence of airway symptoms induced by chemicals and scents in a group of patients with newly diagnosed CPOD and to analyze any relation to illness severity and quality of life. Eighty-one patients with COPD were recruited to the study. By mail they were asked to answer three questionnaires regarding symptoms, quality of life, and social and emotional influence of airway symptoms induced by environmental irritants. A majority (62%) of the COPD patients claimed to be hyperreactive to chemicals and scents. As a group they scored higher on a questionnaire measuring social and emotional influences of such environmental irritants compared to healthy control subjects. Further, high scores were more common among patients with a very severe form of COPD and among patients with regular use of β(2)-stimulants. High scores were also associated with significantly more airway symptoms and, in some aspects, with impaired quality of life. In conclusion, the results of this study show that airway symptoms induced by environmental irritants are common in patients with COPD and that this increased airway sensitivity follows the impairment of lung capacity. The mechanisms behind this remain unclear.

Symptoms induced by environmental irritants and health-related quality of life in patients with chronic cough - A cross-sectional study

BACKGROUND

Chronic cough is a common condition, but some patients have no evident medical explanation for their symptoms. A group of patients has been identified, characterized by upper and lower airway symptoms triggered by chemicals and scents, and heightened cough sensitivity to inhaled capsaicin. Chronic cough is usually a prominent symptom in these patients, and it has been suggested that they suffer from sensory hyperreactivity.Our main aim was to analyse, in a group of patients with chronic cough, the presence of symptoms induced by environmental factors such as chemicals, scents, and cold air, and to measure the social and emotional influences of these symptoms in relation to quality of life. A second aim was to pilot-test a Swedish translation of a cough-specific questionnaire.

METHODS

A total of 119 patients with chronic cough were asked to answer three different questionnaires: a local symptom questionnaire, the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR), and the Nottingham Health Profile (NHP). In addition, a Swedish version of the Hull Airway Reflux Questionnaire (HARQ) was developed and answered by a subgroup of patients and healthy controls.

RESULTS

Sixty-two patients (52%) with mean cough duration of 10.6 years answered the local symptom questionnaire, the CSS-SHR, and the NHP. Of these, 39 (63%) claimed to have cough and other symptoms induced by chemicals and scents. Compared to population-based findings, the patients scored higher on the CSS-SHR, and the CSS-SHR score was significantly higher among chemical-sensitive individuals (p < 0.001). The NHP showed that the patients had a significantly reduced quality of life, which was most pronounced among chemical-sensitive individuals. The 31 patients who answered the HARQ had significantly higher scores (p < 0.0001) than 59 healthy controls.

CONCLUSIONS

Among patients with chronic cough, a majority claimed that environmental factors induced coughing. Both the CSS-SHR and the HARQ score systems seem to be valuable instruments in the mapping of cough patients, supporting the novel paradigm of a cough hypersensitivity syndrome. Our results emphasize that cough is a substantial burden to the patient, influencing daily living and quality of life.

Relationship between psychosocial factors at work and incidence of perceived health problems in the GERICOTS cohort

BACKGROUND

The objective of this study was to investigate the relationship between the incidence of health problems and the psychosocial work environment in a French occupational cohort.

METHODS

Among the 2062 employees in the North of France who participated in the GERICOTS survey between 1999 and 2004, 1154 subjects who kept the same full-time shift in the same firm during the study period (797 men and 357 women) were included. Job strain was assessed using Karasek's model--the strain profile (high psychological demand and low decision latitude) and the iso-strain profile (strain profile and low social support)--and Siegrist's model, Effort-Reward Imbalance (ERI) (high effort and low rewards). Perceived health status was assessed using the four dimensions of the Nottingham Health Profile (emotional reactions, sleep, social isolation, pain). The results are given by the odds ratio adjusted for age, occupational category, and size of firm.

RESULTS

At baseline, higher prevalence of health problems was found in workers with job strain, e.g., between emotional reactions and iso-strain for men, OR=3.50 (2.19-5.60) and for women, 2.64 (1.39-5.04) or between sleep disorders and ERI for men, OR=2.41 (1.71-3.40) and for women, OR=2.41 (1.39-4.20). Longitudinal analysis showed a significant relationship between incidence of health problems and level of job strain in 1999, e.g., between sleep disorder incidence and strain profile, OR=1.89 (1.16-3.06) and ERI, OR=2.20 (1.43-3.38).

CONCLUSION

These results show a significant relationship between perceived health and job stress in 1999 but also between incidence of health problems between 1999 and 2004 and job strain in 1999.