Chest
Volume 113, Issue 3, March 1998, Pages 619-624
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Clinical Investigations: Dyspnea
Validation of a New Dyspnea Measure: The UCSD Shortness of Breath Questionnaire

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Objective

Evaluate the reliability and validity of a new version of the University of California, San Diego Shortness of Breath Questionnaire (SOBQ), a 24-item measure that assesses self-reported shortness of breath while performing a variety of activities of daily living.

Design

Patients enrolled in a pulmonary rehabilitation program were asked to complete the SOBQ, the Quality of Well-Being Scale, the Center for Epidemiologic Studies Depression Scale, and a 6-min walk with modified Borg scale ratings of perceived breathlessness following the walk.

Setting

University medical center pulmonary rehabilitation program.

Patients

Thirty-two male subjects and 22 female subjects with a variety of pulmonary diagnoses: COPD (n=28), cystic fibrosis (n=9), and postlung transplant (n=17).

Measurements and results

The current version of the SOBQ was compared with the previous version, the format of which often resulted in a significant number of “not applicable” answers. The results demonstrated that the SOBQ had excellent internal consistency (α=0.96). The SOBQ was also significantly correlated with all validity criteria.

Conclusions

The SOBQ is a valuable assessment tool in both clinical practice and research in patients with moderate-to-severe lung disease.

Section snippets

Subjects

The 54 subjects in this study were a convenience sample of patients evaluated at the University of California, San Diego Pulmonary Rehabilitation Program. Subjects ranged in age from 12 to 82 years; 41% were female (Table 1). Diagnostic breakdown was as follows: COPD (n=28), cystic fibrosis (CF) (n=9), and postlung transplant (n=17). Three patients with restrictive parenchymal disease and two patients with pulmonary vascular disease were excluded due to small sample size. Of the postlung

Results

Subject characteristics are shown in Table 1. The 28 subjects with COPD were older and had higher scores on the CESD, SOBQ, and Borg ratings of PB after the 6MW, with lower QWB scores. These were associated with lower 6MW distances, FEV1, Dco, MIP, and MEP. Mean scores on the old and new versions of the SOBQ were similar for each group, with slightly higher mean values on the new version.

An internal consistency criterion of 0.70 was chosen as good evidence for reliability.18 The SOBQ

Discussion

The results of this study and our previous experience4 indicate that the UCSD SOBQ is a reliable and valid instrument that can be used to assess dyspnea associated with ADLs in patients with moderate-to-severe chronic lung disease. Dyspnea is a primary symptom and an important outcome measure in evaluating patients with chronic lung diseases.19, 20 The choice of a dyspnea measure depends not only on the purpose of the application, but also on the reliability and validity of the measure.

We have

Appendix—UCSD SOBQ

UCSD Medical Center Pulmonary Rehabilitation Program Shortness-of-Breath Questionnaire ©1995 The Regents of the University of California

Instructions: For each activity listed below, please rate your breathlessness on a scale between zero and five where 0 is not at all breathless and 5 is maximally breathless or too breathless to do the activity. If the activity is one which you do not perform, please give your best estimate of breathlessness. Your responses should be for an “average” day during

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    Presented in part at the annual meeting of the American Association of Cardiovascular and Pulmonary Rehabilitation, September 1994, Portland, Ore.

    Supported by grants 2RT0268 from the University of California Tobacco Related Disease Research Program; HL34732 from the National Heart, Lung, and Blood Institute (Dr. Kaplan); and by Award No. HL02215 of the National Institutes of Health NHLBI Preventive Pulmonary Academic Award (Dr. Ries).

    Currently at the Oregon Research Institute, Eugene.

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