A breath of fresh air: Validity and reliability of a Portuguese version of the Multidimensional Dyspnea Profile for patients with COPD

Abstract

Aim To provide a Portuguese version of the Multidimensional Dyspnea Profile (MDP), investigating its validity and reliability in Brazilian patients with COPD. Methods This was a cross-sectional study for translation and linguist validation of the Portuguese MDP version for patients with COPD. The process occurred according to the protocol of Mapi Research Trust, Lyon, France. Three scores of MDP were used for the analysis: the immediate unpleasantness of dyspnea (A1); the “immediate perception domain” (S) (sum of A1 plus the sensory descriptors) and the “emotional response domain” (A2) (sum of the emotional descriptors). The questionnaires COPD assessment Test (CAT), Hospital Anxiety and Depression scale (HADS) and Medical Research Council scale (MRC) were used as anchors to investigate MDP’s validity. Internal consistency was assessed with Cronbach’s alpha. Test–retest reliability was assessed with intraclass correlation coefficient (ICC) and concurrent validity was assessed with Spearman correlation coefficients. Results Thirty patients with moderate-severe COPD were studied for MDP’s validation analysis (43% male, 63±8years, body mass index [BMI] 27±6Kg/m 2 , forced expiratory volume in the first second [FEV 1 ] 48±15%predicted, six-minute walking test [6MWT] 464±84m and 84±16%predicted), whereas 10 patients were excluded from the test-retest reliability analysis due to missing data, resulting in a sample of 20 subjects for this purpose (50% male, 62±8years, BMI 27±6Kg/m 2 , FEV 1 48±15%predicted, 6MWT 452±93m and 82±19%predicted). Both samples were similar regarding general characteristics ( P >0,05 for all variables). MDP presented strong correlations, i.e., ICC intra-rater: A1: 0.77 (0.48–0.90), S: 0.78 (0.52–0.91), and A2: 0.85 (0.66–0.94), with high internal consistency (Cronbach's α 0.86, 0.88 and 0.92 respectively); and ICC inter-rater: A1: 0.74 (0.46–0.89), S: 0.75 (0.48–0.89) and A2: 0.91 (0.78–0.96) with Cronbach's α 0.85, 0.86 and 0.95 respectively. Conclusion The Portuguese version of the MDP is the first valid and reliable instrument to assess dyspnea multidimensionally in Portuguese-speaking patients with COPD.

Validity and reliability of the Turkish version of the Multidimensional Dyspnea Profile in outpatients with respiratory disease

“…However, the test-retest reliability decreased moderate-to-high after a one-week period. High test-retest reliability results for a short interval (hours to days) have been reported in the other validation studies [5,11,15,16]. Similar to our findings, test-retest reliability tends to decrease after weeks [5,11,16].…”

“…In this study, the MDP showed a two-factor structure for both determined situations (i.e., activity and rest) similar to findings in the previous validation studies [5,11,15,16,18]. In the original development study of the MDP, three domains were proposed as immediate sensory response, immediate unpleasantness, and resultant emotional response under sensory and affective dimensions based on a well-developed conceptual model of pain perception [3].…”

“…In that model, the "breathing discomfort" item should be in the affective dimension. However, our study and other studies suggested that the MDP has a two-factor structure as IP and ER domains, and "breathing discomfort" item is clustered under the IP domain [5,11,12,15,16,18]. These results suggest that two domains are necessary to describe dyspnea.…”

“…In our study, most of the predetermined hypotheses were confirmed showing its construct validity. Although some outcome measures were different from our ones and some correlations were slightly different for the same measures in the other validation studies, they also reported that the MDP had construct validity [5,11,15,16,18]. Since the FEV1 is weakly associated with the severity of dyspnea [18], we expected to find nonsignificant or weak correlations and it was confirmed.…”

“…The MDP has an increasing use in international studies and was previously validated and/or translated into Dutch for Belgium and Netherlands, English for USA, Canada, UK, and Australia, French for Belgium, Canada, and France, German for Germany, Swedish for Sweden, Portuguese for Brazil [12][13][14][15][16][17][18]. However, the MDP does not have a Turkish validation.…”