Confirmatory Evaluation of the Modified Medical Research Council Questionnaire for Assessment of Dyspnea in Patients with Chronic Obstructive Pulmonary Disease in Portugal

Abstract

Introduction: The Modified British Medical Research Council Questionnaire is considered an adequate and simple measure of breathlessness in chronic obstructive pulmonary disease. It is widely used in clinical practice in Portugal, but it still lacks confirmatory evaluation for the Portuguese setting. The aim of this study was to perform a cultural adaptation and validation of the Modified British Medical Research Council Questionnaire so that its most suitable version can be made available to researchers and clinicians in Portugal.Material and Methods: We performed a cross-sectional descriptive study involving patients with chronic obstructive pulmonary disease aged 40 years or older. We applied the Modified British Medical Research Council Questionnaire and the previously validated Portuguese-language version of the clinical questionnaire for chronic obstructive pulmonary disease between January and June 2019. We determined the agreement between the two questionnaires with kappa agreement, with a 95% confidence interval, and we used Spearman correlation to find a correlation between two scores.Results: The study included 65 patients managed in a hospital pulmonology clinic (aged 68 ± 7 years; with predicted FEV1 of 49.86% ± 16.5%). The Modified British Medical Research Council scale correlated significantly with all the domains and the overall score of the clinical questionnaire for chronic obstructive pulmonary disease (0.46 < r < 0.68; p < 0.001). In bilingual patients, interclass correlation coefficient was 0.912 (p < 0.001).Discussion: Our study showed that the Portuguese-language version of the Modified British Medical Research Council Questionnaire is feasible and externally valid when compared with a traditional and previously validated instrument.Conclusion: The Portuguese version of the Modified British Medical Research Council Questionnaire is a valid instrument for measurement of breathlessness in chronic obstructive pulmonary disease.

Telerehabilitation Intervention in Transitional Care for People with COVID-19: Pre-Post Study with a Non-Equivalent Control Group

“… LCADL (the London Chest Activity of Daily Living scale) [ 31 , 32 ]—assesses dyspnea associated with the performance of life activities in four domains: personal care; household activities; physical activities; and leisure activities. mMRC (modified MRC Dyspnea questionnaire) [ 33 ]—rates the impact of dyspnea on daily activities. Borg scale [ 34 , 35 ]—evaluates subjective perceived effort, dyspnea, and/or fatigue of individuals subjected to a certain level of physical effort.…”

“…LCADL (the London Chest Activity of Daily Living scale) [31,32]-assesses dyspnea associated with the performance of life activities in four domains: personal care; household activities; physical activities; and leisure activities. • mMRC (modified MRC Dyspnea questionnaire) [33]-rates the impact of dyspnea on daily activities.…”

Effects of Six Weeks of Supervised Telerehabilitation on Pulmonary Function, Functional Capacity, and Dyspnoea among individuals with Long COVID

“…Change in baseline perception of dyspnea level at six weeks was assessed on a 5-point ordinal scale (0: no dyspnea; 4: Severe dyspnea). [30]…”

Study of Persistent Covid Cases in Health Workers

“…Para evaluar clínica de COVID Persistente desde la Unidad de Vigilancia de la Salud del Servicio de Prevención de Riesgos Laborales, se aplicó el Procedimiento de actuación asistencial en trabajadores/as con COVID Persistente (2021), vigente en EDPSSBC Este procedimiento consiste en: el envío de una encuesta de sintomatología compatible COVID Persistente (Fiebre, febrícula o escalofríos, fatiga que impide actividad diaria, mialgia en reposo o actividad diaria, artralgia de extremidades en reposo, disnea en reposo o actividades diarias , tos persistente, dolor torácico en reposo o actividad diaria, anosmia o ageusia, cefalea, diarrea, pérdida memoria, cambios en estado de ánimo, tristeza, llanto, nerviosismo, insomnio, alopecia) a los trabajadores que habían padecido COVID-19; a los que respondían afirmativamente síntomas Persistentes de más de 12 semanas, se les citaba para la realización de un examen de salud, dicho examen de salud comprendía una parte de enfermería con la realización de un nuevo cuestionario de síntomas de COVID Persistente en el momento de la visita, aplicación de diferentes test y escalas, todos con validez y confiabilidad (10,11). Dentro de estas escalas se encuentra: Escalas funcionales de calidad de vida EQ5D (EuroQol) (Cronbach 0,75) (12,13), Test mMRC para evaluación de la disnea (coef Pearson 0,92) (14,15), Test de ansiedad /depresión de Hamilton (HAD) (Cronbach 0,89) (16,17) , Escala Estado Funcional Post COVID-19 (PCFS) ((kappa 0,63)) (18,19), Escala Modificada de Impacto de Fatiga (MFIS) (Cronbach 0,81) (20,21),Escala de sueño: Índice de Gravedad del Insomnio (Cronbach de 0,82) (22,23), Cuestionario de evaluación del dolor (Bpi) (Cronbach 0,76) (24,25) y Evaluación Cognitiva Montreal (MOCA) (Cronbach de 0,891) (26,27). Además se realizaba la determinación analítica específica: Anticuerpos (Ac) totales SARS CoV-2, hemograma, VSG, albúmina, bilirrubina total y directa, calcio serico, colesterol total y fracciones de colesterol, complemento CH50, C3,C4, creatinina, filtrado glomerular, factor reumatoide, ferritina, hierro , folato, fosfatasa alcalina, fósforo, GGT, GOT, GPT, glucosa, hemoglobina glicosilada, ionograma (sodio y potasio), proteína C reactiva, proteínas totales, transferrina, triglicéridos, urea, vitamina B12, vitamina D, antitrombina III, , tiempo protrombina, Tromboplastina parcial activada, anticuerpos antinucleares, autoanticuerpos DNA, TSH, T3 y T4, apoproteína, creatinkinasa, fibrinógeno, deshidrogenasa láctica, síndrome anti fosfolípidos; se registraban los datos antropométricos: peso, talla y perímetro abdominal; medida de tensión arterial, pulso, saturación de oxígeno, de temperatura corporal; se realizaba una espirometría y un electrocardiograma.…”