Adaptation and validation of the Chinese version of Dyspnoea-12 scale in individuals with chronic obstructive pulmonary disease

Tiffany Ching Man Choi; Lloyd Long Yu Chan; Hin Cheung Tsang; Yee Ping Vong; Yui Kwan Cheng; Yuk Ling To; Kah Lin Choo; Janelle Yorke

doi:10.1111/crj.13411

Adaptation and validation of the Chinese version of Dyspnoea-12 scale in individuals with chronic obstructive pulmonary disease

Clin Respir J. 2021 Oct;15(10):1081-1087. doi: 10.1111/crj.13411. Epub 2021 Jul 6.

Authors

Tiffany Ching Man Choi¹, Lloyd Long Yu Chan², Hin Cheung Tsang³, Yee Ping Vong³, Yui Kwan Cheng³, Yuk Ling To³, Kah Lin Choo⁴, Janelle Yorke⁵

Affiliations

¹ School of Health Sciences, Caritas Institute of Higher Education, Tseung Kwan O, New Territories, Hong Kong.
² Neuroscience Research Australia, School of Population Health, The University of New South Wales, Randwick, New South Wales, Australia.
³ Department of Physiotherapy, North District Hospital, Sheung Shui, New Territories, Hong Kong.
⁴ Department of Medicine, North District Hospital, Sheung Shui, New Territories, Hong Kong.
⁵ Division of Nursing, Midwifery and Social Work, School of Health Sciences, The University of Manchester, Manchester, UK.

Abstract

Introduction: Dyspnoea-12 scale is a validated assessment tool, capturing the perception of dyspnoea and its physical and affective effects in individuals with chronic obstructive pulmonary disease (COPD). A validated version for the Chinese-speaking population has been unavailable.

Objective: To develop a Chinese version of D-12 (D-12-C) scale and evaluate its validity and reliability.

Methods: D-12 was translated from English to traditional Chinese in collaboration with a physician and a linguist. Back translation was adopted to ensure accuracy of the translation. A total of 155 COPD patients were recruited to test the reliability and validity of the D-12-C scale. Internal reliability and test-retest reliability were measured with Cronbach's alpha coefficient and intra-class correlation coefficient, respectively. Construct validity was assessed through exploratory factor analysis (EFA). Concurrent validity was assessed by the correlation of D-12-C total score and sub-scores and the Chinese version of Saint George's Respiratory Questionnaire (SGRQ), 36-Item Short Form Health Survey (SF-36), COPD Assessment Test (CAT) and Hospital Anxiety and Depression Scale (HADS) total score and sub-scores.

Results: The two-factor structure of D-12-C was confirmed by EFA. D-12-C and its sub-scores demonstrated high level of internal reliability (Cronbach's alpha = 0.88) and moderate level of test-retest reliability. D-12-C total score, physical and affective sub-scores were significantly correlated to SGRQ total score (r_s = 0.59, p < 0.001) and activity sub-score (r_s = 0.38, p = 0.006), SF-36 mental health sub-score (r_s = -0.36, p < 0.001), CAT (r_s = 0.56, p < 0.001), HADS anxiety (r_s = 0.51, p < 0.001) and depression sub-scores (r_s = 0.44, p < 0.001).

Conclusion: D-12-C scale was developed, which demonstrated satisfactory reliability and validity in measuring dyspnoea among COPD patients.

Keywords: assessment tool; chronic obstructive pulmonary disease; dyspnoea.

MeSH terms

China / epidemiology
Dyspnea / diagnosis
Dyspnea / etiology
Humans
Pulmonary Disease, Chronic Obstructive* / complications
Pulmonary Disease, Chronic Obstructive* / diagnosis
Quality of Life
Reproducibility of Results
Surveys and Questionnaires