TY - JOUR
T1 - Test-retest reliability of multidimensional dyspnea profile recall ratings in the emergency department
T2 - A prospective, longitudinal study
AU - Parshall, Mark B.
AU - Meek, Paula M.
AU - Sklar, David
AU - Alcock, Joe
AU - Bittner, Paula
N1 - Funding Information:
This work was supported by the National Institutes of Health [Grant NR010006; PI Robert B. Banzett] and by the New Mexico VA Health Care System, Albuquerque, New Mexico. We wish to express our heartfelt thanks to our participants and to the physicians and nurses of the Emergency Departments of the University of New Mexico Hospital, the Raymond G. Murphy VA Medical Center, and Presbyterian Kaseman Hospital. In particular, we wish to thank Michael Richards, MD, Cameron Crandall, MD, and Michael Chicarelli, RN, MSN, of University of New Mexico; Henry Holmes, RN, Raymond G. Murphy VA Medical Center and Annie Cook, Sandra Diesel, Gaylene Vargas, and Barbara Gabaldon of the NMVAHCS Research Service; and Johanna Stiesmeyer, RN, MSN, and Larraine Yeager, RN, MSN, of Presbyterian Healthcare Services, Albuquerque NM, for their support. We are deeply grateful to Robert Banzett, PhD, Richard Schwartzstein, MD, and Robert Lansing, PhD, of Beth Israel Deaconess Medical Center, Harvard School of Medicine, for their collaboration in the development of the MDP and for their support, encouragement, and critical discussion. We also wish to thank: Nancy Ridenour, PhD, RN, FAAN, Dean of the University of New Mexico College of Nursing, and Patricia Moritz, PhD, RN, FAAN, Dean of the University of Colorado College of Nursing, for their support; Ms. Anne Mattarella of the University of New Mexico College of Nursing for expert assistance with technical editing; and the reviewers of the manuscript for their helpful suggestions.
PY - 2012/5/24
Y1 - 2012/5/24
N2 - Background: Dyspnea is among the most common reasons for emergency department (ED) visits by patients with cardiopulmonary disease who are commonly asked to recall the symptoms that prompted them to come to the ED. The reliability of recalled dyspnea has not been systematically investigated in ED patients.Methods: Patients with chronic or acute cardiopulmonary conditions who came to the ED with dyspnea (N = 154) completed the Multidimensional Dyspnea Profile (MDP) several times during the visit and in a follow-up visit 4 to 6 weeks later (n = 68). The MDP has 12 items with numerical ratings of intensity, unpleasantness, sensory qualities, and emotions associated with how breathing felt when participants decided to come to the ED (recall MDP) or at the time of administration (" now" MDP). The recall MDP was administered twice in the ED and once during the follow-up visit. Principal components analysis (PCA) with varimax rotation was used to assess domain structure of the recall MDP. Internal consistency reliability was assessed with Cronbach's alpha. Test-retest reliability was assessed with intraclass correlation coefficients (ICCs) for absolute agreement for individual items and domains.Results: PCA of the recall MDP was consistent with two domains (Immediate Perception, 7 items, Cronbach's alpha = .89 to .94; Emotional Response, 5 items; Cronbach's alpha = .81 to .85). Test-retest ICCs for the recall MDP during the ED visit ranged from .70 to .87 for individual items and were .93 and .94 for the Immediate Perception and Emotional Response domains. ICCs were much lower for the interval between the ED visit and follow-up, both for individual items (.28 to .66) and for the Immediate Perception and Emotional Response domains (.72 and .78, respectively).Conclusions: During an ED visit, recall MDP ratings of dyspnea at the time participants decided to seek care in the ED are reliable and sufficiently stable, both for individual items and the two domains, that a time lag between arrival and questionnaire administration does not critically affect recall of perceptual and emotional characteristics immediately prior to the visit. However, test-retest reliability of recall over a 4- to 6-week interval is poor for individual items and significantly attenuated for the two domains.
AB - Background: Dyspnea is among the most common reasons for emergency department (ED) visits by patients with cardiopulmonary disease who are commonly asked to recall the symptoms that prompted them to come to the ED. The reliability of recalled dyspnea has not been systematically investigated in ED patients.Methods: Patients with chronic or acute cardiopulmonary conditions who came to the ED with dyspnea (N = 154) completed the Multidimensional Dyspnea Profile (MDP) several times during the visit and in a follow-up visit 4 to 6 weeks later (n = 68). The MDP has 12 items with numerical ratings of intensity, unpleasantness, sensory qualities, and emotions associated with how breathing felt when participants decided to come to the ED (recall MDP) or at the time of administration (" now" MDP). The recall MDP was administered twice in the ED and once during the follow-up visit. Principal components analysis (PCA) with varimax rotation was used to assess domain structure of the recall MDP. Internal consistency reliability was assessed with Cronbach's alpha. Test-retest reliability was assessed with intraclass correlation coefficients (ICCs) for absolute agreement for individual items and domains.Results: PCA of the recall MDP was consistent with two domains (Immediate Perception, 7 items, Cronbach's alpha = .89 to .94; Emotional Response, 5 items; Cronbach's alpha = .81 to .85). Test-retest ICCs for the recall MDP during the ED visit ranged from .70 to .87 for individual items and were .93 and .94 for the Immediate Perception and Emotional Response domains. ICCs were much lower for the interval between the ED visit and follow-up, both for individual items (.28 to .66) and for the Immediate Perception and Emotional Response domains (.72 and .78, respectively).Conclusions: During an ED visit, recall MDP ratings of dyspnea at the time participants decided to seek care in the ED are reliable and sufficiently stable, both for individual items and the two domains, that a time lag between arrival and questionnaire administration does not critically affect recall of perceptual and emotional characteristics immediately prior to the visit. However, test-retest reliability of recall over a 4- to 6-week interval is poor for individual items and significantly attenuated for the two domains.
KW - Dyspnea
KW - Emergency department visits
KW - Questionnaires
KW - Recall
KW - Test-retest reliability
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U2 - 10.1186/1471-227X-12-6
DO - 10.1186/1471-227X-12-6
M3 - Article
C2 - 22624887
AN - SCOPUS:84861335203
SN - 1471-227X
VL - 12
JO - BMC Emergency Medicine
JF - BMC Emergency Medicine
M1 - 6
ER -