Validation of the Swedish Multidimensional Dyspnea Profile (MDP) in outpatients with cardiorespiratory disease

Magnus Ekström; Hans Bornefalk; Magnus Sköld; Christer Janson; Anders Blomberg; Jacob Sandberg; Anna Bornefalk-Hermansson; Helena Igelström; Josefin Sundh

doi:10.1136/bmjresp-2018-000381

Validation of the Swedish Multidimensional Dyspnea Profile (MDP) in outpatients with cardiorespiratory disease

BMJ Open Respir Res. 2019 Sep 18;6(1):e000381. doi: 10.1136/bmjresp-2018-000381. eCollection 2019.

Authors

Magnus Ekström^{1

2}, Hans Bornefalk³, Magnus Sköld⁴, Christer Janson⁵, Anders Blomberg⁶, Jacob Sandberg^{7

8}, Anna Bornefalk-Hermansson⁹, Helena Igelström¹⁰, Josefin Sundh¹¹

Affiliations

¹ Department of Clinical Sciences, Lund, Respiratory Medicine and Allergology, Faculty of Medicine, Lund University, Lund, Sweden.
² Department of Medicine, Blekinge Hospital, Karlskrona, Sweden.
³ Hans Bornefalk AB, Vallentuna, Sweden.
⁴ Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
⁵ Department of Medical Sciences: Respiratory Medicine, Uppsala University, Uppsala, Sweden.
⁶ Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
⁷ Jämjö Primary Health Care Central, Karlskrona, Sweden.
⁸ Department of Clinical Sciences, Lunds Universitet, Lund, Sweden.
⁹ Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
¹⁰ Department of Neuroscience, Uppsala University, Uppsala, Sweden.
¹¹ Department of Respiratory Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden.

Abstract

Introduction: Breathlessness is a cardinal symptom in cardiorespiratory disease. An instrument for measuring different aspects of breathlessness was recently developed, the Multidimensional Dyspnea Profile (MDP). This study aimed to validate the MDP in terms of the underlying factor structure, internal consistency, test-retest reliability and concurrent validity in Swedish outpatients with cardiorespiratory disease.

Methods: Outpatients with stable cardiorespiratory disease and breathlessness in daily life were recruited. Factor structure of MDP was analysed using confirmatory factor analysis; internal consistency was analysed using Cronbach's alpha; and test-retest reliability was analysed using intraclass correlation coefficients (ICCs) for patients with unchanged breathlessness between assessments (baseline, after 30-90 min and 2 weeks). Concurrent validity was evaluated using correlations with validated scales of breathlessness, anxiety, depression and health-related quality of life.

Results: In total, 182 outpatients with cardiorespiratory disease and breathlessness in daily life were included; 53.3% were women; main diagnoses were chronic obstructive pulmonary disease (24.7%), asthma (21.4%), heart failure (19.2%) and idiopathic pulmonary fibrosis (18.7%). The MDP total, immediate perception and emotional response scores, and individual item scores showed expected factor structure and acceptable measurement properties: internal consistency (Cronbach's alpha, range 0.80-0.93); test-retest reliability at 30-90 min and 2 weeks (ICC, range 0.67-0.91); and concurrent validity. There was no evidence of a learning effect. Findings were similar between diagnoses.

Discussion: MDP is a valid instrument for multidimensional measurement of breathlessness in Swedish outpatients across cardiorespiratory diseases.

Keywords: Swedish; breathlessness; dyspnoea; heart disease; measurement; multidimensional; respiratory disease.

Publication types

Observational Study
Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Aged
Aged, 80 and over
Dyspnea / diagnosis*
Dyspnea / etiology
Female
Humans
Male
Middle Aged
Outpatients
Pulmonary Disease, Chronic Obstructive / complications*
Pulmonary Heart Disease / complications*
Quality of Life*
Reproducibility of Results
Surveys and Questionnaires*
Sweden
Translations