nach oben

Erschienen in:

01.01.2015 | Quantitative Methods Special Section

The St George’s Respiratory Questionnaire revisited: a psychometric evaluation

verfasst von: Muirne C. S. Paap, Danny Brouwer, Cees A. W. Glas, Evelyn M. Monninkhof, Benjamin Forstreuter, Marcel E. Pieterse, Job van der Palen

Erschienen in: Quality of Life Research | Ausgabe 1/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The St George’s Respiratory Questionnaire (SGRQ) has clearly acquired the status of legacy questionnaire for measuring health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). The main aim of this study was to assess the underlying dimensionality of the SGRQ and to investigate the added value of the empirical weights used to calculate total scores.

Methods

The official Dutch translation of the SGRQ was completed by 444 COPD patients participating in two clinical studies. These data were used for secondary data analysis in this study. Three complementary statistical methods were used to assess dimensionality: Mokken scale analysis (MSA), parametric multidimensional item response theory (IRT) and bifactor analysis. Additionally, the original SGRQ weighting procedure was compared to IRT-based weighting.

Results

The results of the MSA and multidimensional item response theory (MIRT) pointed toward a unidimensional structure. The bifactor analyses indicated that there was a strong general factor, but the group factors did have additional value. Nineteen items performed poorly in the MSA, MIRT analysis or both. Shortening the scale from 50 to 31 items did not negatively impact measurement precision. SGRQ total score and IRT-derived scores correlated strongly, 0.90 for the one-parameter model and 0.99 for the two-parameter model.

Conclusion

The SGRQ contains some multidimensionality, but an abbreviated version can be used as a unidimensional tool in patients with COPD. Subscale scores should be used with care. SGRQ total scores correlated highly with IRT-based scores, and thus, the weighting methods may be used interchangeably to calculate total scores.

Nur mit Berechtigung zugänglich

Total scale: nine items showed poor fit under the 1PL model, five under the 2PL model. Shorter scale: 3 items showed poor fit under the 1PL model, 0 under the 2PL model.

To obtain the discrimination parameter per category, the parameter estimate was multiplied by category number for polytomous items. This value was then used in calculating the correlations.

Jones, P. W., Quirk, F. H., & Baveystock, C. M. (1991). The St George’s Respiratory Questionnaire. Respiratory Medicine, 85(Supplement 2), 25–31.PubMedCrossRef

Jones, P. W., Quirk, F. H., Baveystock, C. M., & Littlejohns, P. (1992). A self-complete measure of health status for chronic airflow limitation. The St. George’s Respiratory Questionnaire. American Review of Respiratory Disease, 145(6), 1321–1327.PubMedCrossRef

Quirk, F. H., & Jones, P. W. (1990). Patients’ perception of distress due to symptoms and effects of asthma on daily living and an investigation of possible influential factors. Clinical Science (London), 79(1), 17–21.

Barr, J. T., Schumacher, G. E., Freeman, S., LeMoine, M., Bakst, A. W., & Jones, P. W. (2000). American translation, modification, and validation of the St. George’s Respiratory Questionnaire. Clinical Therapeutics, 22(9), 1121–1145.PubMedCrossRef

Meguro, M., Barley, E. A., Spencer, S., & Jones, P. W. (2007). Development and validation of an Improved, COPD-specific version of the St. George Respiratory Questionnaire. Chest, 132(2), 456–463.PubMedCrossRef

Embretson, S. E., & Reise, S. (2000). Item response theory for psychologists. Mahwah, NJ: Erlbaum.

Rasch, G. (1960). Probabilistic models for some intelligence and attainment tests. Chicalo, IL: University of Chicago Press.

Jones, P. W. (2009). St George’s Respiratory Questionnaire: Manual. London: Division of Cardiac and Vascular Science, St George’s, University of London.

Quirk, F. H., Baveystock, C. M., Wilson, R., & Jones, P. W. (1991). Influence of demographic and disease related factors on the degree of distress associated with symptoms and restrictions on daily living due to asthma in six countries. European Respiratory Journal, 4(2), 167–171.PubMed

10.

Monninkhof, E., van der Valk, P., van der Palen, J., van Herwaarden, C., & Zielhuis, G. (2003). Effects of a comprehensive self-management programme in patients with chronic obstructive pulmonary disease. European Respiratory Journal, 22(5), 815–820.PubMedCrossRef

11.

Christenhusz, L. C., Prenger, R., Pieterse, M. E., Seydel, E. R., & van der Palen, J. (2012). Cost-effectiveness of an intensive smoking cessation intervention for COPD outpatients. Nicotine & Tobacco Research, 14(6), 657–663.CrossRef

12.

Mokken, R. J. (1971). A theory and procedure of scale analysis. The Hague: Mouton.CrossRef

13.

Sijtsma, K., & Molenaar, I. W. (2002). Introduction to nonparametric item response theory (Vol. 5). Thousand Oaks: Sage Publications.

14.

R Development Core Team. (2012). R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing.

15.

van der Ark, L. A. (2007). Mokken scale analysis in R. Journal of Statistical Software, 20(11), 1–19.

16.

Paap, M. C. S., Kreukels, B. P. C., Cohen-Kettenis, P. T., Richter-Appelt, H., de Cuypere, G., & Haraldsen, I. R. (2011). Assessing the utility of diagnostic criteria: a multisite study on gender identity disorder. Journal of Sexual Medicine, 8(1), 180–190.PubMedCrossRef

17.

Sijtsma, K., Emons, W. H., Bouwmeester, S., Nyklicek, I., & Roorda, L. D. (2008). Nonparametric IRT analysis of Quality-of-Life Scales and its application to the World Health Organization Quality-of-Life Scale (WHOQOL-Bref). Quality of Life Research, 17(2), 275–290.PubMedCentralPubMedCrossRef

18.

Wismeijer, A. A. J. (2012). Dimensionality analysis of the thought suppression inventory: Combining EFA, MSA, and CFA. Journal of Psychopathology and Behavioral Assessment, 34(1), 116–125.

19.

Watson, R., Deary, I. J., & Shipley, B. (2008). A hierarchy of distress: Mokken scaling of the GHQ-30. Psychological Medicine, 38(04), 575–579.

20.

Watson, R., van der Ark, L. A., Lin, L.-C., Fieo, R., Deary, I. J., & Meijer, R. R. (2012). Item response theory: How Mokken scaling can be used in clinical practice. Journal of Clinical Nursing, 21(19–20), 2736–2746.

21.

Paap, M. C. S., Meijer, R. R., Cohen-Kettenis, P. T., Richter-Appelt, H., de Cuypere, G., Kreukels, B. P. C., et al. (2012). Why the factorial structure of the SCL-90-R is unstable: Comparing patient groups with different levels of psychological distress using Mokken Scale Analysis. Psychiatry Research, 200(2–3), 819–826.PubMedCrossRef

22.

Beukers, F., Houtzager, B. A., Paap, M. C. S., Middelburg, K. J., Hadders-Algra, M., Bos, A. F., et al. (2012). Parental psychological distress and anxiety after a successful IVF/ICSI procedure with and without preimplantation genetic screening: Follow-up of a randomised controlled trial. Early Human Development, 88(9), 725–730.PubMedCrossRef

23.

Blom, E. H., Bech, P., Hogberg, G., Larsson, J. O., & Serlachius, E. (2012). Screening for depressed mood in an adolescent psychiatric context by brief self-assessment scales—testing psychometric validity of WHO-5 and BDI-6 indices by latent trait analyses. Health Qual Life Outcomes, 10(1), 149.PubMedCentralPubMedCrossRef

24.

Roorda, L. D., Green, J. R., Houwink, A., Bagley, P. J., Smith, J., Molenaar, I. W., et al. (2012). Item hierarchy-based analysis of the Rivermead Mobility Index resulted in improved interpretation and enabled faster scoring in patients undergoing rehabilitation after stroke. Archives of Physical Medicine and Rehabilitation, 93(6), 1091–1096.PubMedCrossRef

25.

Straat, J. H., van der Ark, L. A., & Sijtsma, K. (2013). Comparing optimization algorithms for item selection in Mokken scale analysis. Journal of Classification, 30(1), 75–99.

26.

Reise, S. P., & Waller, N. G. (2009). Item response theory and clinical measurement. Annual Review of Clinical Psychology, 5(1), 27–48.PubMedCrossRef

27.

Muraki, E. (1992). A generalized partial credit model: Application of an EM algorithm. Applied Psychological Measurement, 16(2), 159–176.CrossRef

28.

van den Berg, S. M., Heuven, H. C. M., van den Berg, L., Duffy, D. L., & Serpell, J. A. (2010). Evaluation of the C-BARQ as a measure of stranger-directed aggression in three common dog breeds. Applied Animal Behaviour Science, 124(3–4), 141–146.

29.

van den Berg, S. M., Paap, M. C. S., Derks, E. M., et al. (2013). Using multidimensional modeling to combine self-report symptoms with clinical judgment of schizotypy. Psychiatry Research, 206(1), 75–80.

30.

Glas, C. A. W. (2010). Preliminary manual of the software program multidimensional item response theory (MIRT). Enschede: Department of Research Methodology, Measurement and Data-Analysis, University of Twente.

31.

Reise, S. P., Morizot, J., & Hays, R. D. (2007). The role of the bifactor model in resolving dimensionality issues in health outcomes measures. Quality of Life Research, 16, 19–31.PubMedCrossRef

32.

Reise, S. P. (2012). The rediscovery of bifactor measurement models. Multivariate Behavioral Research, 47(5), 667–696.PubMedCentralPubMedCrossRef

33.

Reise, S. P., Moore, T. M., & Haviland, M. G. (2010). Bifactor models and rotations: Exploring the extent to which multidimensional data yield univocal scale scores. Journal of Personality Assessment, 92(6), 544–559.PubMedCentralPubMedCrossRef

34.

Gustafsson, J.-E., & Åberg-Bengtsson, L. (2010). Unidimensionality and interpretability of psychological instruments. In S. E. Embretson (Ed.), Measuring psychological constructs: Advances in model-based approaches (pp. 97–121). Washington, DC: American Psychological Association.

35.

Reise, S. P., Scheines, R., Widaman, K. F., & Haviland, M. G. (2013). Multidimensionality and structural coefficient bias in structural equation modeling: A bifactor perspective. Educational and Psychological Measurement, 73(1), 5–26.

36.

Schmid, J., & Leiman, J. M. (1957). The development of hierarchical factor solutions. Psychometrika, 22, 53–61.CrossRef

37.

Revelle, W. (2012). Psych: Procedures for psychological, psychometric, and personality research. R package version 1.1–10. Retrieved from http://personality-project.org/r/psych.manual.pdf.

38.

Muthén, L. K., & Muthén, B. O. (2006). Mplus user’s guide, 4th, 6th edns. Los Angeles, CA: Muthén & Muthén.

39.

Cook, K. F., Kallen, M. A., & Amtmann, D. (2009). Having a fit: impact of number of items and distribution of data on traditional criteria for assessing IRT’s unidimensionality assumption. Quality Life Research, 18(4), 447–460.CrossRef

40.

Hu, L., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to unparameterized model misspecification. Psychological Methods, 3, 424–453.CrossRef

41.

Jones, P. W. (2002). Interpreting thresholds for a clinically significant change in health status in asthma and COPD. European Respiratory Journal, 19(3), 398–404.PubMedCrossRef

42.

Jones, P. W. (2005). St. George’s Respiratory Questionnaire: MCID. COPD: Journal of Chronic Obstructive Pulmonary Disease, 2(1), 75–79.PubMedCrossRef

43.

Al-Shair, K., Atherton, G. T., Kennedy, D., Powell, G., Denning, D. W., & Caress, A. (2013). Validity and reliability of the St. George’s Respiratory Questionnaire in assessing health status in patients with chronic pulmonary aspergillosis. Chest, 144(2), 623–631.

44.

Weldam, S. W., Schuurmans, M. J., Liu, R., & Lammers, J. W. (2013). Evaluation of Quality of Life instruments for use in COPD care and research: A systematic review. International Journal of Nursing Studies, 50(5), 688–707.

45.

Bae, Y. J., Kim, Y. S., Park, C. S., Lee, Y. S., Chang, Y. S., Cho, Y. S., et al. (2011). Reliability and validity of the St George’s Respiratory Questionnaire for asthma. The International Journal of Tuberculosis and Lung Disease, 15(7), 966–971.PubMedCrossRef

46.

Tafti, S. F., Cheraghvandi, A., Mokri, B., & Talischi, F. (2011). Validity and specificity of the Persian version of the Saint George Respiratory Questionnaire. Journal of Asthma, 48(6), 589–592.PubMedCrossRef

47.

Liang, W.-M., Chen, J.-J., Chang, C.-H., Chen, H.-W., Chen, S.-L., Hang, L.-W., et al. (2008). An empirical comparison of the WHOQOL-BREF and the SGRQ among patients with COPD. Quality of Life Research, 17(5), 793–800.PubMedCentralPubMedCrossRef

48.

El Rhazi, K., Nejjari, C., Benjelloun, M. C., Bourkadi, J., Afif, H., Serhier, Z., et al. (2006). Validation of the St. George’s Respiratory Questionnaire in patients with COPD or asthma in Morocco. The International Journal of Tuberculosis and Lung Disease, 10(11), 1273–1278.PubMed

49.

Sanjuas, C., Alonso, J., Prieto, L., Ferrer, M., Broquetas, J. M., & Anto, J. M. (2002). Health-related quality of life in asthma: A comparison between the St George’s Respiratory Questionnaire and the Asthma Quality of Life Questionnaire. Quality of Life Research, 11(8), 729–738.PubMedCrossRef

50.

Engstrom, C. P., Persson, L. O., Larsson, S., & Sullivan, M. (1998). Reliability and validity of a Swedish version of the St George’s Respiratory Questionnaire. European Respiratory Journal, 11(1), 61–66.PubMedCrossRef

51.

Ferrer, M., Alonso, J., Prieto, L., Plaza, V., Monso, E., Marrades, R., et al. (1996). Validity and reliability of the St George’s Respiratory Questionnaire after adaptation to a different language and culture: the Spanish example. European Respiratory Journal, 9(6), 1160–1166.PubMedCrossRef

52.

Yu, D. T. W., Scudds, R. J., & Scudds, R. A. (2004). Reliability and validity of a Hong Kong Chinese Version of the St George’s Respiratory Questionnaire in Patients with COPD. Hong Kong Physiotherapy Journal, 22(1), 33–39.CrossRef

53.

Rutten-van Molken, M., Roos, B., & Van Noord, J. A. (1999). An empirical comparison of the St George’s Respiratory Questionnaire (SGRQ) and the Chronic Respiratory Disease Questionnaire (CRQ) in a clinical trial setting. Thorax, 54(11), 995–1003.PubMedCrossRef

54.

Karpinski, N. (2005). Validierung von Lebensqualitäts-Assessments bei chronisch–obstruktiven Atemwegserkrankungen (validation of quality of life-assessments in patients with chronic obstructive pulmonary disease). Bremen: University of Bremen. Retrieved from http://d-nb.info/991362772/34.

55.

Paap, M. C. S. (2011). Examining the validity of the assessment of gender identity disorder: Diagnosis, self-reported psychological distress and strategy adjustment. Oslo: University of Oslo. Retrieved from https://www.duo.uio.no/bitstream/handle/10852/27940/dravhandling-paap.pdf.

56.

Wismeijer, A. A. J., Sijtsma, K., van Assen, M. A. L. M., & Vingerhoets, A. J. J. M. (2008). A comparative study of the dimensionality of the self-concealment scale using principal components analysis and Mokken scale analysis. Journal of Personality Assessment, 90(4), 323–334.PubMedCrossRef

57.

Nunnally, J. C. (1978). Psychometric theory. New York: McGraw-Hill.

58.

Timmerman, M. E. (2005). Factor analysis. Retrieved March 7, 2013, from http://www.ppsw.rug.nl/~metimmer/.

59.

Emons, W. H. M., Sijtsma, K., & Pedersen, S. S. (2012). Dimensionality of the Hospital Anxiety and Depression Scale (HADS) in cardiac patients: Comparison of Mokken Scale analysis and factor analysis. Assessment, 19(3), 337–353.

60.

Salaffi, F., Franchignoni, F., Giordano, A., Ciapetti, A., Gasparini, S., & Ottonello, M. (2013). Classical test theory and Rasch analysis validation of the recent-onset arthritis disability questionnaire in rheumatoid arthritis patients. Clinical Rheumatology, 32(2), 211–217.

61.

Brouwer, D., Meijer, R. R., Weekers, A. M., & Baneke, J. J. (2008). On the dimensionality of the Dispositional Hope Scale. Psychological Assessment, 20(3), 310–315.PubMedCrossRef

62.

Sousa, R. M., Dewey, M. E., Acosta, D., Jotheeswaran, A. T., Castro-Costa, E., Ferri, C. P., et al. (2010). Measuring disability across cultures–the psychometric properties of the WHODAS II in older people from seven low- and middle-income countries. The 10/66 Dementia Research Group population-based survey. International Journal of Methods In Psychiatric Research, 19(1), 1–17.PubMedCentralPubMed

Titel: The St George’s Respiratory Questionnaire revisited: a psychometric evaluation
verfasst von: Muirne C. S. Paap
Danny Brouwer
Cees A. W. Glas
Evelyn M. Monninkhof
Benjamin Forstreuter
Marcel E. Pieterse
Job van der Palen
Publikationsdatum: 01.01.2015
Verlag: Springer International Publishing
Erschienen in: Quality of Life Research / Ausgabe 1/2015
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-013-0570-y

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

The St George’s Respiratory Questionnaire revisited: a psychometric evaluation

Abstract

Purpose

Methods

Results

Conclusion

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2015

Time to health-related quality of life score deterioration as a modality of longitudinal analysis for health-related quality of life studies in oncology: do we need RECIST for quality of life to achieve standardization?

Does spouse participation influence quality of life reporting in patients with Parkinson’s disease?

Sample size for pre-tests of questionnaires

Validation of a pediatric oral health-related quality of life scale in Navajo children

Using quantitative methods within the Universalist model framework to explore the cross-cultural equivalence of patient-reported outcome instruments

Modeling health-related quality of life in people recovering from stroke