Background
Methods
Item selection and development
Patients
Psychometric evaluation of the item bank
Test design
Assessing item quality and calibrating the item bank
Results
Item selection and development
Domain definition
Item generation and revision
Item nr | Sourcea
| Original Item | Revised Item | Revised response format (RF) and instruction (In) |
---|---|---|---|---|
1 | QoL-RIQ | Being in air-conditioned buildings | Being in air-conditioned buildings (for instance, in hospitals) | RF1, In1 |
2 | QoL-RIQ | On cold days | RF1, In1 | |
3 | QoL-RIQ | On foggy days | RF1, In1 | |
4 | QoL-RIQ | On humid days | RF1, In1 | |
5 | On windy days | RF1, In1 | ||
6 | QoL-RIQ | Being outside during the polling season | RF1, In1 | |
7 | QoL-RIQ | Due to domestic animals or pets | RF1, In1 | |
8 | QoL-RIQ | By flowers, trees, plants | RF1, In1 | |
9 | VQ11 | I feel unable to achieve my objectives | Because of my COPD, I feel unable to achieve all of my objectives. | RF2, In2 |
10 | I am confident I will be able to cope with my COPD, even if the complaints get worse. | RF2b, In2 | ||
11 | I can imagine that there are people with severe COPD complaints, who feel that life is not worth living anymore. | RF2, In2 | ||
12 | I don’t like having to ask somebody to help me, when I cannot do something myself. | RF2, In2 | ||
13 | Because of my COPD, I appreciate my friends more. | Because of my COPD, I appreciate my social contacts (e.g., friends, partner, relatives) more. | RF2b, In2 | |
14 | When I think about my COPD, I have a feeling of hopelessness. | RF2, In2 | ||
15 | I shun activities I know will cause fatigue and breathlessness. | I shun activities I know will cause fatigue. | RF2, In2 | |
16 | Since being diagnosed with COPD, I have lived more consciously. | RF2b, In2 | ||
17 | I find it frustrating that I have to accept help for things I was used to doing myself. | RF2, In2 | ||
18 | If my COPD symptoms get worse, I don’t care about life anymore. | RF2, In2 | ||
19 | I am content with the things I can still do. | RF2b, In2 | ||
20 | I feel disappointed, when I’m not able to do something because of my COPD. | RF2, In2 | ||
21 | Because of my COPD I’m afraid of being alone. | RF2, In2 | ||
22 | When I worry about my COPD, I find it hard to talk about it. | RF2, In2 | ||
23 | I don’t feel restricted, due to my COPD. | I feel restricted, due to my COPD. | RF2, In2 | |
24 | I value my life just as much as I did before I was diagnosed with COPD. | RF2b, In2 | ||
25 | I shun activities I know will cause fatigue and breathlessness. | I shun activities I know will cause breathlessness. | RF2, In2 | |
26 | I avoid thinking about how my COPD could get worse in the future. | RF2, In2 | ||
27 | Once in a while I have such shortness of breath that I fear I will suffocate. | Once in a while I have such shortness of breath/wheezy chest that I fear I will suffocate. | RF2, In2 | |
28 | I find it very hard to accept that I cannot do everything I would like to do, due to my COPD. | I find it hard to accept that I cannot do everything I would like to do, due to my COPD. | RF2, In2 | |
29 | QoL-RIQ | Feeling dependent upon others | I don’t like the feeling of being dependent upon others. | RF2, In2 |
30 | MRF-26 | Because of my lung disease, I cannot talk as much as I would like to. | Because of my COPD, I cannot talk as much as I would like to. | RF2, In2 |
31 | Because of my COPD, I am sometimes unable to control my bowel movements. | RF2, In2 | ||
32 | MRF-26 | Because of my COPD, I visit friends and acquaintances less frequently than I used to. | Because of my COPD, I go out to see friends or acquaintances less than usual. | RF2, In2 |
33 | MRF-26 | Because of my COPD, I spend much more time alone. | Because of my COPD, I spend much more time alone. | RF2, In2 |
34 | MRF-26 | Because of my COPD, I would like somebody to accompany me, when I go out | Because of my COPD, when I am outside I feel I need to have someone with me. | RF2, In2 |
35 | SGRQ-C | My cough hurts | RF2, In2 | |
36 | SGRQ-C | My cough makes me tired | RF2, In2 | |
37 | SGRQ-C | I am breathless when I talk | I get breathless when I talk | RF2, In2 |
38 | SGRQ-C | I am breathless when I bend over | I get breathless when I bend over | RF2, In2 |
39 | SGRQ-C | My cough or breathing disturbs my sleep | RF2, In2 | |
40 | SGRQ-C | I get exhausted easily | I get tired easily | RF2, In2 |
41 | SGRQ-C | My cough or breathing is embarrassing in public | I feel ashamed when I have to cough or when I have difficulty breathing in the presence of other people | RF2, In2 |
42 | SGRQ-C | My chest trouble is a nuisance to my family, friends or neighbours | I feel that my chest trouble is a nuisance to my environment (e.g. family, friends or neighbours) | RF2, In2 |
43 | SGRQ-C | I get afraid or panic when I cannot get my breath | RF2, In2 | |
44 | SGRQ-C | I feel that I am not in control of my chest problem | I have the feeling that I am not in control of my chest problem | RF2, In2 |
45 | SGRQ-C | I have become frail or an invalid because of my chest | I have become frail or an invalid because of my chest problem | RF2, In2 |
46 | SGRQ-C | Everything seems too much of an effort | RF2, In2 | |
47 | SGRQ-C | My breathing makes it difficult to do things such as walk up hills, carrying things up stairs, light gardening such as weeding, dance, play bowls or play golf | My breathing problems make it difficult to do light gardening, such as weeding. | RF2, In2 |
48 | SGRQ-C | My breathing makes it difficult to do things such as carry heavy loads, dig the garden or shovel snow, jog or walk at 5 miles per hour, play tennis or swim. | My breathing problems make it difficult to exercise (e.g., jogging, playing tennis, or swimming). | RF2, In2 |
49 | SGRQ-C | My breathing makes it difficult to do things such as walk up hills, carrying things up stairs, light gardening such as weeding, dance, play bowls or play golf. | My breathing problems make it difficult to do things such as dancing, playing golf, or playing bowls. | RF2, In2 |
50 | It frustrated me that I couldn’t do everything I wanted to do anymore. | RF3, In3 | ||
51 | I thought sometimes, I’m really fed up with everything. | RF3, In3 | ||
52 | I wanted to stay in bed/lie down on the couch all day, when I had a “bad” day. | RF3, In3 | ||
53 | I resigned myself to the fact that I was not able to do certain things anymore, due to my COPD. | I could accept it, when I was not able to do something anymore, due to my COPD. | RF3b, In3 | |
54 | I tried to find an alternative when I could not perform a certain activity due to my COPD. | I persevered until I had finished an activity, despite the fact that I couldn’t perform that activity well, due to my COPD. | RF3b, In3 | |
55 | I panicked, when I had trouble breathing | RF3, In3 | ||
56 | I could cope with my COPD. | RF3b, In3 | ||
57 | I got my breathing problems under control. | RF3b, In3 | ||
58 | SGRQ-C | I cough | I coughed. | RF3, In3 |
59 | SGRQ-C | I bring up phlegm (sputum) | I brought up phlegm (sputum). | RF3, In3 |
60 | SGRQ-C | I have shortness of breath | I had shortness of breath. | RF3, In3 |
61 | SGRQ-C | I have attacks of wheezing | I had attacks of wheezing. | RF3, In3 |
62 | SGRQ-C | Getting washed or dressed | RF3, In4 | |
63 | SGRQ-C | Walking around the home | RF3, In4 | |
64 | SGRQ-C | Walking outside on the level | Going for a walk | RF3, In4 |
65 | SGRQ-C | Walking up a flight of stairs | Walking up a flight of stairs (one floor) | RF3, In4 |
66 | SGRQ-C | Walking up hills | Walking up a steep hill | RF3, In4 |
Preparing the data for psychometric analysis
Psychometric evaluation of the item bank
Assessing item quality: results of the MSA and visual inspection of GAM plots
Item nr | item content (key words) |
\( \widehat{\boldsymbol{\alpha}} \)
|
\( \widehat{{\boldsymbol{\beta}}_1} \)
|
\( \widehat{{\boldsymbol{\beta}}_2} \)
|
\( \widehat{{\boldsymbol{\beta}}_3} \)
|
\( \widehat{{\boldsymbol{\beta}}_4} \)
| booklet | flagged in MSA (booklet) |
---|---|---|---|---|---|---|---|---|
1 | air-conditioning | 1.06 | −2.64 | −1.08 | 0.27 | 1 | ||
2 | cold | 1.15 | −3.1 | −0.92 | 0.32 | 1.54 | 1, 2, 3 | |
3 | fog | 1.4 | −2.08 | −0.28 | 0.71 | 1.83 | 1 | |
4 | humidity | 1.39 | −2.32 | −0.33 | 0.77 | 1.64 | 1 | |
5 | wind | 1.25 | −2.09 | −0.38 | 0.62 | 1.88 | 1, 2 | |
9 | achieving objectives | 1.8 | −1.04 | 0.83 | 1.38 | 2.31 | 1, 2, 3 | |
10 | confidence | 0.31 | −11.43 | −5.73 | −2.02 | 7.99 | 1, 2, 3 | 1, 2, 3 |
11 | life worth living | 0.76 | −2.28 | 0.56 | 2.2 | 3.72 | 2 | 2 |
12 | asking for help | 0.81 | −1.78 | 1.39 | 2.24 | 4.16 | 1, 2, 3 | 2, 3 |
13 | friendship | −0.59 | 4.97 | 2.5 | 0.57 | −3.6 | 3 | 3 |
14 | hopelessness | 1.69 | −2.51 | −0.84 | 0.15 | 1.34 | 1 | |
15 | fatigue | 1.21 | −2.27 | 0.01 | 0.94 | 2.7 | 1, 2, 3 | |
16 | living consciously | −0.52 | 5.69 | 2.59 | 0.23 | −5.77 | 2 | 2 |
17 | accepting help | 1.52 | −1.05 | 0.72 | 1.46 | 2.29 | 1 | |
18 | life worth living 2 | 1.32 | −2.71 | −1.57 | −0.38 | 1.18 | 3 | |
19 | feeling content | 0.26 | −11.08 | −6.75 | −3.34 | 4.8 | 1 | 1 |
20 | feeling disappointed | 1.35 | −2.06 | −0.4 | 0.68 | 2.47 | 2 | |
21 | fear of being alone | 1.69 | −1.65 | −0.44 | 0.75 | 2 | ||
22 | talking about anxiety | 1.1 | −1.02 | −0.04 | 1.85 | 1 | ||
23 | feeling restricted | 2.33 | −1.08 | 0.5 | 1.16 | 1.87 | 3 | |
24 | valuing life | 0.71 | −4.84 | −2.22 | −0.93 | 2.64 | 3 | 3 |
25 | shunning activities | 1.43 | −2.28 | 0.16 | 0.85 | 2.26 | 2 | |
26 | avoidance | 0.65 | −4.09 | −0.44 | 1.17 | 3.68 | 1 | 1 |
27 | fear of suffocation | 1.94 | −2.18 | −0.87 | −0.14 | 1.12 | 1, 2, 3 | |
28 | not accepting restrictions | 1.61 | −1.32 | 0.56 | 1.31 | 2.41 | 1 | |
29 | dependence | 2.08 | −2.12 | −0.44 | 0.03 | 1.2 | 2 | |
30 | talking | 1.72 | −2.34 | −0.65 | −0.06 | 1.22 | 3 | |
31 | bowel problems | 0.86 | −2.91 | −1.18 | 0.66 | 1 | 1 | |
32 | friendship 2 | 1.91 | −2.06 | −0.75 | −0.18 | 0.94 | 1, 2, 3 | |
33 | alone | 1.74 | −2.1 | −0.75 | −0.13 | 1.18 | 3 | |
34 | fear of being alone 2 | 1.67 | −1.39 | −0.63 | 0.95 | 2 | ||
35 | cough hurts | 1.41 | −1.68 | −0.5 | 0.98 | 1 | ||
36 | cough tired | 1.79 | −1.78 | −0.05 | 0.58 | 1.43 | 1 | |
37 | breathless talk | 1.48 | −0.53 | 0.24 | 1.69 | 2 | ||
38 | breathless bend | 1.52 | −1.87 | 0.07 | 0.72 | 1.9 | 3 | |
39 | sleep disturbed | 1.44 | −2.63 | −0.75 | 0.09 | 1.54 | 1, 2, 3 | 2 |
40 | exhausted | 2.04 | −1.13 | 0.96 | 1.43 | 3 | ||
41 | cough embarrassing | 1.11 | −3.35 | −1.19 | −0.18 | 1.94 | 1, 2, 3 | 3 |
42 | nuisance to others | 1.97 | −2.21 | −0.86 | −0.15 | 1.22 | 2 | |
43 | panic | 2.4 | −1.86 | −0.63 | 0.04 | 1.19 | 2 | |
44 | not in control | 1.64 | −1.41 | −0.39 | 1.59 | 1 | ||
45 | frail, invalid | 2.33 | −1.75 | −0.28 | 0.3 | 1.28 | 2 | |
46 | effort | 2.22 | −1.99 | −0.56 | 0.16 | 1.54 | 3 | |
47 | activities (gardening) | 2.34 | −1.13 | 0.11 | 0.62 | 1.64 | 1 | |
48 | activities (exercise) | 1.55 | −0.82 | 0.92 | 1.54 | 3 | 3 | |
49 | activities (dancing) | 2.12 | −0.88 | 0.35 | 0.81 | 1.8 | 1 | |
50 | frustration | 2.21 | −2.07 | −0.7 | 0.46 | 1.2 | 3 | |
51 | being fed up | 1.7 | −2.41 | −1.37 | −0.66 | 1 | ||
52 | wanting to stay in bed | 1.35 | −2.14 | −0.94 | 0 | 3 | ||
53 | acceptance | −0.32 | 4.93 | 2.4 | −2.92 | −8.17 | 2 | 2 |
54 | adapting | 0.12 | −14.8 | −7.53 | 3.94 | 20.35 | 3 | 3 |
55 | panic 2 | 1.88 | −2.06 | −0.88 | 0.25 | 2 | ||
56 | coping | 1.08 | −3.1 | −1.08 | 0.97 | 3 | ||
57 | control | 1.39 | −1.05 | 0.74 | 1 | |||
58 | cough | 0.74 | −3.97 | −0.92 | 1.51 | 3.32 | 1 | 1 |
59 | phlegm | 0.8 | −3.27 | −1.43 | 0.52 | 2.17 | 1 | 1 |
60 | short of breath | 1.95 | −1.58 | −0.22 | 1.55 | 1 | ||
61 | wheezing | 0.81 | −3.47 | −1.51 | 0.49 | 2.02 | 1 | 1 |
62 | breathless wash | 2.28 | −1.47 | −0.64 | 0.1 | 0.66 | 3 | |
63 | breathless walk 1 | 2.49 | −2.07 | −1.25 | −0.2 | 0.47 | 3 | |
64 | breathless walk 2 | 0.98 | −1.98 | −0.51 | 1.24 | 2.31 | 1, 2, 3 | 1, 2 |
65 | breathless stairs | 0.77 | −1.52 | −0.19 | 1.35 | 2.92 | 2 | 2 |
66 | breathless hills | 0.04 | −17.48 | 6.54 | 22.32 | 36.14 | 1 | 1, 2 |