Chest
Volume 112, Issue 3, September 1997, Pages 614-622
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Clinical Investigations: COPD
A New Self-Administered Questionnaire to Monitor Health-Related Quality of Life in Patients With COPD

https://doi.org/10.1378/chest.112.3.614Get rights and content

Study objective

To develop and validate a brief, computer-scannable, self-administered questionnaire to monitor health-related quality of life in patients with COPD. The Seattle Obstructive Lung Disease Questionnaire (SOLQ) consists of 29 items measuring four health dimensions: physical function, emotional function, coping skills, and treatment satisfaction.

Methods

A series of studies was performed to assess reliability, validity, and responsiveness. Internal consistency was measured using a cross-sectional survey of 203 COPD patients. Reproducibility was tested over a 4-month interval among 97 patients with self-reported stable conditions. To assess construct validity, SOLQ scales were correlated with corresponding Chronic Respiratory Disease Questionnaire (CRDQ) scales, the COPD Self-Efficacy Scale (CSES), percent predicted FEV1, and 6-min walk test. Treatment satisfaction scores of 920 subjects were correlated with a general measure of patient satisfaction. Baseline and follow-up scores of subjects were compared to assess treatment responsiveness.

Results

SOLQ scales were reliable (Cronbach's α 0.79 to 0.93, and intraclass correlation coefficients 0.64 to 0.87). Change in SOLQ scores correlated with corresponding CRDQ scales: dyspnea, r=0.42; emotional burden, r=0.49; mastery, r=0.36. Coping skills correlated highly with CSES, r=0.93. Treatment satisfaction correlation was r=0.54. Significant changes occurred in all three scales postintervention.

Conclusion

The SOLQ is a reliable, valid, and responsive measure of physical and emotional function, coping skills, and treatment satisfaction. Brief, self-administered, and computer scannable, it is useful in monitoring long-term outcomes among large groups of COPD patients.

Section snippets

Development of the SOLQ

Three dimensions of health and one of treatment satisfaction were included in the new questionnaire. The physical function scale assesses the degree of dyspnea and the extent of physical limitation. This scale is unique because it includes items specific to pulmonary disease and items derived from the physical functioning scale of the SF-36. The emotional function scale measures the impact of the disease on patients' psychological well-being. The coping skills scale measures self-efficacy and

Subject Characteristics

Participants in the study were predominantly male, 95% men, with a mean age of 70 years for the reliability study and 67 years for the validation study. Ninety-five percent of the validation study participants were white and the remainder were African-American.

Reliability

Internal consistency, measured by Cronbach's α for the 203 clinic subjects, was high for each scale: physical function, 0.93; emotional function, 0.79; coping skills, 0.82; and treatment satisfaction, 0.90. A comparison of the scores

Discussion

This report describes a series of investigations that demonstrate the reliability, validity, and responsiveness of the SOLQ, a new self-administered health-related quality of life instrument for COPD. All four scales had excellent internal consistency. The test-retest reliability of the questionnaire was clearly demonstrated by the high intraclass correlation coefficients among patients with stable disease followed up over a 4-month interval. Despite the length of follow-up, a factor that could

Acknowledgments

We would like to thank our research team for their various contributions to this project: Jan Prodzinski, Barb Stansfeld, Barb Weinstein, Tasha Essen, Dr. Hu Lan Ding, Anneliese Schleyer, David Josephson, and Ed Nelson.

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