Validación de la versión en español del cuestionario COPD-Q/EPOC-Q de conocimiento de la EPOC

doi:10.1016/j.arbres.2015.03.013

Archivos de Bronconeumología

Volume 52, Issue 1, January 2016, Pages 12-16

https://doi.org/10.1016/j.arbres.2015.03.013 Get rights and content

Resumen

Fundamentos

A pesar de que el reconocimiento de la importancia de la formación de los pacientes con EPOC ha crecido en los últimos años, no se está midiendo el grado de conocimiento de dicha enfermedad por falta de instrumentos específicos. El objetivo de este estudio es validar el cuestionario de conocimiento de la EPOC (EPOC-Q) de 13 ítems.

Métodos

Tras la doble traducción del EPOC-Q se llevó a cabo la validación lógica y de contenido por un grupo de neumólogos expertos en EPOC y 8 pacientes con la enfermedad. La fiabilidad se estudió en un grupo independiente de 59 pacientes con EPOC grave vistos en planta o en consultas de neumología de 6 centros de varias regiones de España (Andalucía, Baleares, Castilla-La Mancha, Galicia y Madrid). Esta muestra también se usó para otras validaciones internas y externas.

Resultados

El grupo tenía una media de edad de aproximadamente 70 años y una alfabetización en salud media baja. El número de respuestas acertadas fue de 8,3 (DE: 1,9), con una mediana de 8 y un rango entre 3 y 13. Los efectos suelo y techo fueron 0 y 1,5%, respectivamente. La consistencia interna del cuestionario es buena (alfa de Cronbach de 0,85) y la fiabilidad también alta, siendo el coeficiente kappa > 0,6 en todos los ítems y el coeficiente de correlación intraclase de la puntuación total de 0,84.

Conclusión

El cuestionario EPOC-Q de 13 ítems es un instrumento válido, aplicable y fiable para evaluar el conocimiento de la EPOC.

Abstract

Rationale

Although recognition of the importance of educating chronic obstructive pulmonary disease (COPD) patients has grown in recent years, their understanding of this disease is not being measured due to a lack of specific instruments. The aim of this study was to validate the COPD-Q questionnaire, a 13-item instrument for determining COPD knowledge.

Methods

The COPD-Q was translated and backtranslated, and subsequently submitted to logic and content validation by a group of COPD experts and 8 COPD patients. Reliability was studied in an independent group of 59 patients with severe COPD seen in the pulmonology ward or clinics of 6 hospitals in Spain (Andalusia, Baleares, Castilla-La Mancha, Galicia and Madrid). This sample was also used for other internal and external validations.

Results

The mean age of the group was approximately 70 years and their health awareness was low-to-medium. The number of correct answers was 8.3 (standard deviation: 1.9), median 8, range 3-13. Floor and ceiling effects were 0% and 1.5%, respectively. Internal consistency of the questionnaire was good (Cronbach's alpha = 0.85) and reliability was also high, with a kappa coefficient > 0.6 for all items and an intraclass correlation efficient of 0.84 for the total score.

Conclusion

The 13-item COPD-Q is a valid, applicable and reliable instrument for determining patients’ knowledge of COPD.

Section snippets

Introducción

La concienciación sobre la importancia de las intervenciones formativas dirigidas a pacientes con enfermedades crónicas ha aumentado en los últimos años¹, tanto porque es mayor el interés de los propios afectados por conocer mejor sus dolencias como porque ha calado en los sistemas sanitarios la necesidad de promover los autocuidados de las enfermedades crónicas como forma de mejorar la asistencia2, 3. Además, las posibilidades que ofrecen Internet y la telefonía móvil han agigantado las

Validación lógica y de contenido de la traducción

La validez lógica es el grado en que parece que un cuestionario mide lo que se quiere medir. Se considera que el contenido es válido desde este punto de vista si contempla todos o al menos un número suficiente de los aspectos relacionados con el concepto, en este caso el conocimiento de la EPOC. Esto es un proceso subjetivo para cuya determinación primero se realizó una doble traducción por 2 médicos bilingües y luego un grupo de 14 neumólogos hispanoparlantes, expertos en EPOC, evaluó la

Resultados

Se reclutaron 59 pacientes, 30 con baja alfabetización. Los pacientes de la muestra tienen de media obstrucción grave (FEV₁ 43,6 ± 18%) y su edad es de aproximadamente 70 años (tabla 1). La proporción de mujeres es del 20% (tabla 1). No se observaron diferencias significativas en las características generales de ambos grupos (tabla 1), aunque había una tendencia a que los que tenían menos alfabetización fuesen más jóvenes.

Tampoco hubo diferencias en las puntuaciones del EPOC-Q entre ambos grupos (

Discusión

La versión traducida al español del COPD-Q⁹, el EPOC-Q, es sencilla de administrar y, basándose en la opinión de expertos y pacientes, todas las preguntas son fáciles de entender. Se observó una elevada consistencia interna (alfa de Cronbach de 0,825) y una buena reproducibilidad (coeficiente de correlación intraclase de 0,842).

Aunque el COPD-Q fue diseñado originalmente para evaluar pacientes de baja alfabetización en salud, el EPOC-Q no parece funcionar de forma diferente en los pacientes con

Conflicto de intereses

Ninguno de los autores percibe ningún conflicto de intereses con el contenido este artículo.

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The COPD-Q is a valid and reliable questionnaire that assesses COPD knowledge. It has a maximum score of 13, indicating the best COPD knowledge [24]. Pharmacological management in COPD patients was assessed with the Test of Adherence to Inhalers (TAI) [25].
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Patients were randomly allocated to a control group that received standard treatment or an intervention group that received an individualized SDM-PE program in addition to standard treatment. The SDM-PE program included personalized health care focused on information about the disease, healthcare management, and reinforcement of behaviors regarding nutrition and exercise taking into account patients’ preferences.
A comparative analysis between groups showed a significant improvement in perceived health status at discharge in patients included in the experimental group compared to those in the control group (60.28 ± 21.65 vs. 54.13 ± 22.69, p = 0.036). In addition, perceived health status, COPD knowledge, adherence to pharmacological treatment, general functionality, and healthy lifestyle measures were significantly better at 3-month follow-up in the intervention group.
An SDM-PE program significantly enhanced all the clinical measures assessed during hospitalization at 3-month follow-up.
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Translation and Validation of the Multidimensional Dyspnea-12 Questionnaire
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La disnea es un síntoma con un componente multidimensional, aunque las herramientas que se utilizan habitualmente para evaluarla no tienen en cuenta esta faceta. El cuestionario Disnea-12 valora la multidimensionalidad de la disnea, específicamente las dimensiones afectiva y sensorial. El objetivo de este estudio es validar el cuestionario Disnea-12 al español.
Se realizó una traducción del original en inglés al español y del español al inglés para verificar la equivalencia del texto. Posteriormente se verificó la comprensión del texto tras pasárselo a 10 pacientes. La fiabilidad y la validez del cuestionario se estudiaron en un grupo independiente de EPOC diagnosticados y clasificados por las guías GOLD de las consultas externas de neumología del Hospital Universitario Marqués de Valdecilla.
El grupo (n = 51) tenía una media de edad de 65 años y un FEV1 medio del 50%. Todos los pacientes entendieron las preguntas del cuestionario. El instrumento presentó consistencia interna de α = 0,937 y un coeficiente de correlación intraclase: 0,969; p < 0,001. Se encontraron correlaciones estadísticamente significativas con las puntuaciones del HAD (HADansiedad r = 0,608 y HADdepresión r = 0,615), disnea de la mMRC (r = 0,592), T6MM (r = –0,445), FEV1 (r = –0,312), las 4 dimensiones de CRQ-SAS (disnea r = –0,626; fatiga r = –0,718; función emocional r = –0,663; control de enfermedad r = –0,740), el CAT (r = 0,669) y el índice de disnea basal (r = –0,615). Los grupos GOLD más sintomáticos (B y D) presentaron una puntuación 10,32 puntos mayor en en el Disnea-12 (p < 0,001).
El cuestionario Disnea-12 es un instrumento válido y fiable para evaluar la disnea de forma multidimensional.
Dyspnea is a multidimensional symptom, but this multidimensionality is not considered in most dyspnea questionnaires. The Dyspnea-12 takes a multidimensional approach to the assessment of dyspnea, specifically the sensory and the affective response. The objective of this study was to translate into Spanish and validate the Dyspnea-12 questionnaire.
The original English version of the Dyspnea-12 questionnaire was translated into Spanish and backtranslated to analyze its equivalence. Comprehension of the text was verified by analyzing the responses of 10 patients. Reliability and validation of the questionnaire were studied in an independent group of COPD patients attending the pulmonology clinics of Hospital Universitario Marqués de Valdecilla, diagnosed and categorized according to GOLD guidelines.
The mean age of the group (n = 51) was 65 years and mean FEV1 was 50%. All patients understood all questions of the translated version of Dyspnea-12. Internal consistency of the questionnaire was α=0.937 and intraclass correlation coefficient was = .969; P < .001. Statistically significant correlations were found with HADS (anxiety r = .608 and depression r = .615), mMRC dyspnea (r = .592), 6 MWT (r = –0.445), FEV1 (r = –0.312), all dimensions of CRQ-SAS (dyspnea r = –0.626; fatigue r = –0.718; emotional function r = –0.663; mastery r = –0.740), CAT (r = 0.669), and baseline dyspnea index (r = –0.615). Dyspnea-12 scores were 10.32 points higher in symptomatic GOLD groups (B and D) (P < .001).
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OriginalValidación de la versión en español del cuestionario COPD-Q/EPOC-Q de conocimiento de la EPOCValidation of the Spanish Version of the COPD-Q Questionnaire on COPD Knowledge

Resumen

Fundamentos

Métodos

Resultados

Conclusión

Abstract

Rationale

Methods

Results

Conclusion

Section snippets

Introducción

Validación lógica y de contenido de la traducción

Resultados

Discusión

Conflicto de intereses

Patient Educ Couns.

Public health activities in improvement of citizens’ health. 25 years leading up to establishment of a health improvement center

Hokenfu Zasshi.

Self-management education for patients with chronic obstructive pulmonary disease

Cochrane Database Syst Rev.

Changes in costs and effects after the implementation of disease management programs in the Netherlands: Variability and determinants

Cost Eff Resour Alloc.

Measuring respiratory symptoms of COPD: Performance of the EXACT-Respiratory Symptoms Tool (E-RS) in three clinical trials

Respir Res.

A telehealth program for self-management of COPD exacerbations and promotion of an active lifestyle: A pilot randomized controlled trial

Int J Chron Obstruct Pulmon Dis.

Systems biology and p4 medicine: Past, present, and future

Rambam Maimonides Med J.

Effectiveness of chronic obstructive pulmonary disease-management programs: Systematic review and meta-analysis

Am J Med.

Bristol COPD Knowledge Questionnaire (BCKQ): Testing what we teach patients about COPD

Chron Respir Dis.

Original
Validación de la versión en español del cuestionario COPD-Q/EPOC-Q de conocimiento de la EPOCValidation of the Spanish Version of the COPD-Q Questionnaire on COPD Knowledge