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British Journal of Cancer logoLink to British Journal of Cancer
. 2000 Feb;82(4):800–805. doi: 10.1054/bjoc.1999.1002

Development and validation of the Cancer Dyspnoea Scale: a multidimensional, brief, self-rating scale

K Tanaka 1,2, T Akechi 1,4, T Okuyama 1,2, Y Nishiwaki 2, Y Uchitomi 1,3
PMCID: PMC2374383  PMID: 10732749

Abstract

Dyspnoea is one of the most frequent and refractory symptoms in cancer patients. Lack of an appropriate assessment tool for dyspnoea seems to disturb establishment of management strategy. The purpose of this study was to develop and validate a brief self-rating scale to assess the multidimensional nature of dyspnoea in cancer patients. We developed a 12-item scale, the Cancer Dyspnoea Scale (CDS), composed of three factors (sense of effort/sense of anxiety/sense of discomfort), by using factor analysis. One hundred and sixty-six patients with advanced or recurrent lung cancer participated in the validation phase. The CDS showed good feasibility (average time required to complete it was 140 s). Construct validity, confirmed by repeating factor analysis, was good. Convergent validity, confirmed by a relation to Visual Analogue Scale of dyspnoea and modified Borg's scale, was also good (average: r = 0.57 and 0.52, respectively, and both P< 0.001). The CDS had good internal consistency (average Cronbach's alpha = 0.86) and stability (average test-retest reliability r = 0.66, P< 0.005). The present study demonstrated that the CDS is a brief, valid and feasible scale for assessing the multidimensional nature of dyspnoea in cancer patients. © 2000 Cancer Research Campaign

Keywords: cancer, dyspnoea, assessment, scale, multidimensional, validation

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Selected References

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  1. Aitken R. C. Measurement of feelings using visual analogue scales. Proc R Soc Med. 1969 Oct;62(10):989–993. [PMC free article] [PubMed] [Google Scholar]
  2. Bonomi A. E., Cella D. F., Hahn E. A., Bjordal K., Sperner-Unterweger B., Gangeri L., Bergman B., Willems-Groot J., Hanquet P., Zittoun R. Multilingual translation of the Functional Assessment of Cancer Therapy (FACT) quality of life measurement system. Qual Life Res. 1996 Jun;5(3):309–320. doi: 10.1007/BF00433915. [DOI] [PubMed] [Google Scholar]
  3. Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med. 1970;2(2):92–98. [PubMed] [Google Scholar]
  4. Burdon J. G., Killian K. J., Jones N. L. Pattern of breathing during exercise in patients with interstitial lung disease. Thorax. 1983 Oct;38(10):778–784. doi: 10.1136/thx.38.10.778. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Burns B. H., Howell J. B. Disproportionately severe breathlessness in chronic bronchitis. Q J Med. 1969 Jul;38(151):277–294. [PubMed] [Google Scholar]
  6. Daut R. L., Cleeland C. S., Flanery R. C. Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases. Pain. 1983 Oct;17(2):197–210. doi: 10.1016/0304-3959(83)90143-4. [DOI] [PubMed] [Google Scholar]
  7. Elliott M. W., Adams L., Cockcroft A., MacRae K. D., Murphy K., Guz A. The language of breathlessness. Use of verbal descriptors by patients with cardiopulmonary disease. Am Rev Respir Dis. 1991 Oct;144(4):826–832. doi: 10.1164/ajrccm/144.4.826. [DOI] [PubMed] [Google Scholar]
  8. FLETCHER C. M., ELMES P. C., FAIRBAIRN A. S., WOOD C. H. The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. Br Med J. 1959 Aug 29;2(5147):257–266. doi: 10.1136/bmj.2.5147.257. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Gift A. G., Cahill C. A. Psychophysiologic aspects of dyspnea in chronic obstructive pulmonary disease: a pilot study. Heart Lung. 1990 May;19(3):252–257. [PubMed] [Google Scholar]
  10. Gift A. G. Validation of a vertical visual analogue scale as a measure of clinical dyspnea. Rehabil Nurs. 1989 Nov-Dec;14(6):323–325. doi: 10.1002/j.2048-7940.1989.tb01129.x. [DOI] [PubMed] [Google Scholar]
  11. Higginson I., McCarthy M. Measuring symptoms in terminal cancer: are pain and dyspnoea controlled? J R Soc Med. 1989 May;82(5):264–267. doi: 10.1177/014107688908200507. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Mador M. J., Rodis A., Magalang U. J. Reproducibility of Borg scale measurements of dyspnea during exercise in patients with COPD. Chest. 1995 Jun;107(6):1590–1597. doi: 10.1378/chest.107.6.1590. [DOI] [PubMed] [Google Scholar]
  13. Mahler D. A., Rosiello R. A., Harver A., Lentine T., McGovern J. F., Daubenspeck J. A. Comparison of clinical dyspnea ratings and psychophysical measurements of respiratory sensation in obstructive airway disease. Am Rev Respir Dis. 1987 Jun;135(6):1229–1233. doi: 10.1164/arrd.1987.135.6.1229. [DOI] [PubMed] [Google Scholar]
  14. Manning H. L., Schwartzstein R. M. Pathophysiology of dyspnea. N Engl J Med. 1995 Dec 7;333(23):1547–1553. doi: 10.1056/NEJM199512073332307. [DOI] [PubMed] [Google Scholar]
  15. McCord M., Cronin-Stubbs D. Operationalizing dyspnea: focus on measurement. Heart Lung. 1992 Mar;21(2):167–179. [PubMed] [Google Scholar]
  16. McGavin C. R., Artvinli M., Naoe H., McHardy G. J. Dyspnoea, disability, and distance walked: comparison of estimates of exercise performance in respiratory disease. Br Med J. 1978 Jul 22;2(6132):241–243. doi: 10.1136/bmj.2.6132.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Moody L., McCormick K., Williams A. Disease and symptom severity, functional status, and quality of life in chronic bronchitis and emphysema (CBE). J Behav Med. 1990 Jun;13(3):297–306. doi: 10.1007/BF00846836. [DOI] [PubMed] [Google Scholar]
  18. Muza S. R., Silverman M. T., Gilmore G. C., Hellerstein H. K., Kelsen S. G. Comparison of scales used to quantitate the sense of effort to breathe in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1990 Apr;141(4 Pt 1):909–913. doi: 10.1164/ajrccm/141.4_Pt_1.909. [DOI] [PubMed] [Google Scholar]
  19. O'Connor P. J., Raglin J. S., Morgan W. P. Psychometric correlates of perception during arm ergometry in males and females. Int J Sports Med. 1996 Aug;17(6):462–466. doi: 10.1055/s-2007-972879. [DOI] [PubMed] [Google Scholar]
  20. Reuben D. B., Mor V. Dyspnea in terminally ill cancer patients. Chest. 1986 Feb;89(2):234–236. doi: 10.1378/chest.89.2.234. [DOI] [PubMed] [Google Scholar]
  21. Ripamonti C., Bruera E. Dyspnea: pathophysiology and assessment. J Pain Symptom Manage. 1997 Apr;13(4):220–232. doi: 10.1016/s0885-3924(96)00327-2. [DOI] [PubMed] [Google Scholar]
  22. Simon P. M., Schwartzstein R. M., Weiss J. W., Fencl V., Teghtsoonian M., Weinberger S. E. Distinguishable types of dyspnea in patients with shortness of breath. Am Rev Respir Dis. 1990 Nov;142(5):1009–1014. doi: 10.1164/ajrccm/142.5.1009. [DOI] [PubMed] [Google Scholar]
  23. Simon P. M., Schwartzstein R. M., Weiss J. W., Lahive K., Fencl V., Teghtsoonian M., Weinberger S. E. Distinguishable sensations of breathlessness induced in normal volunteers. Am Rev Respir Dis. 1989 Oct;140(4):1021–1027. doi: 10.1164/ajrccm/140.4.1021. [DOI] [PubMed] [Google Scholar]
  24. Wolkove N., Dajczman E., Colacone A., Kreisman H. The relationship between pulmonary function and dyspnea in obstructive lung disease. Chest. 1989 Dec;96(6):1247–1251. doi: 10.1378/chest.96.6.1247. [DOI] [PubMed] [Google Scholar]

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