Authors (including presenting author) :
Cherry Wai Lee Lau(1), Damian Chi Hong Siu(1), Chi Tao So(1), Eric Hei Man Hui(1), Alexandra Fung(1), Tak Ming Chan(1), Fion Siu Fun Chan(1), Catherine Kam Fung Chan(1), Dr. Sai On Ling(2), Dr. Hoi Yee Kwan(2)
Affiliation :
(1)The hospital Authority Coordinating Committee- Grade in Occupational Therapy (Respiratory Sub-Specialty Group), (2)Respiratory Medical Department of Kowloon Hospital
Introduction :
Measurement of functional status of patients with COPD is essential in a multidimensional evaluation for healthcare professionals to have a comprehensive picture about the impacts of the disease and facilitate continuity of care. The Manchester Respiratory Activities of Daily Living Questionnaire (MRADLQ) is a multidimensional patient-reported questionnaire using a self-administered scale originally written in English and could be completed in about 10 minutes. MRADLQ is a valid and reliable tool measuring the functional ability of COPD patients in four domains: (1) mobility; (2) kitchen tasks; (3) domestic tasks; and (4) leisure activities. However, it has not yet been validated in Hong Kong.
Objectives :
To develop a Chinese version of MRADLQ with pictorial enhancement (C-MRADLQ) and examine its reliability and validity
Methodology :
A total of 302 subjects were recruited in the study. 238 subjects suffering from COPD were recruited from nine public hospitals and 64 subjects with normal spirometry results without previous clinical diagnosis of COPD from five Nurse and Allied Health Respiratory Clinics by convenient sampling were controls to examine validity of C-MRADLQ. Ten out of total 302 subjects were re-assessed with the C-MRADLQ after one week for test-retest reliability. The criterion validity of C-MRADLQ was examined by correlation with spirometry results, COPD classifications and groups by Global Initiative for Chronic Obstructive Lung Disease (GOLD), the modified Medical Research Council Dyspnea Scale (mMRC Dyspnea Scale), COPD Assessment Test (CAT), Chinese Version of the Shortness of Breath Questionnaire (C-SOBQ), number of admission and the ADO index by use of Spearman’s rank correlation coefficient. Multiple linear regression analysis was used to explore the predictors of total C-MRADLQ score.
Result & Outcome :
The C-MRADLQ shows good test-retest reliability as indicated by an intra-class correlation coefficient value of 0.975. Spearman’s rank correlation coefficient shows C-MRADLQ significantly correlated with COPD stage, COPD group, SOBQ score, CAT score, mMRC, ADO, index, spirometry results, and number of admissions. Multiple linear regression analysis using stepwise method indicated the SOBQ score, number of admissions, FEV1/FVC, and COPD group could significantly predict the total C-MRADLQ score. A total of 67.9% of participants’ mMRC levels were correctly classified by using the C-MRACLQ total score. Discussion & Conclusions: The Chinese version of the MRADLQ with pictorial enhancement was a valid and useful tool to understand patients with COPD and functional impairment in daily living. It can be adopted in clinical practice and provide healthcare professionals a comprehensive picture on patients’ ADL performance which guide for our treatment focus. This valid and reliable instrument allows healthcare professionals to document functional outcomes effectively among patients with COPD in Hong Kong.
