Estudo comparativo entre dois questionários de qualidade de vida em pacientes com DPOC

Abstract

Objective: To compare two quality of life questionnaires-the Saint George's Respiratory Questionnaire (SGRQ) and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36)-in patients with COPD, focusing on the discriminative properties of the questionnaires and correlating their domains with the following variables: Modified Medical Research Council Dyspnea Scale score; Beck Depression Inventory score; visual analog scale general health perception; Mini-Mental State Examination score; and a COPD clinical score developed specifically for the study. Methods: We interviewed 30 COPD patients between May and September of 2006. For the SF-36 and SGRQ, scores (total and domain) were compared and correlated. Results: With the exception of the pain domain, all of the SF-36 domains correlated significantly with the SGRQ total score (r = −0.5 to −0.69; p < 0.01). Of the SGQR domains, only the symptoms domain correlated significantly with all of the variables studied (p < 0.05). Conclusions:The majority of the expected correlations between the SGRQ and the SF-36 were observed, as were those expected between the two questionnaires and the other variables studied. The SGRQ, notably the symptoms domain, presented better discriminative properties than did the generic SF-36 questionnaire. The SF-36 is not an appropriate instrument for determining the affective state of COPD patients. QoL, even with the use a generic questionnaire, allows the measurement of subjective diseaserelated aspects of perception.(13) Regarding the correlation with the severity of COPD, the SF-36 and the SGRQ are equally discriminative, using criteria established by the Global Initiative for Chronic Obstructive Lung Disease and by the British Thoracic Society; this correlation is more frequently seen between stages I and IV of the disease.(3) Some studies have compared the SF-36 and the SGRQ, and, although both seemed to be discriminative in COPD patients, there were differences in certain domains, such as the emotional problems domain. (14) Other studies have demonstrated that the SF-36 and the SGRQ correlate well with overall mortality in COPD patients. For the Brazilian population, there have been no studies, not even preliminary ones, comparing the SF-36 and the SGRQ in terms of their discriminative and longitudinal properties in COPD patients. (15) The objective of the present study was to compare two QoL questionnaires, namely the SGRQ (modified Brazilian version) and the SF-36 (Brazilian version), in outpatients diagnosed with COPD, focusing on the discriminative properties of the questionnaires and correlating their domains with variables of interest in COPD, such as degree of dyspnea, cognitive capacity and depression.

Pulmonary rehabilitation improves only some domains of health-related quality of life measured by the Short Form-36 questionnaire

“…Buss and Silva have concluded that a disease-specific instrument St. George's respiratory questionnaire (SGRQ) has better discriminative properties than the SF-36. [16] Wilke noted that the SGRQ correlated with the SF-36 PCS at particular time points during a longitudinal study but that the changes overtime correlated poorly. [17] Third, COPD is a chronic disease with both respiratory and systemic effects complicated by acute exacerbations.…”

Methods for qualitative and quantitative analysis of pain and quality of life validated in Brazil: systematic review

“…According to Nascimento and Silva [4], the VAS can be very useful to assess pain as it is a simple instrument. However, corroborating with Buss and Silva [10], the use of VAS may be inappropriate for patients with low levels of education and with cognitive and visual impairment. VAS often consists of a 10-cm straight line, being zero no pain and ten the maximum pain felt (figure 2).…”

“…The patient is asked to evaluate and mark, on the line, the pain felt at the moment [4,26]. According to Buss and Silva [10], more cognitively impaired patients had difficulty in understanding the VAS, which can be attributed to the greater difficulty of this group in defining a single global health assessment score based on their perception. According to Nascimento and Silva [4], the VAS can be very useful to assess pain as it is a simple instrument.…”

“…Evaluating the QoL indicators is nothing more than inferring on the impact of the disease in the physical and mental aspects of the patients, through questionnaires and instruments, representing the best attempt to cover the entire extent of the disease [10].…”

Long-Term Efficacy of Pulmonary Rehabilitation in Patients with Occupational Respiratory Diseases

“…Both the SGRQ and SF-36 questionnaires indicated a lower quality of life at baseline than expected from lung function, age and disease [21,22,23,24]. No clinically relevant changes were observed after rehabilitation.…”