Psychometric evaluation of the shortened version of the Functional Difficulties Questionnaire to assess thoracic physical function

Abstract

Objective:

The aim of this study was to investigate the psychometric properties of the shortened version of the Functional Difficulties Questionnaire (FDQ).

Design:

This is a multisite observational study.

Setting:

The study was conducted in four tertiary care hospitals in Australia.

Subjects:

A total of 225 participants, following cardiac surgery, were involved in the study.

Intervention:

Participants completed the original 13-item FDQ and other measures of physical function, pain and health-related quality of life.

Method:

Item reduction was utilized to develop the shortened version. Reliability was evaluated using intraclass correlation coefficients (ICCs), the smallest detectable change and Bland–Altman plots. The validity and responsiveness were evaluated using correlation. Anchor and distribution-based calculation was used to calculate the minimal clinical important difference (MCID).

Results:

Item reduction resulted in the creation of a 10-item shortened version of the questionnaire (FDQ-s). Within the cohort of cardiac surgery patient, the mean (SD) for the FDQ-s was 38.7 (19.61) at baseline; 15.5 (14.01) at four weeks and 7.9 (12.01) at three months. Validity: excellent internal consistency (Cronbach’s α > 0.90) and fair-to-excellent construct validity (>0.4). Reliability: internal consistency was excellent (Cronbach’s α > 0.8). The FDQ-s had excellent test–retest reliability (ICC = 0.89–0.92). Strong responsiveness overtime was demonstrated with large effect sizes (Cohen’s d > 1.0). The MCID of the FDQ-s was calculated between 4 and 10 out of 100 (in cm).

Conclusion:

The FDQ-s demonstrated robust psychometric properties as a measurement tool of physical function of the thoracic region following cardiac surgery.

Keywords

Functional Difficulties Questionnaire psychometric physical function outcome measurement cardiac surgery

Get full access to this article

View all access options for this article.

References

Katijjahbe

Granger

Denehy

, et al. Short physical performance battery can be utilized to evaluate physical function in patients after cardiac surgery. Cardiopulm Phys Ther J 2018; 29(2): 88–96.

Lapier

Schenk

. Thoracic musculoskeletal considerations following open heart surgery. Cardiopulm Phys Ther J 2002; 13(2): 16–20.

Lapier

Wilson

. Prevalence and severity of symptoms in patients recovering from coronary artery bypass graft. Acute Care Perspect 2007; 16(3): 10–15.

Min

Mazzurco

Gure

, et al. Longitudinal functional recovery after geriatric cardiac surgery. J Surg Res 2015; 194(1): 25–33.

Veal

Bereznicki

Thompson

, et al. Pain and functionality following sternotomy: a prospective 12-month observational study pain med. Pain Med 2016; 17(6): 1155–1162.

Sturgess

Denehy

Tully

, et al. The functional difficulty questionnaire: a new tool for assessing physical function of thethoracic region in a cardiac surgery population. Cardiopul Phys Ther J 2018; 29(3): 110–123.

Myles

. Meaningful outcome measures in cardiac surgery. J Extra Corpor Technol 2014; 46(1): 23–27.

Tully

. Quality-of-life measures for cardiac surgery practice and research: a review and primer. J Extra Corpor Technol 2013; 45(1): 8–15.

King

Parry

Southern

, et al. Women’s Recovery from Sternotomy-Extension (WREST-E) study: examining long-term pain and discomfort following sternotomy and their predictors. Heart 2008; 94(4): 493–497.

10.

Terwee

Mokkink

Knol

, et al. Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res 2012; 21(4): 651–57.

11.

Terwee

Mokkink

van Poppel

, et al. Qualitative attributes and measurement properties of physical activity questionnaires: a checklist. Sports Med 2010; 40(7): 525–537.

12.

Katijjahbe

Granger

Denehy

, et al. Standard restrictive sternal precautions and modified sternal precautions had similar effects in people after cardiac surgery via median sternotomy (‘SMART’ Trial): a randomised trial. J Physiother 2018; 64(2): 97–106.

13.

Katijjahbe

Denehy

Granger

, et al. The Sternal Management Accelerated Recovery Trial (S.M.A.R.T) – standard restrictive versus an intervention of modified sternal precautions following cardiac surgery via median sternotomy: study protocol for a randomised controlled trial. Trials 2017; 18(1): 290.

14.

Sturgess

Denehy

Tully

, et al. A pilot thoracic exercise programme reduces early (0–6 weeks) sternal pain following open heart surgery. Int J Ther Rehabil 2014; 21(3): 110–17.

15.

Portney

Watkins

. Foundations of clinical research: application to clinical practice. Upper Saddle River, NJ: Pearson Education, 2009.

16.

Field

. Discovering statistics using IBM SPSS statistics: and sex and drugs and rock ‘n’ roll. 4th ed. London, England: SAGE, 2013.

17.

Giavarina

. Understanding bland Altman analysis. Biochem Med 2015; 25(2): 141–151.

18.

Terwee

Bot

de Boer

, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007; 60: 34–42.

19.

Husted

Cook

Farewell

, et al. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol 2000; 53(5): 459–468.

20.

Wyrwich

Spertus

Kroenke

, et al. Clinically important differences in health status of life for patients with heart disease: an expert panel report. Am Heart J 2004; 147(4): 615–622.

21.

Wyrwich

Tierney

Wolinsky

. Using the standard error of measurement to identify important changes on the Asthma Quality of Life Questionnaire. Qual Life Res 2002; 11: 1–7.

22.

Wyrwich

Wolinsky

. Identifying meaningful intra-individual change standards for health-related quality of life measures. J Eval Clin Pract 2000; 6(1): 39–49.

23.

Wyrwich

Tierney

Wolinsky

. Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. J Clin Epidemiol 1999; 52(9): 861–873.

24.

Ware

Kosinki

Dewey

. How to score version two of the SF-36 Health Survey. Lincoln, RI: QualityMetric, 2000.

25.

de Vet

Terwee

Ostelo

, et al. Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change. Health Qual Life Outcomes 2006; 4: 54.

26.

Pack

Woodbury

Headley

, et al. Ambulation orderlies and recovery after cardiac surgery: a pilot randomized controlled trial. J Clin Exerc Physiol 2017; 6(3): 42–49.

27.

Maltenfort

Diaz-Ledezma

. Statistics in brief: minimum clinically important difference-availability of reliable estimates. Clin Orthop Relat Res 2017; 475(4): 933–946.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.30 MB