Propriedades de medida da versão em português do Brasil do Bronchiectasis Health Questionnaire (BHQ) para uso em pacientes com bronquiectasia não-fibrocística

Abstract

Introduction: Bronchiectasis (BQT) is a chronic respiratory disease that has a negative impact on the quality of life (QL) of the patients. The instruments used to assess the QL of these patients are lengthy, and therefore need a sizeable amount of time to be applied. The Bronchiectasis Health Questionnaire (BHQ) assesses the QL of patients with BQT in a short and practical manner and generates a single final score. Objective: To test BHQ measurement properties in patients with bronchiectasis, to correlate BHQ scores with lung function (FVC and FEV1) and distance traveled in SWTI, and to compare BHQ scores by disease severity (E-FACED and BSI) , dyspnea scores (mMRC), and exacerbations. Methodology: Design study of measurement properties analysis whose original version of the BHQ was translated into Portuguese, with appropriate cultural and conceptual adaptations. On the first visit, the first BHQ (BHQ-1) and the QL questionnaire Saint George’s Respiratory Questionnaire were applied. After 7 to 14 days, the second BHQ (BHQ-2) was applied. The patients were submitted to spirometry and incremental shuttle walk test, and answered the modified Medical Research Council dyspnea scale (MMRC). E-FACED and BSI was used to assess the severity of the BQT. Results: We evaluated 101 patients ( 41 males, age 49.0±13.0 years old, mMRC: median 2 (Interquartilic range: 1-2), E-FACED: median 3 (Interquartilic range: 3-4), FEV1 50.8±18.0 %predicted). When analyzing the measurement properties of the BHQ in Brazilian Portuguese, we observed that the internal consistency was adequate (chronbach alpha 0.93), with substantial reliability(ICC2,1: 0.86 [95% CI: 0.79 - 0.90]), p <0.0001). The standard error of measurement presented was very good (SEM = 1.68% and MDC 90% = -0.50). Bland Altman analysis showed small mean differences (-0.94), with a small confidence interval (95% CI: -9.78 - 7.90). The validity of the construct was high with the domains symptoms (r = -0.72 and p <0.001) and total score (r = -0.75 and p <0.001) and moderate with the domains activities (r = -0.60 and p < 0.001) and impacts (r = -0.60 and p <0.001) of the SGRQ. We found no evidence of floor or ceiling effects. Moderate negative correlations were also observed with dyspnea (MRCm, r = -0.53 and p = 0.001) and weak with BQT severity by E-FACED (r = -0.24 and p = 0.02) and BSI = -0.30 and p = 0.03). No correlations were observed with the distance covered by SWTI and pulmonary function. Conclusion: The BHQ is reliable, valid and presents adequate internal consistency to evaluate the impact of BQT on the QL of Brazilian patients.