ArticleBMJ open respiratory research2025
Development of the Cystic Fibrosis Stress Questionnaire: testing and validation.
Article in BMJ open respiratory research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveCare guidelines for cystic fibrosis (CF) recommend annual screening for anxiety and depression using standardised measures, the Patient Health Questionnaire (PHQ-9) and the Generalised Anxiety Disorder Scale (GAD-7). Research in other chronic illness groups such as diabetes has demonstrated that illness-specific distress predicts daily functioning above and beyond depression alone. To address the need for a measure of illness-specific distress, we developed and validated the CF Stress Questionnaire (CFSQ), which could serve as a meaningful adjunct to mental health screening.
methodsWe developed a CF-specific measure of perceived stress with multiple phases of input from our patient population. We then conducted a multisite CFSQ validation study with 200 adults with CF across 3 geographically diverse CF centres, to examine the CFSQ's factor structure, internal consistency, convergent validity and test-retest reliability.
resultsResults of item and subscale-level analyses indicate that all but one subscale met the established internal consistency cut-off of >0.6. In terms of convergent validity, the CFSQ and its subscales were moderately to highly correlated with the PHQ-9 (r=0.73 for total score, p<0.05) and the GAD-7 (r=0.66 for total score, p<0.05) and moderately correlated with quality of life as measured by the Cystic Fibrosis Questionnaire Revised (CFQ-R) Social (r=-0.59 for total score, p<0.05) and Treatment Burden subscales (r=-0.63 for total score, p<0.05). Subscales of the CFSQ were moderately correlated with the CFQ-R Emotional or Physical Functioning subscales, and weakly correlated with forced expiratory volume in 1 s per cent predicted or body mass index.
conclusionsThe CFSQ is a valid and reliable measure in terms of internal consistency and convergent validity with existing measures of mental health and quality of life commonly used in CF care and research.
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