ArticleInternational journal of chronic obstructive pulmonary disease2026
The Development and Initial Psychometric Testing of a Patient-Reported Outcome Measure to Assess COPD-Related Emotional Distress.
Article in International journal of chronic obstructive pulmonary disease, 2026. 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
Purpose: Emotional distress is prevalent in patients with COPD and highly relevant to patients. Research in chronic disease indicates that illness-related emotional distress might be specific and sensitive enough to explain self-management behaviour. However, as no currently available instrument assesses COPD-related emotional distress (CRED), it has only been assessed regarding overall distress, using mainly anxiety and depression as outcomes. Therefore, this study aimed to develop and test a preliminary item list to measure CRED. Patients and Methods: Following Food and Drug Administration (FDA) guidelines, a multistep mixed-method study was conducted. Based on an earlier qualitative study and literature review, a conceptual framework and item list were developed. The item list's content validity was assessed via patient interviews using cognitive debriefing techniques and a survey involving a panel of clinicians. Finally, its psychometric properties were tested in a cross-sectional study. Construct validity was established by comparing the CRED-V1 with established questionnaires like the COPD Assessment Test (CAT), the Hospital Anxiety and Depression Scale (HADS), and the modified Medical Research Counsel (mMRC) dyspnoea scale. Results: The first German COPD-Related Emotional Distress questionnaire-version 1 (CRED-V1) contained 36 items. Its content validity was confirmed by nine patients and ten clinicians. Psychometric testing in 264 patients with COPD revealed two formative (symptom- and treatment-related) and four reflective (restricted mobility-, restricted relationship-, disease unpredictability- and stigma-related) subcategories. For all reflective subscales, Cronbach's alpha values were >0.8. Structural equation modelling was possible for 32 items: An R Conclusion: This work reports the initial development of a new innovative tool for the assessment of CRED in patients with COPD.
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