Validity and Reliability of the Turkish Version of the Nijmegen Questionnaire in Asthma

Objective: The Nijmegen Questionnaire (NQ) enables the assessment and identification of symptoms related to respiratory dysfunction and hyperventilation syndrome. The aim was to investigate the validity of the Turkish version of the NQ in asthmatics. Material and Methods: Fifty-four individuals with asthma were included. Spirometry was performed. Dyspnea was assessed using the modified Borg and modified Medical Research Council scales. Breath-holding time was recorded. End-tidal carbon dioxide was measured using a portable capnograph. Oxygen saturation and heart rate were recorded. Asthma Control Test was used to evaluate the asthma control level. Quality of life was assessed using the Asthma Quality of Life Questionnaire and Nottingham Health Profile. Beck Depression Inventory was used to determine depression. Results: Bartlett’s test of sphericity (360.749, df 105, P < .001) and Kaiser–Meyer–Olkin criterion (0.752) for 15-item NQ supported a single-factor model with 36.38% of explained variability through principal component analysis and explanatory factor analysis. For 15-item NQ with this single-factor model, Cronbach’s alpha was 0.872, and the test–retest reliability was 0.628. There was a significant negative correlation between NQ and Asthma Control Test (r = −0.448), and Asthma Quality of Life Questionnaire (r = −0.743) and a significant positive association with Beck Depression Inventory (r = 0.477), Nottingham Health Profile—energy (r = 0.370), Nottingham Health Profile—pain (r = 0.313), Nottingham Health Profile—sleep (r = 0.294), and Nottingham Health Profile—physical activity scores (r = 0.406) (P < .05). Conclusions: The 15-item Turkish version of the NQ is valid and reliable in asthmatics. Individuals with uncontrolled asthma have higher NQ scores than those with well-controlled asthma. NQ is associated with asthma control level, asthma-related quality of life, health profile, and depression.

[1]  Turkish Version of Nijmegen Questionnaire , 2020, Case Medical Research.

[2]  P. Kersten,et al.  The Nijmegen Questionnaire: A valid measure for hyperventilation syndrome , 2019, New Zealand Journal of Physiotherapy.

[3]  Kevin McCarthy,et al.  Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement , 2019, American journal of respiratory and critical care medicine.

[4]  Young-Bae Park,et al.  Association of dysfunctional breathing with health-related quality of life: A cross-sectional study in a young population , 2018, PloS one.

[5]  Klaas Sijtsma,et al.  Methods for Estimating Item-Score Reliability , 2018, Applied psychological measurement.

[6]  S. Fowler,et al.  Dysfunctional breathing: a review of the literature and proposal for classification , 2016, European Respiratory Review.

[7]  H. Folgering,et al.  The Nijmegen Questionnaire and dysfunctional breathing , 2015, ERJ Open Research.

[8]  Pedro M. Valero-Mora,et al.  The Scree Test and the Number of Factors: a Dynamic Graphics Approach , 2015, The Spanish Journal of Psychology.

[9]  E. Skordilis,et al.  Hyperventilation in asthma: A validation study of the Nijmegen Questionnaire – NQ , 2014, The Journal of asthma : official journal of the Association for the Care of Asthma.

[10]  A. Yorgancioglu,et al.  The validation of the Turkish version of Asthma Control Test , 2013, Quality of Life Research.

[11]  P. Brand,et al.  Dysfunctional breathing in children with asthma: a rare but relevant comorbidity , 2012, European Respiratory Journal.

[12]  Gail M. Sullivan A primer on the validity of assessment instruments. , 2011, Journal of graduate medical education.

[13]  P. Lehrer,et al.  Psychophysiologic treatment for patients with medically unexplained symptoms: a randomized controlled trial. , 2011, Psychosomatics.

[14]  T. Ritz,et al.  Hyperventilation in panic disorder and asthma: empirical evidence and clinical strategies. , 2010, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[15]  E. Clini,et al.  Measures of dyspnea in pulmonary rehabilitation , 2010, Multidisciplinary respiratory medicine.

[16]  Marc M Cohen,et al.  Investigating the claims of Konstantin Buteyko, M.D., Ph.D.: the relationship of breath holding time to end tidal CO2 and other proposed measures of dysfunctional breathing. , 2008, Journal of alternative and complementary medicine.

[17]  E. Holloway,et al.  Integrated breathing and relaxation training (the Papworth method) for adults with asthma in primary care: a randomised controlled trial , 2007, Thorax.

[18]  D. Price,et al.  The prevalence of dysfunctional breathing in adults in the community with and without asthma. , 2005, Primary care respiratory journal : journal of the General Practice Airways Group.

[19]  Douglas G. Bonett,et al.  Sample Size Requirements for Comparing Two Alpha Coefficients , 2003 .

[20]  Yrd. Doç. Dr. Şener Büyüköztürk Faktör Analizi: Temel Kavramlar ve Ölçek Geliştirmede Kullanımı , 2002 .

[21]  Mike Thomas,et al.  Prevalence of dysfunctional breathing in patients treated for asthma in primary care: cross sectional survey , 2001, BMJ : British Medical Journal.

[22]  C. Bombardier,et al.  Guidelines for the process of cross-cultural adaptation of self-report measures. , 2000, Spine.

[23]  T. Arasıl,et al.  The development and psychometric assessment of the Turkish version of the Nottingham Health Profile , 2000, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[24]  H. Folgering The pathophysiology of hyperventilation syndrome. , 1999, Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace.

[25]  W. Gardner The pathophysiology of hyperventilation disorders. , 1996, Chest.

[26]  O. Löwhagen,et al.  Psychological differences between asthmatics and patients suffering from an asthma-like condition, functional breathing disorder: A comparison between the two groups concerning personality, psychosocial and somatic parameters , 1993, Integrative physiological and behavioral science : the official journal of the Pavlovian Society.

[27]  G. Guyatt,et al.  Evaluation of impairment of health related quality of life in asthma: development of a questionnaire for use in clinical trials. , 1992, Thorax.

[28]  C. Bass,et al.  CONTROLLED STUDY OF RESPIRATORY RESPONSES DURING PROLONGED MEASUREMENT IN PATIENTS WITH CHRONIC HYPERVENTILATION , 1986, The Lancet.

[29]  R. Brislin Back-Translation for Cross-Cultural Research , 1970 .

[30]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[31]  Reynold A Panettieri,et al.  Asthma , 1894, Annals of Internal Medicine.

[32]  M. Ravanbakhsh,et al.  Reliability and Validity of the Iranian Version of Nijmegen Questionnaire in Iranians with Asthma , 2015, Tanaffos.

[33]  Marc M Cohen,et al.  Relationships between measures of dysfunctional breathing in a population with concerns about their breathing. , 2011, Journal of bodywork and movement therapies.

[34]  A. Yorgancioglu,et al.  Validity and reliability of "Asthma Quality of Life Questionnaire" in a sample of Turkish adult asthmatic patients. , 2011, Tuberkuloz ve toraks.

[35]  Philip Marcus,et al.  Development of the asthma control test: a survey for assessing asthma control. , 2004, The Journal of allergy and clinical immunology.

[36]  O. Van den Bergh,et al.  Medically unexplained dyspnea: psychophysiological characteristics and role of breathing therapy. , 2004, Chinese medical journal.

[37]  I. Wiklund The Nottingham Health Profile--a measure of health-related quality of life. , 1990, Scandinavian journal of primary health care. Supplement.

[38]  H. Duivenvoorden,et al.  Efficacy of Nijmegen Questionnaire in recognition of the hyperventilation syndrome. , 1985, Journal of psychosomatic research.

[39]  G. Borg Psychophysical bases of perceived exertion. , 1982, Medicine and science in sports and exercise.