Measuring the state of health is a method for quantifying, in a standardized and objective manner, the impact of an illness on the day-to-day life, health and wellbeing of a patient. This process is very similar to gathering a well-structured clinical history but, instead of the collection of simple clinical findings, it provides a quantitative measure of the individual’s quality of life (QoL), which can be used for scientific purposes.
At present, chronic obstructive pulmonary disease (COPD) is recognized to be one of the major causes of death in industrialized countries and it represent a multisystemic pathology that induces disabilities and handicaps .
Pulmonary rehabilitation is an essential component in the management of COPD patients, and its success is mainly obtained through the improvement in exercise capacity, dyspnoea and QoL [2–8]. Measuring QoL has, thus, become a central focus in the study of COPD.
Traditionally, results in the fields of health/medicine and rehabilitation have almost always been measured through objective medical evaluations. On the other hand, recently there has been an ever-increasing focus on the patients’ perspective . Therefore, the evaluation of outcomes patient-focused and measuring the wellbeing perceived by the individual in the physical, psychological, social and material areas [10, 11], have lead to the development of a new concept of QoL [11, 12] and of patient’s satisfaction. Indeed, the evaluation of the state of health and the influence of therapeutic intervention should incorporate not only changes in the gravity of illness, but also the impact upon the state of wellbeing.
The World Health Organization (WHO) defines QoL as “an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns. It is a broad ranging concept, affected by the person’s physical health, psychological state, level of independence, social relationships, and to salient features of their environment” . Nevertheless, different studies and reports on QoL used different definitions for QoL [10–12].
However, among all definitions, there is agreement concerning the concept that QoL expresses patient point of view by a subjective dimension and that QoL can express the results of medical intervention [2, 10–12]. Therefore, the methods for evaluating QoL should be practical and simple to use, for clinical research and for evaluating the results of medical intervention.
Two main kinds of questionnaires for evaluating QoL exist, one generic and one illness-specific. The former includes the Sickness Impact Profile (SIP), the Nottingham Impact Profile (NIP) and the Short Form 36 (SF-36) [13–15]. The latter allows comparing patients suffering from different and specific pathologies and it investigates the characteristic aspects of an illness, including questions concerning symptoms linked to the illness itself. Effectively, a fair number of instruments/tools specific for COPD are at our disposal, including the Chronic Respiratory Questionnaire (CRQ), the St George Respiratory Questionnaire (SGRQ), the Maugeri Foundation Respiratory Failure Questionnaire, the Airways Questionnaire (AQ 30\20), the Breathing Problems Questionnaire (BPQ), the Pulmonary Functional Status & Dyspnea Questionnaire (PFSDQ) and the Pulmonary Functional Status & Dyspnea Questionnaire-Modified (PFSDQ-M) [16–22].
Nowadays, outcome measures are necessary for describing individual improvements and the efficacy of a rehabilitation program for COPD patients and consequently both CRQ and SGRQ represent the most used questionnaires for these patients, demonstrating to be responsive to respiratory rehabilitation [2, 16, 23, 24]. Furthermore, due to the often incurable and relentlessly progressive respiratory deficiency led by COPD, the specific questionnaire named MRF-26 has recently been developed [18, 21, 22].
Therefore, the aim of the present study was to begin the development a novel questionnaire for the evaluation of QoL in patients suffering from respiratory failure due to COPD undergoing an in-patient pulmonary rehabilitation program.