A Preliminary Validation of The Arabic Multidimensional Dyspnea Profile

Abstract

Recognizing dyspnea as a complex symptom is advised by the American Thoracic Society. Evaluating not only the underlying causes of dyspnea, rather the sensory and the emotional aspects of dyspnea perception is crucial, prompting a shift from treating solely the physical illness to tailoring therapies based on individual needs. Conventional dyspnea scales offer a limited view of breathlessness, merely quantifying its intensity. However, comprehending dyspnea necessitates a nuanced scale that accounts for its various aspects. The Multidimensional Dyspnea Profile (MDP) offers a comprehensive evaluation of dyspnea perception, dividing its description into sensory and affective components. The aim of this project is to validate the Arabic version of the MDP among individuals suffering from chronic pulmonary illnesses. Ultimately, the goal is to incorporate this version into healthcare facilities to gain a more comprehensive understanding of dyspnea perception and enhance prognostic capabilities. The pilot study will follow a cross-sectional quasi-experimental design at the American University of Beirut Medical Center from April to November 2024. Twenty-five participants answered a baseline questionnaire [T0] that assessed their dyspnea [using the Arabic MDP and other scales]. They then performed a six-minute walking test followed up by a repeat assessment of their dyspnea levels [T1]. The sample consisted of72% males with mean age of 63.6±8.67 years. Reliability analysis of the Immediate Perception domain showed higher consistency results in comparison to the Emotional Response domain (T0: 0.701, 0.364 respectively for both domains and T1: 0.723 for the Immediate Perception domain). Concurrent validity showed strong correlation between Borg and Immediate Perception domain at T1 (r=0.832, p=0.00). Divergent validity showed weak correlations between Immediate Perception domain at T0 with BMI (r=0.051, p=0.81) and Ratio of FEV1/FVC (r=0.118, p=0.573). Age and CCI were found to be negatively correlated with the Emotional Response domain at T0 ( r= -0.575, p= 0.003 and r= -0.563, p =0.003). Fatigue showed a strong negative correlation with the MDP scores across both times T0 and T1 ( Immediate Perception at T1: r= -0.621, p=0.00). A notable finding was the decrease in the MDP scores after conducting the 6MWT (Median score of Immediate Perception at was computed to be 18 at T0 and 10 at T1. Nonetheless, the median scores of the Borg scale were found to be higher in T1 than T0 (0 and 3). These results provide evidence for the psychometric validity of the Arabic version of the MDP and support its use in capturing a holistic assessment of dyspnea.