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Evaluation of the Short-Form 36-Item Questionnaire to Measure Health-Related Quality of Life in Patients With Idiopathic Pulmonary Fibrosis^*

^* From the Pulmonary Division (Ms. T. Y. Martinez, and Drs. Pereira, dos Santos, Guimarães, and Martinez) and Rheumatology Division (Dr. Ciconelli), Federal University of São Paulo/UNIFESP, Brazil.

Correspondence to: José A. B. Martinez, MD, Department of Internal Medicine, Hospital das Clínicas de Ribeirão Preto, Av. Bandeirantes 3900 Ribeirão Preto, São Paulo, Brazil, CEP: 14048–900; e-mail: jabmarti{at}fmrp.usp.br

Objective: To validate the use of the 36-item short-form questionnaire (SF-36) for measuring health-related quality of life (HRQL) in patients with idiopathic pulmonary fibrosis (IPF).

Design: Observational data at a single point in time.

Setting: A specialized outpatient respiratory clinic.

Participants: Thirty-four patients (mean ± SE age, 58.29 ± 1.87 years) with IPF and no significant comorbidity. A matched control group for HRQL measurements was composed of 34 normal subjects (mean age, 58.00 ± 1.89 years).

Measurements and results: Dyspnea was measured by the baseline dyspnea index (BDI). Respiratory function evaluation included FVC, FEV₁, and resting arterial blood gases. IPF patients showed a mean BDI score of 5.21 ± 0.46. The mean FVC and FEV₁ values were 62.41 ± 2.96% and 66.41 ± 3.33%, respectively. The mean PaO₂ was 67 ± 2.51 mm Hg, and the mean PaCO₂ was 37 ± 1.05 mm Hg. Patients scored significantly worse than control subjects with respect to the SF-36 domains of physical functioning, physical role, general health perceptions, vitality, social functioning, emotional role, and mental health index. BDI scores were significantly correlated with five SF-36 components, and FVC and FEV₁ were significantly correlated with two SF-36 components. Significant negative correlations were found between arterial pH and four SF-36 domains.

Conclusions: Patients with IPF have a significant impairment of HRQL in both physical and psychological functioning. Dyspnea is the most important factor influencing the quality of life in these subjects. The SF-36 questionnaire is a valid instrument to evaluate HRQL in IPF patients.

Key Words: dyspnea • idiopathic pulmonary fibrosis • lung function • quality of life

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