In addition to the physiological changes of improved exercise capacity, pulmonary rehabilitation (PR) needs to combine self-management support with motivating and empowering participants. The education component in PR needs to focus on developing self-management skills and promoting behavior change. To be able to focus on development of the necessary capabilities, understanding the level the patient is at is the first step needed. This is achieved through baseline measures of knowledge, skills and motivation. Determining the impact of the intervention can also be achieved through follow-up of assessment of change in knowledge, skills and motivation. Appropriate educational outcome measures are needed to effectively evaluate the changes in behavior before and after completion of pulmonary rehabilitation. To support healthcare professionals, this website provides guidance in which measures can be used to evaluate baseline and follow-up knowledge, skills and motivations for planning program education and measuring impact.
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Healthy Education Impact Questionnaire
collated by Dr. Felicity Blackstock (School of Health Science, Western Sydney University, New South Wales, Australia) -
Lung Information Needs Questionnaire
collated by Dr Nicola Roberts (Nursing and Community Health/School of Health and Life Sciences Glasgow Caledonian University, Glasgow, Scotland, United Kingdom) -
Bristol COPD Knowledge Questionnaire
collated by Dr Nicola Roberts (Nursing and Community Health/School of Health and Life Sciences Glasgow Caledonian University, Glasgow, Scotland, United Kingdom)
Healthy Education Impact Questionnaire
| Description | |
|---|---|
| Name of Questionnaire | Healthy Education Impact Questionnaire |
| Abbreviation/ Alternate Name | heiQ™ |
| Description: | Assesses impact of educational interventions for people with chronic conditions. |
| Developer | R Osborne et al 1 |
| richardo@unimelb.edu.au | |
| Cost | On application |
| License required | Yes, contact author. |
| Administration | Self-administered |
| Time to complete | Not known |
| Number of items | 42 items |
| Domains/categories (#) | 8 |
| Name of domains/categories | 1.Positive and active engagement in life 2.Health directed behavior 3.Skill and technique acquisition 4.Constructive attitudes and approaches 5.Self-monitoring and insight 6.Health services navigation 7.Social integration and support 8.Emotional wellbeing |
| Scaling of items | 6-point Likert scale (strongly disagree to strongly agree) |
| Scoring | All domains positive score, except emotional wellbeing where reverse scored. Each domain assessed individually. |
| Test-retest/reproducibility | Cronbach’s α 0.70 to 0.89 each domain. Positive and Active Engagement in Life α = 0.86; Health Directed Behavior α = 0.80; Skill and Technique Acquisition α = 0.81; Constructive Attitudes and Approaches α = 0.81; Self-Monitoring and Insight α = 0.70; Health Service Navigation α = 0.82; Social Integration and Support α = 0.86; and Emotional Wellbeing α = 0.89. 1 |
| Validity | Confirmatory factor analysis: SatorraBentler Scaled (robust) x2 = 1420, d.f. 791, p = 0.0; RMSEA = 0.037 (90% confidence intervals 0.033–0.040); CFI = 0.99. 1 |
| Responsiveness to PR | Trend toward improvement 2 |
| MCID | No specific score, however, effect size of 0.5 considered clinically important. 1 |
| Languages and cultural adaptation | 18 including: Bulgarian 3, Italian 4, Japanese 5, Dutch, German & French 6, French Canadian 7 |
| Reference | 1.Osborne RH et al. Patient Educ Couns. 2007; 66: 192-201. 2.Blackstock FC et al. Respirology. 2014; 19:193-202. 3.Todorova E et al. University of National and World Economy, Sofia, Bulgaria. 2018; (1): 157-170. 4.Pozza A et al. Psychol Res Behav Management. 2020; 13:459-471. 5.Morita R et al. Japan J Nurs Science. 2013; 10:255. 6.Ammerlaan J et al. Health Quality of Life Outcomes. 2017; 15:28. 7.Maunsell E et al. Cancer. 2014; 120:3228–3236. |
| Date of most recent changes | September 22, 2020 |
Abbreviations: CFI = Comparative Fit Index; MCID = Minimally Important Difference; PR=Pulmonary Rehabilitation; RMSEA= Root mean square error of approximation
Lung Information Needs Questionnaire
| Description | |
|---|---|
| Name of Questionnaire | Lung Information Needs Questionnaire 1 |
| Abbreviation/ Alternate Name | LINQ |
| Description: | Assesses patients’ need for information about their COPD to guide clinical encounters. http://www.linq.org.uk/LINQhome.htm |
| Developers | Rupert C M Jones, Michael E Hyland |
| rupert.jones@pms.ac.uk , mhyland@plymouth.ac.uk | |
| Cost | Free for clinical use and not-for-profit research |
| License required | For-profit research |
| Administration | Self-complete |
| Time to complete | 6 minutes |
| Number of items | 16-22 depending upon version |
| Domains/categories (#) | Assesses patients’ need for information about their COPD to guide clinical encounters. |
| Name of domains/categories | Six domains include: disease knowledge; medicines; self-management; smoking; exercise; and diet. |
| Scaling of items | N/A |
| Scoring | Scoring based on summing items from each domain. Range 0–25/32. Higher scores indicate higher need for information. |
| Test-retest/ reproducibility | Cronbach’s α= 0.62 2 Test retest each domain r=0.66–0.98 2 |
| Validity | Significant correlations with SWT between change in medicine domain scores & change scores (p=0.04). No correlations found between changes in LINQ total and domain scores and changes in dyspnoea, SWT and HADS domain scores. 2 |
| Responsiveness to PR | LINQ total score post-PR improved significantly with a large effect size [t(114)=11.83, p<0.001, r=0.74]. All domain scores improved significantly, with a medium to large effect size, with exception of smoking. Diet and exercise improved the most, followed by self-management, disease knowledge and medicine domains. 2 |
| MCID | Informal assessment suggests a change of 1 point a significant change as perceived by patients with COPD. 3 |
| Languages | English, Bulgarian, Chinese, Dutch, French, German, Italian, Japanese, Portuguese, Russian, Spanish 4 |
| References | 1.Hyland ME e. al. Respir Med. 2006; 100:1807–1816. 2.Jones RC et al. Respir Med. 2008; 102:1439–1445. 3.Lung Information Needs Questionnaire http://www.linq.org.uk/ LINQusing.htm 4.www.linq.org.uk/LINQscoring.htm |
| Date of most recent changes | September 23, 2020 |
Abbreviations: HADS=Hospital Anxiety & Depression Scale; MCID=Minimal clinically important difference; SWT=Shuttle Walking Test.
Bristol COPD Knowledge Questionnaire
| Description | |
|---|---|
| Name of Questionnaire | Bristol COPD Knowledge Questionnaire |
| Abbreviation/Alternate Name | BCKQ |
| Description: | Assesses patient’s knowledge about topics related to COPD. |
| Developer | Roger White |
| roger.white4@virgin.net | |
| Cost | Freely available from Dr Roger White |
| License required | No |
| Administration | Self-administered |
| Time to complete | 15–20 minutes |
| Number of items | 65 |
| Domains/categories (#) | 13 categories |
| Name of domains/categories | The questionnaire contains 13 topics, each with five statements giving a total of 65 questions. These topics covered epidemiology and physiology, aetiology, common symptoms, breathlessness, phlegm, chest infections, exercise, smoking, immunization, inhaled bronchodilators, antibiotics, oral steroids and inhaled steroids |
| Scaling of items | True, False, Don’t know |
| Scoring | Correct =1, incorrect =0. No mark awarded for a ‘don’t know’. Scoring based on percentage of items answered correctly. |
| Test-retest/reproducibility | Test retest r= 0.71 1 |
| Validity | Content 1 |
| Responsiveness to PR | Mean change score of 10.64 pre/post pulmonary rehabilitation program (p<0.001) 2 Education only program, total BCKQ score increased from baseline of 27.6±8.7 to 36.5±7.7 points (p<0.001) 3 |
| MCID | N/A |
| Languages | English |
| Reference | 1.White R et al. Chron Respir Dis. 2006; 3:123–131 2.Cosgrove et al. BMC Pulm Med. 2013; 13: 50. 3.Hill K et al. Patient Educ Couns 2010; 81:14–18. |
| Date of most recent changes | September 23, 2020 |
Abbreviations: MCID: Minimal Clinically Important Difference; N/A=not available; PR=Pulmonary Rehabilitation
