The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

CORRELATION OF THE SF-36® HEALTH SURVEY WITH THE PULMONARY FUNCTION STATUS SCALE WHEN MEASURING OUTCOMES IN A PULMONARY REHABILITATION PROGRAM

Debbie Koehl, MS, RRT-NPS, Pulmonary Rehabilitation Program, Methodist Hospital, Clarian Health Partners, Indianapolis, Indiana.

Background: Utilizing clinical outcomes to evaluate pulmonary rehabilitation programs is common practice. Choosing which outcome tool to use is often not an easy task for a program. There are many different types of outcomes that can be evaluated. There are also disease specific and generic tools that can be utilized. This study will correlate two types of clinical outcomes tools to evaluate whether one or both tools should be used. The study utilized the Pulmonary Function Status Scale (PFSS) and the SF-36® Health Survey.

Methods: This research is a correlational study to determine if the PFSS scores of daily activity/social functioning and psychological functioning correlate with the SF-36® component scores of physical and mental. The MINITAB statistical software program, release 13, utilizing the Pearson's r correlation coefficient was used to analyze the data. Date were collected from patients enrolled in a pulmonary rehabilitation program and any information identifying individual patients was removed. The research compared the scores obtained before starting the program and scores obtained after program completion. Both instruments used in this study had been deemed reliable and valid through previous clinical research. Eighty-six patients' records met the criteria for the study. The average age of the patients was 64.95 years. There were 53 male and 34 female patients. Eighty percent of the patients had the diagnosis of COPD or emphysema.

Results: Data were analyzed for the subjects as a whole and for subgroups that were selected based on gender and diagnosis. Gender analysis was selected as a subgroup in order to see if the instruments correlated differently. When looking at the correlation data between the subsets, there were many weak to moderate correlations. Although twelve correlations were statistically significant, the actual correlation coefficients were not high enough to indicate a strong correlation between the two instruments and their component scores. This indicates that the instruments are measuring different outcomes, and that while the scores showed statistical significance, clinical significance could not be shown due to the low correlation of the instruments.

Conclusions: Pulmonary rehabilitation programs measure clinical outcomes and would prefer to do so in an efficient and effective manner. They want to be able to evaluate functional improvement for each patient, but the manner in which they do this can vary. Many programs choose a disease specific instrument, like the PFSS. Other programs opt for a generic, but well-known instrument, like the SF-36®. While clinicians would rather use a disease specific instrument, as many studies state they are more sensitive to change, there are many available and they may not be as well known as the SF-36®. This study has shown that there is not a strong correlation between these two instruments and that they indeed are measuring different outcomes. In conclusion, further research needs to occur in order to decide which instrument will become the most valuable tool for pulmonary rehabilitation programs to use when evaluating outcomes. In the meantime, many programs may continue to use more than one instrument to measure outcomes.

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