Reliability and validity of the Turkish version of the Barthel Index-dyspnea in patients with pulmonary hypertension.

Abstract

Background/aim: The Barthel Index-dyspnea (BI-d) is a respiratory disease-specific tool developed on the basis of the Barthel Index (BI), which provides a simple and quick way to measure the degree of dyspnea in activities of daily living (ADL). Dyspnea is one of the most common symptoms of pulmonary hypertension (PH). The objective of this study was to explore the reliability and validity of the Turkish version of the BI-d in patients with PH.

Materials and methods: A total of 73 PH patients were included in the study. Criterion validity was explored using the modified Medical Research Council (mMRC) dyspnea scale, 6-min walk test (6MWT), and London Chest Activities of Daily Living (LCADL) scale, while divergent validity was examined through correlations between the BI-d and BI.

Results: The BI-d demonstrated strong correlations with the LCADL (r = 0.801) and mMRC (r = 0.775), and a moderately negative correlation with the 6MWD (r = -0.510), supporting criterion-related validity. A weak negative correlation with the BI (r = -0.289) supported divergent validity. The BI-d scores differed significantly across the mMRC grades and PH functional classes, confirming known-group validity. Reliability analyses showed good internal consistency (Cronbach's α = 0.85) and excellent test-retest reliability (intraclass correlation coefficient = 0.94).

Conclusion: The Turkish version of the BI-d demonstrates high reliability and validity in PH. As a tool that integrates respiratory burden with activity-related functional performance, it provides a practical assessment of dyspnea-related impairment during ADL.