A Breathlessness Catastrophizing Scale for chronic obstructive pulmonary disease

Objective: Catastrophizing about breathlessness may be related to disability in patients with chronic obstructive pulmonary disease (COPD), but assessment options are limited. This study reports the initial validation of a 13-item Breathlessness Catastrophizing Scale (BCS). Method: Pulmonary rehabilitation inpatients completed "spirometric, functional performance and questionnaire assessments at admission (N = 242) and discharge (n = 186). Results: The BCS comprised a unifactorial scale that demonstrated excellent internal consistency (Cronbach's alpha = .96) and correlated with measures of anxiety sensitivity, depression, and self-efficacy, but not with performance on walk and stair-climbing tests. BCS scores improved robustly with rehabilitation, approaching a medium effect size (d = .43), and demonstrated a modest association with enhanced performance in a stair-climbing test of exercise tolerance. Conclusion: The BCS is a reliable measure of catastrophizing in severe COPD that has good convergent validity and sensitivity to change. Its association with functional performance requires further investigation. However, it appears that a high level of catastrophizing about breathlessness is not a barrier to functional improvement with inpatient pulmonary rehabilitation. (C) 2014 Elsevier Inc. All rights reserved.