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Development of the Cystic Fibrosis Stress Questionnaire: testing and validation.

Carolyn J Snell1,2, Morgan E Ryan3, Isabel V Bailey3

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The new Cystic Fibrosis Stress Questionnaire (CFSQ) effectively measures illness-specific distress in adults with CF. This validated tool complements existing mental health screenings, improving care for individuals with CF.

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Cystic FibrosisPsychologySurveys and Questionnaires

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Area of Science:

  • Psychological Medicine
  • Chronic Illness Management
  • Health Psychology

Background:

  • Cystic Fibrosis (CF) care guidelines mandate annual anxiety and depression screening using standardized tools like the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7).
  • Research in chronic conditions, such as diabetes, indicates that illness-specific distress is a significant predictor of daily functioning, independent of depression levels.
  • A validated measure for illness-specific distress in CF is needed to enhance current mental health screening protocols.

Purpose of the Study:

  • To develop and validate the Cystic Fibrosis Stress Questionnaire (CFSQ) as a measure of illness-specific distress.
  • To assess the CFSQ's utility as an adjunct to existing mental health screening tools in CF care.

Main Methods:

  • Development of a CF-specific perceived stress measure through multi-phase patient input.
  • A multisite validation study involving 200 adults with CF across three diverse CF centers.
  • Examination of the CFSQ's factor structure, internal consistency, convergent validity, and test-retest reliability.

Main Results:

  • The CFSQ demonstrated good internal consistency, with all but one subscale meeting the >0.6 cut-off.
  • Convergent validity was supported by moderate to high correlations between the CFSQ and the PHQ-9 (r=0.73) and GAD-7 (r=0.66).
  • Moderate correlations were observed between the CFSQ and CFQ-R Social (r=-0.59) and Treatment Burden (r=-0.63) subscales, with weaker correlations to lung function and BMI.

Conclusions:

  • The Cystic Fibrosis Stress Questionnaire (CFSQ) is a valid and reliable measure for assessing illness-specific distress in adults with CF.
  • The CFSQ demonstrates strong convergent validity with established mental health and quality of life measures used in CF care and research.
  • The CFSQ can serve as a valuable supplementary tool to existing mental health screening in cystic fibrosis management.