Caroci Adelaide de Souza, Lareau Suzanne C
School of Nursing, Loma Linda University, California, USA.
Heart Lung. 2004 Mar-Apr;33(2):102-10. doi: 10.1016/j.hrtlng.2003.11.004.
The purpose of this study was to determine whether differences existed between reports of dyspnea in stable chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) subjects.
Sixty stable COPD (n=30) and CHF (n=30) male, outpatient subjects were studied. Subjects were asked to both endorse (from a pre-designed list of descriptors) and volunteer terms that best described their breathing discomfort. Subjects also reported the frequency and the intensity of breathlessness (0-10 scale) using the Pulmonary Functional Status and Dyspnea Questionnaire.
From the endorsed list of descriptors, my breath does not go out all the way, was significantly different (COPD=11, CHF=4, P<.05) between groups. The most common terms volunteered by COPD subjects were scary (n=5, P<.02), hard to breathe (n=5), shortness of breath (n=4), and cannot get enough air (n=4), whereas CHF subjects volunteered the terms, shortness of breath (n=9), gasping (n=6), and cannot get enough air (n=4). There was no difference in the frequency with which both groups experienced dyspnea or times per month they reported severe to very severe dyspnea. Subjects with COPD experienced a higher intensity of breathlessness on different occasions P<.05.
Stable COPD and CHF patients use and recognize a variety of terms that describe their breathing distress. There was, however, only 1 unique term among the endorsed and volunteered terms, and that was among the COPD subjects. COPD and CHF subjects shared many common terms and also experienced dyspnea with similar frequency. The uniqueness of terms among the COPD group was less clear. The study highlights the variability of the dyspnea experience among COPD and CHF patients and the potential difficulty identifying unique dyspnea terms in these subjects.
本研究旨在确定稳定期慢性阻塞性肺疾病（COPD）患者与充血性心力衰竭（CHF）患者在呼吸困难报告方面是否存在差异。
对60名稳定期COPD（n = 30）和CHF（n = 30）男性门诊患者进行了研究。要求受试者从预先设计的描述词列表中选择并自行说出最能描述其呼吸不适的词汇。受试者还使用肺功能状态和呼吸困难问卷报告呼吸困难的频率和强度（0 - 10级）。
在选定的描述词列表中，“我的气出不彻底”在两组之间存在显著差异（COPD = 11，CHF = 4，P <.05）。COPD患者自行说出的最常见词汇是“可怕”（n = 5，P <.02）、“呼吸困难”（n = 5）、“气短”（n = 4）和“空气不够用”（n = 4），而CHF患者自行说出的词汇是“气短”（n = 9）、“喘气”（n = 6）和“空气不够用”（n = 4）。两组患者呼吸困难的频率以及每月报告严重至极重度呼吸困难的次数没有差异。COPD患者在不同情况下呼吸困难的强度更高（P <.05）。
稳定期COPD和CHF患者使用并认可多种描述其呼吸窘迫的词汇。然而，在选定和自行说出的词汇中，只有一个独特的词汇，且该词汇出现在COPD患者中。COPD和CHF患者共享许多常见词汇，且呼吸困难的频率相似。COPD组中词汇的独特性不太明显。该研究强调了COPD和CHF患者呼吸困难体验的变异性以及在这些患者中识别独特呼吸困难词汇的潜在困难。
