von Leupoldt Andreas, Seemann Nadine, Gugleva Tatiana, Dahme Bernhard
Psychological Institute III, University of Hamburg, Von-Melle-Park 5, 20146 Hamburg, Germany.
Respir Med. 2007 Apr;101(4):839-44. doi: 10.1016/j.rmed.2006.06.033. Epub 2006 Sep 12.
The perception of dyspnea shows many similarities to the perception of pain. Both are multidimensional processes, which are not only influenced by sensory input but also by nonsensory factors like attention. Recent research has suggested that attentional distraction might reduce the perception of dyspnea but results are conflicting. Furthermore, the specific impact of attentional distraction on the distinct dimensions of perceived dyspnea has not been studied yet. Therefore, the present study examined the specific impact of changes in the attentional focus on the sensory and affective dimension of perceived dyspnea. Dyspnea was induced in forty-four healthy volunteers (mean age: 27.7 years, range: 18-47 years) by breathing through an inspiratory resistive load (3.57 kPa/L/s), while attention was directed either to breathing or distracted by reading texts. Inspiratory time (T(i)) and breathing frequency (f) were measured continuously. After each condition the experienced intensity (i.e., sensory dimension) and unpleasantness (i.e., affective dimension) of dyspnea were rated on separate visual analog scales (VAS), presented in randomized order. ANOVAs showed that attentional distraction during loaded breathing reduced the perceived unpleasantness of dyspnea (P<0.05), while the perceived intensity of dyspnea as well as T(i) and f remained unchanged. The results show that attentional distraction reduces the affective, but not the sensory dimension of induced dyspnea in healthy volunteers. Future studies are needed to clarify whether attentional distraction can effectively be used as intervention technique for reducing the unpleasant aspects of dyspnea in different patients groups.
对呼吸困难的感知与对疼痛的感知有许多相似之处。两者都是多维度的过程，不仅受感觉输入的影响，还受注意力等非感觉因素的影响。最近的研究表明，注意力分散可能会降低对呼吸困难的感知，但结果相互矛盾。此外，注意力分散对感知到的呼吸困难不同维度的具体影响尚未得到研究。因此，本研究考察了注意力焦点变化对感知到的呼吸困难的感觉维度和情感维度的具体影响。通过吸气阻力负荷（3.57 kPa/L/s）呼吸，在44名健康志愿者（平均年龄：27.7岁，范围：18 - 47岁）中诱发呼吸困难，同时将注意力引导至呼吸或通过阅读文本使其分散。连续测量吸气时间（T(i)）和呼吸频率（f）。在每种情况之后，在单独的视觉模拟量表（VAS）上对呼吸困难的体验强度（即感觉维度）和不愉快程度（即情感维度）进行评分，评分以随机顺序呈现。方差分析表明，负荷呼吸期间的注意力分散降低了呼吸困难的感知不愉快程度（P<0.05），而呼吸困难的感知强度以及T(i)和f保持不变。结果表明，注意力分散降低了健康志愿者中诱发的呼吸困难的情感维度，但未降低感觉维度。需要进一步的研究来阐明注意力分散是否可以有效地用作干预技术，以减轻不同患者群体中呼吸困难的不愉快方面。
