Petersen Sibylle, Morenings Matthias, von Leupoldt Andreas, Ritz Thomas
Department of Psychology, University of Hamburg, Hamburg, Germany.
Br J Health Psychol. 2009 Nov;14(Pt 4):751-65. doi: 10.1348/135910709X412800. Epub 2009 Feb 27.
Dyspnea is defined as an uncomfortable awareness of the need to breathe. Verbal report of dyspnea can be a valuable source of diagnostic information. However, little is known about the cognitive representation of respiratory sensations and about their affective evaluation in individuals not suffering from respiratory disease. Such knowledge would be important in evaluating the comparability of respiratory sensation report between healthy controls and patient groups.
Five hundred and eighty-two healthy individuals rated 20 descriptors of respiratory sensation with regard to frequency, valence, and situational incidence. Ratings were analysed on the level of subgroups of items found with cluster analysis and Multidimensional Scaling (MDS).
Not all respiratory sensations commonly subsumed under dyspnea are perceived to be uncomfortable by healthy individuals. Two higher-order clusters were found, interpreted as (1) compensation of dyspnea and (2) breathing deficiencies. Breathing deficiencies were unknown by approximately 50% of participants and rated to be less frequent and more uncomfortable than compensation of dyspnea. Furthermore, three dimensions of respiratory sensations were found using MDS interpreted as (1) fit between need for air and actual breathing, (2) effort, and (3) attempt of voluntary control.
The extent to which respiratory sensation ratings can be compared between patients and healthy individuals is limited. Latent dimensions of dyspnea might be less affected by differences in interpretation and evaluation of language descriptors of dyspnea and could help to assess comparability of sensation report between groups with different experiential background regarding breathlessness.
呼吸困难被定义为对呼吸需求的一种不舒服的感知。呼吸困难的口头报告可能是诊断信息的一个有价值来源。然而，对于未患呼吸系统疾病的个体，呼吸感觉的认知表征及其情感评价知之甚少。此类知识对于评估健康对照与患者组之间呼吸感觉报告的可比性很重要。
582名健康个体就频率、效价和情境发生率对20个呼吸感觉描述词进行了评分。通过聚类分析和多维标度法（MDS）在项目亚组层面上对评分进行了分析。
并非所有通常归类于呼吸困难的呼吸感觉都被健康个体视为不舒服。发现了两个高阶聚类，解释为（1）呼吸困难的代偿和（2）呼吸不足。约50%的参与者不了解呼吸不足，且其被评定为比呼吸困难的代偿频率更低、更不舒服。此外，使用MDS发现了呼吸感觉的三个维度，解释为（1）空气需求与实际呼吸之间的匹配度，（2）努力程度，以及（3）自主控制尝试。
患者与健康个体之间呼吸感觉评分的可比较程度有限。呼吸困难的潜在维度可能较少受到呼吸困难语言描述词解释和评价差异的影响，并有助于评估具有不同呼吸体验背景的组之间感觉报告的可比性。
