Elliott M W, Adams L, Cockcroft A, MacRae K D, Murphy K, Guz A
Department of Medicine, Charing Cross and Westminister Medical School, London, UK.
Am Rev Respir Dis. 1991 Oct;144(4):826-32. doi: 10.1164/ajrccm/144.4.826.
The main objective of the present study was to test the hypothesis that patients with cardiopulmonary disease can reliably identify different sensory qualities of their experience of breathlessness. A secondary aim was to examine whether there was any relationship between such specific descriptors of the sensation of breathlessness and a patient's clinical diagnosis. A randomly ordered list of 45 descriptors of breathing discomfort related to exertion was administered on two occasions to 208 patients with cardiopulmonary disease; patients identified the descriptors that applied to their own experience. A total of 169 patients were considered reliable in that their responses were repeatable between questionnaires; there was evidence that an individual's reliability could be assessed by asking repeat questions within a questionnaire. With these patients, individual descriptors generated different degrees of yes and no response and were answered with a variable consistency, suggesting that some questions may be more useful than others in discriminating between the quality of patients' sensations. Overall, patients with obstructive disorders (asthma and chronic obstructive airways disease [COAD]) answered yes more often than those with restrictive or cardiac conditions, possibly reflecting differences in severity of disease. A cluster analysis separated the descriptors into 12 groups which appeared to describe different aspects of breathing discomfort. Relative to their response to other clusters, COAD patients were more inclined to identify distress, asthma patients to indicate wheeziness, restrictive patients to report rapid breathing, and the cardiac group to describe a need to sign. A second cluster analysis separated patients into 12 groups based on responses for the descriptor clusters.(ABSTRACT TRUNCATED AT 250 WORDS)
患有心肺疾病的患者能够可靠地识别其呼吸困难体验的不同感觉特征。次要目的是检查呼吸困难感觉的此类特定描述词与患者的临床诊断之间是否存在任何关联。将一份随机排序的45个与运动相关的呼吸不适描述词清单分两次发给208名心肺疾病患者；患者识别适用于自身体验的描述词。共有169名患者被认为回答可靠，因为他们在两份问卷之间的回答具有可重复性；有证据表明，通过在一份问卷中询问重复问题可以评估个体的可靠性。对于这些患者，各个描述词产生了不同程度的肯定和否定回答，且回答的一致性各不相同，这表明在区分患者感觉的性质方面，有些问题可能比其他问题更有用。总体而言，阻塞性疾病（哮喘和慢性阻塞性气道疾病[COAD]）患者回答“是”的频率高于限制性或心脏疾病患者，这可能反映了疾病严重程度的差异。聚类分析将描述词分为12组，这些组似乎描述了呼吸不适的不同方面。相对于他们对其他组的回答，COAD患者更倾向于识别痛苦，哮喘患者倾向于指出喘息，限制性疾病患者报告呼吸急促，而心脏疾病组描述有叹气的需求。第二次聚类分析根据描述词组的回答将患者分为12组。（摘要截短于250字）
