Department of Clinical Health Psychology, Central and North West London NHS Foundation Trust, Uxbridge, UK.
Psychol Health Med. 2010 Aug;15(4):371-85. doi: 10.1080/13548506.2010.482142.
Non-pharmacological breathlessness interventions in lung cancer have proven beneficial. Breathlessness is also a major symptom in chronic obstructive pulmonary disease (COPD). This study measured the effectiveness of a non-exercise-based four-week cognitive-behavioural breathlessness intervention, delivered in a group setting for elderly patients with severe COPD. The results of the one-year feasibility study are presented. Patients with COPD were asked to complete the St. George's Respiratory Questionnaire and Hospital Anxiety and Depression Scale six weeks before the intervention, at the start and end of the intervention and at six weeks follow-up. The multidisciplinary intervention used a cognitive-behavioural format to address understanding of COPD and medication, anxiety, panic and depression, activity pacing, relaxation, breathing retraining and goal-setting. Retrospective data on accident & emergency (A&E) attendances and length of hospital stay was collected six months before and six months after the intervention and the data compared to a matched waiting list control group. The results showed significant improvements in depression and health status. There was a non-significant improvement in anxiety. There was a significant reduction in A&E attendance and a non-significant reduction in length of hospital stay in the intervention group, compared to comparative increases in the control group, highlighting the cost-effectiveness of the intervention.
在肺癌中,非药物性呼吸困难干预已被证明是有益的。呼吸困难也是慢性阻塞性肺疾病(COPD)的主要症状。本研究评估了一种非基于运动的四周认知行为性呼吸困难干预措施对老年重度 COPD 患者的有效性,该措施在小组环境中实施。本文呈现了为期一年的可行性研究的结果。在干预前六周、干预开始时、结束时和六周随访时,COPD 患者被要求完成圣乔治呼吸问卷和医院焦虑和抑郁量表。多学科干预采用认知行为模式来解决对 COPD 和药物的理解、焦虑、恐慌和抑郁、活动节奏、放松、呼吸训练和设定目标。在干预前六个月和干预后六个月收集了关于急诊(A&E)就诊次数和住院时间的回顾性数据,并将数据与匹配的等待名单对照组进行了比较。结果显示,抑郁和健康状况有显著改善。焦虑有非显著性改善。与对照组的比较增加相比,干预组的 A&E 就诊次数显著减少,住院时间无显著减少,突出了干预的成本效益。