Solomon Brahm K, Wilson Keith G, Henderson Peter R, Poulin Patricia A, Kowal John, McKim Douglas A
School of Psychology, University of Ottawa, Canada.
Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Canada.
J Psychosom Res. 2015 Jul;79(1):62-8. doi: 10.1016/j.jpsychores.2014.11.020. Epub 2014 Dec 3.
Catastrophizing about breathlessness may be related to disability in patients with chronic obstructive pulmonary disease (COPD), but assessment options are limited. This study reports the initial validation of a 13-item Breathlessness Catastrophizing Scale (BCS).
Pulmonary rehabilitation inpatients completed spirometric, functional performance and questionnaire assessments at admission (N=242) and discharge (n=186).
The BCS comprised a unifactorial scale that demonstrated excellent internal consistency (Cronbach's alpha=.96) and correlated with measures of anxiety sensitivity, depression, and self-efficacy, but not with performance on walk and stair-climbing tests. BCS scores improved robustly with rehabilitation, approaching a medium effect size (d=.43), and demonstrated a modest association with enhanced performance in a stair-climbing test of exercise tolerance.
The BCS is a reliable measure of catastrophizing in severe COPD that has good convergent validity and sensitivity to change. Its association with functional performance requires further investigation. However, it appears that a high level of catastrophizing about breathlessness is not a barrier to functional improvement with inpatient pulmonary rehabilitation.
对慢性阻塞性肺疾病（COPD）患者而言，对呼吸急促的灾难化认知可能与功能障碍有关，但评估方法有限。本研究报告了一个包含13个条目的呼吸急促灾难化量表（BCS）的初步验证情况。
肺部康复住院患者在入院时（N = 242）和出院时（n = 186）完成了肺功能、功能表现和问卷调查评估。
BCS是一个单因素量表，具有出色的内部一致性（克朗巴哈系数α = 0.96），并与焦虑敏感性、抑郁和自我效能感的测量指标相关，但与步行和爬楼梯测试的表现无关。BCS评分在康复过程中显著改善，接近中等效应量（d = 0.43），并且在运动耐力的爬楼梯测试中与表现增强存在适度关联。
BCS是一种可靠的测量严重COPD患者灾难化认知的方法，具有良好的聚合效度和对变化的敏感性。其与功能表现的关联需要进一步研究。然而，似乎对呼吸急促的高度灾难化认知并非住院肺部康复功能改善的障碍。
