Hulme Katrin, Deary Vincent, Dogan Sian, Parker Sean M
Respiratory Medicine, North Tyneside Hospital, Northumbria Healthcare NHS Foundation Trust, North Shields, UK; Health Psychology, Guy's Hospital, King's College London, London, UK; Health Psychology, Staffordshire University, Stoke-on-Trent, UK.
Psychology Dept, Northumbria University, Newcastle, UK.
ERJ Open Res. 2017 Mar 20;3(1). doi: 10.1183/23120541.00099-2016. eCollection 2017 Jan.
Chronic refractory cough (CRC) is a common problem in respiratory clinics. Adverse effects on quality of life are documented in the literature, but relatively little is known about the underlying psychological factors in this patient population. We aimed to investigate the association of psychological factors with chronic cough, comparing CRC to explained cough and non-cough groups. 67 patients attending a specialist cough clinic (CRC, n=25; explained cough, n=42) and 22 non-cough individuals participated. All participants completed the Hospital Anxiety & Depression Scale, Big Five Inventory (Personality), Chalder Fatigue Scale and Patient Health Questionnaire-15. Cough patients also completed the Illness Perception Questionnaire-Revised. Appropriate statistical analyses were used to compare participant groups. Chronic refractory coughers displayed significantly higher levels of anxiety, depression, fatigue and somatic physical symptoms than non-cough participants. Compared to explained coughers, there were higher depression and fatigue scores and significantly more negative illness representations (specifically, strong beliefs regarding negative consequences, lower illness coherence and higher emotional representations). "Explained" coughers reported significantly increased fatigue and somatic symptoms in comparison to non-coughers. The prevalence of fatigue, low mood, negative illness beliefs and increased physical symptom reporting should be considered in consultations and in developing novel interventions for CRC patients.
慢性难治性咳嗽(CRC)是呼吸科门诊的常见问题。文献记载了其对生活质量的不良影响,但对于该患者群体潜在的心理因素却知之甚少。我们旨在研究心理因素与慢性咳嗽之间的关联,将CRC患者与已明确病因的咳嗽患者及非咳嗽患者群体进行比较。67名到专科咳嗽门诊就诊的患者(CRC患者25名,已明确病因的咳嗽患者42名)以及22名非咳嗽个体参与了研究。所有参与者均完成了医院焦虑抑郁量表、大五人格量表、查尔德疲劳量表和患者健康问卷-15。咳嗽患者还完成了修订版疾病认知问卷。采用适当的统计分析方法对各参与者组进行比较。与非咳嗽参与者相比,慢性难治性咳嗽患者表现出显著更高水平的焦虑、抑郁、疲劳和躯体症状。与已明确病因的咳嗽患者相比,CRC患者的抑郁和疲劳得分更高,且负面疾病认知显著更多(具体而言,对负面后果的强烈信念、较低的疾病连贯性和较高的情绪认知)。与非咳嗽患者相比,已明确病因的咳嗽患者报告的疲劳和躯体症状显著增加。在为CRC患者进行会诊及制定新的干预措施时,应考虑疲劳、情绪低落、负面疾病信念以及躯体症状报告增加的发生率。