Zhou Yan Hua, Mak Yim Wah
School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong 999077, China.
School of Nursing, Zhejiang Chinese Medical University, Hangzhou 310053, China.
Int J Environ Res Public Health. 2017 Oct 24;14(10):1277. doi: 10.3390/ijerph14101277.
Dyspnea has been found to be an independent predictor of mortality among patients with respiratory diseases and is often regarded as a difficult symptom to control in patients with interstitial lung diseases (ILDs). Previous studies have found an association of psychological and physiological factors with dyspnea among patients with chronic obstructive airway diseases. However, symptom management of hospitalized patients with ILDs has been hampered by difficulty in priority, since they are often admitted with multiple psycho-physiological needs. This study examined the prevalence of dyspnea and the psycho-physiological factors associated with it among hospitalized Chinese patients with ILDs. We studied 165 hospitalized patients with ILDs recruited consecutively over three months in a public hospital in Guangzhou, China. Dyspnea and common psycho-physiological factors, including cough symptoms, activity capacity, lung function, physical and mental health status, and anxiety and depression symptoms, were measured. By ordered logistic regression, level of dyspnea statistically significantly affected performance in a six-minute walk test and physical functioning in work or other regular daily activities in hospitalized patients with ILDs. Respiratory rehabilitation with an appropriate intensity of exercise training or other strategies for enhancing the physical functioning of this population with moderate and severe levels of dyspnea should be prioritized.
呼吸困难已被发现是呼吸系统疾病患者死亡率的独立预测因素,并且在间质性肺疾病(ILD)患者中常被视为难以控制的症状。先前的研究发现,慢性阻塞性气道疾病患者的心理和生理因素与呼吸困难有关。然而,由于住院的ILD患者往往因多种心理生理需求而入院,其症状管理因难以确定优先级而受到阻碍。本研究调查了中国住院ILD患者中呼吸困难的患病率及其相关的心理生理因素。我们研究了在中国广州一家公立医院连续三个月招募的165例住院ILD患者。测量了呼吸困难以及常见的心理生理因素,包括咳嗽症状、活动能力、肺功能、身心健康状况以及焦虑和抑郁症状。通过有序逻辑回归分析,呼吸困难程度在统计学上显著影响住院ILD患者的六分钟步行试验表现以及工作或其他日常常规活动中的身体功能。对于中度和重度呼吸困难的这一人群,应优先进行适当强度运动训练的呼吸康复或其他增强身体功能的策略。