Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, Sweden.
Department of Respiratory Medicine, School of Medical Sciences, Örebro University, Örebro, Sweden.
Respirology. 2022 Oct;27(10):874-881. doi: 10.1111/resp.14313. Epub 2022 Jun 13.
Recall of breathlessness is important for clinical care but might differ from the experienced (momentary) symptoms. This study aimed to characterize the relationship between momentary breathlessness ratings and the recall of the experience. It is hypothesized that recall is influenced by the peak (worst) and end (most recent) ratings of momentary breathlessness (peak-end rule).
This study used mobile ecological momentary assessment (mEMA) for assessing breathlessness in daily life through an application installed on participants' mobile phones. Breathlessness ratings (0-10 numerical rating scale) were recorded throughout the day and recalled each night and at the end of the week. Analyses were performed using regular and mixed linear regression.
Eighty-four people participated. Their mean age was 64.4 years, 60% were female and 98% had modified Medical Research Council (mMRC) ≥ 1. The mean number of momentary ratings of breathlessness provided was 7.7 ratings/participant/day. Recalled breathlessness was associated with the mean, peak and end values of the day. The mean was most closely associated with the daily recall. Associations were strong for weekly values: peak breathlessness (beta = 0.95, r = 0.57); mean (beta = 0.91, r = 0.53); and end (beta = 0.67, r = 0.48); p < 0.001 for all. Multivariate analysis showed that peak breathlessness had the strongest influence on the breathlessness recalled at the end of the week.
Over 1 week, recalled breathlessness is most strongly influenced by the peak breathlessness; over 1 day, it is mean breathlessness that participants most readily recalled.
呼吸困难的回忆对于临床护理很重要，但可能与所经历的（瞬间）症状不同。本研究旨在描述瞬间呼吸困难评分与体验回忆之间的关系。研究假设回忆受到瞬间呼吸困难的峰值（最严重）和结束时（最近）评分的影响（峰终规律）。
本研究使用移动生态瞬时评估（mEMA）通过安装在参与者手机上的应用程序来评估日常生活中的呼吸困难。全天记录呼吸困难评分（0-10 数字评分量表），并在每晚和周末结束时进行回忆。使用常规和混合线性回归进行分析。
84 人参与了研究。他们的平均年龄为 64.4 岁，60%为女性，98%为改良医学研究委员会（mMRC）评分≥1。参与者平均每天提供 7.7 次瞬间呼吸困难评分。回忆的呼吸困难与当天的平均值、峰值和结束值相关。平均值与每日回忆最密切相关。每周的峰值呼吸困难（β=0.95，r=0.57）、平均值（β=0.91，r=0.53）和结束时（β=0.67，r=0.48）与每周回忆的关联均较强（p<0.001 均）。多变量分析表明，峰值呼吸困难对周末回忆的呼吸困难影响最大。
在 1 周以上的时间内，回忆的呼吸困难受峰值呼吸困难影响最大；在 1 天内，参与者最容易回忆起平均呼吸困难。
