Reilly Charles C, Higginson Irene J, Chalder Trudie
Department of Physiotherapy, King's College Hospital, London, UK.
Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.
ERJ Open Res. 2024 Apr 29;10(2). doi: 10.1183/23120541.00874-2023. eCollection 2024 Mar.
Understanding the complexity and multidimensional nature of chronic breathlessness is key to its successful management. The aim of this study was to explore illness perceptions, cognitive and behavioural responses to chronic breathlessness in individuals living with advanced respiratory disease.
This was a cross-sectional secondary analysis of data from a feasibility randomised control trial (SELF-BREATHE) for individuals living with chronic breathlessness due to advanced disease. All participants completed the following questionnaires: numerical rating scale (NRS) breathlessness severity, NRS distress due to breathlessness, NRS self-efficacy for managing breathlessness, Dyspnea-12 (D-12), Chronic Respiratory Disease Questionnaire (CRQ), Brief Illness Perception Questionnaire (Brief IPQ) and the Cognitive and Behavioural Responses Questionnaire, short version (CBRQ-S). The associations between the Brief IPQ and CBRQ-S with NRS breathlessness severity, distress and self-efficacy, D-12 and CRQ were examined using Spearman's rho correlation coefficient r. A Spearman's r of ≥0.50 was predefined as the threshold to denote important associations between variables. A p-value of <0.008 was considered statistically significant, to account for the number of comparisons performed.
The illness perception items consequences, identity, concern and emotional response were associated with increased breathlessness severity, increased distress, reduced breathlessness self-management ability and lower health-related quality of life. Symptom focusing and embarrassment avoidance were identified as important cognitive responses to chronic breathlessness.
Interventions that directly target illness perceptions, cognitive and behavioural responses to chronic breathlessness may improve symptom burden, self-efficacy and health-related quality of life.
了解慢性呼吸急促的复杂性和多维度性质是成功管理该病的关键。本研究旨在探讨晚期呼吸系统疾病患者对慢性呼吸急促的疾病认知、认知和行为反应。
这是一项对因晚期疾病导致慢性呼吸急促患者的可行性随机对照试验（SELF-BREATHE）数据进行的横断面二次分析。所有参与者均完成以下问卷：数字评定量表（NRS）呼吸急促严重程度、因呼吸急促导致的NRS痛苦程度、管理呼吸急促的NRS自我效能感、呼吸困难-12（D-12）、慢性呼吸系统疾病问卷（CRQ）、简短疾病认知问卷（简短IPQ）以及认知和行为反应问卷简版（CBRQ-S）。使用Spearman等级相关系数r检验简短IPQ和CBRQ-S与NRS呼吸急促严重程度、痛苦程度和自我效能感、D-12以及CRQ之间的关联。预先将Spearman等级相关系数r≥0.50定义为表示变量之间重要关联的阈值。考虑到所进行的比较次数，p值<0.008被认为具有统计学意义。
疾病认知项目后果、身份认同、担忧和情绪反应与呼吸急促严重程度增加、痛苦加剧、呼吸急促自我管理能力下降以及健康相关生活质量降低相关。症状聚焦和避免尴尬被确定为对慢性呼吸急促的重要认知反应。
直接针对对慢性呼吸急促的疾病认知、认知和行为反应的干预措施可能会改善症状负担、自我效能感和健康相关生活质量。
