Williams Marie T, Lewthwaite Hayley, Brooks Dina, Johnston Kylie N
Innovation, IMPlementation and Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, SA 5000, Australia.
Centre of Research Excellence in Asthma Treatable Traits, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW 2308, Australia.
Healthcare (Basel). 2024 Sep 10;12(18):1813. doi: 10.3390/healthcare12181813.
Explanations provided by healthcare professionals contribute to patient beliefs. Little is known about how healthcare professionals explain chronic breathlessness to people living with this adverse sensation.
A purpose-designed survey disseminated via newsletters of Australian professional associations (physiotherapy, respiratory medicine, palliative care). Respondents provided free-text responses for their usual explanation and concepts important to include, avoid, or perceived as difficult to understand by recipients. Content analysis coded free text into mutually exclusive categories with the proportion of respondents in each category reported.
Respondents ( = 61) were predominantly clinicians (93%) who frequently (80% daily/weekly) conversed with patients about breathlessness. Frequent phrases included within usual explanations reflected breathlessness resulting from medical conditions (70% of respondents) and physiological mechanisms (44%) with foci ranging from multifactorial to single-mechanism origins. Management principles were important to include and phrases encouraging maladaptive beliefs were important to avoid. The most frequent difficult concept identified concerned inconsistent relationships between oxygenation and breathlessness. Where explanations included the term 'oxygen', a form of cognitive shortcut (heuristic) may contribute to erroneous beliefs.
This study presents examples of health professional explanations for chronic breathlessness as a starting point for considering whether and how explanations could contribute to adaptive or maladaptive breathlessness beliefs of recipients.
医疗保健专业人员提供的解释会影响患者的认知。对于医疗保健专业人员如何向有这种不良感觉的人解释慢性呼吸急促，我们了解甚少。
通过澳大利亚专业协会（物理治疗、呼吸医学、姑息治疗）的时事通讯分发一份专门设计的调查问卷。受访者为常见解释以及对接受者来说重要的、应包含、应避免或被认为难以理解的概念提供自由文本回复。内容分析将自由文本编码为相互排斥的类别，并报告每个类别的受访者比例。
受访者（(n = 61)）主要是临床医生（93%），他们经常（80%每天/每周）与患者谈论呼吸急促问题。常见解释中频繁出现的短语反映出呼吸急促是由疾病状况（70%的受访者）和生理机制（44%）导致的，其关注点从多因素到单一机制起源不等。管理原则很重要，应予以包含，而鼓励不良适应信念的短语则应避免。最常被提及的难以理解的概念涉及氧合与呼吸急促之间不一致的关系。当解释中包含“氧气”一词时，一种认知捷径（启发式）可能会导致错误信念。
本研究展示了医疗保健专业人员对慢性呼吸急促的解释示例，作为思考解释是否以及如何可能影响接受者适应性或不良适应性呼吸急促信念的起点。
