THE LANGUAGE OF BREATHLESSNESS - USE OF VERBAL DESCRIPTORS BY PATIENTS WITH CARDIOPULMONARY DISEASE
THE LANGUAGE OF BREATHLESSNESS - USE OF VERBAL DESCRIPTORS BY PATIENTS WITH CARDIOPULMONARY DISEASE
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DOI：
10.1164/ajrccm/144.4.826
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发表时间：
1991-10-01
期刊：
影响因子：
--
通讯作者：
GUZ, A
中科院分区：
文献类型：
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作者：
ELLIOTT, MW;ADAMS, L;GUZ, A
本研究的主要目的是检验以下假设：心肺疾病患者能够可靠地识别其呼吸困难经历的不同感觉质量。 第二个目的是检查这种呼吸困难感觉的具体描述与患者的临床诊断之间是否存在任何关系。 对 208 名心肺疾病患者进行了两次随机排序的 45 种与劳累相关的呼吸不适描述；患者确定了适用于他们自己经历的描述符。 共有 169 名患者被认为是可靠的，因为他们的回答在问卷之间是可重复的；有证据表明，可以通过在调查问卷中提出重复问题来评估个人的可靠性。 对于这些患者，个体描述符产生了不同程度的是和否反应，并且回答具有可变的一致性，这表明某些问题在区分患者感觉的质量方面可能比其他问题更有用。 总体而言，患有阻塞性疾病（哮喘和慢性阻塞性气道疾病 [COAD]）的患者比患有限制性或心脏病的患者更常回答“是”，这可能反映了疾病严重程度的差异。 聚类分析将描述符分为 12 组，这些组似乎描述了呼吸不适的不同方面。 相对于他们对其他类别的反应，COAD 患者更倾向于识别出痛苦，哮喘患者更倾向于表示喘息，限制性患者更倾向于报告呼吸急促，而心脏病组则更倾向于描述需要叹息。 第二次聚类分析根据描述符聚类的反应将患者分为 12 组。 其中一组包含最多数量的 COAD 和哮喘患者；另一组包括数量最多的限制性心脏病患者；然而，每个诊断分组的第二大数字出现在不同的患者分组中。 这些发现表明，进一步发展这种方法来定义患者的呼吸困难，就像疼痛一样，可以提供与病因学相关的临床有用信息，甚至可能提供与这种令人痛苦的症状的治疗相关的信息。
The main objective of the present study was to test the hypothesis that patients with cardiopulmonary disease can reliably identify different sensory qualities of their experience of breathlessness. A secondary aim was to examine whether there was any relationship between such specific descriptors of the sensation of breathlessness and a patient's clinical diagnosis. A randomly ordered list of 45 descriptors of breathing discomfort related to exertion was administered on two occasions to 208 patients with cardiopulmonary disease; patients identified the descriptors that applied to their own experience. A total of 169 patients were considered reliable in that their responses were repeatable between questionnaires; there was evidence that an individual's reliability could be assessed by asking repeat questions within a questionnaire. With these patients, individual descriptors generated different degrees of yes and no response and were answered with a variable consistency, suggesting that some questions may be more useful than others in discriminating between the quality of patients' sensations. Overall, patients with obstructive disorders (asthma and chronic obstructive airways disease [COAD]) answered yes more often than those with restrictive or cardiac conditions, possibly reflecting differences in severity of disease. A cluster analysis separated the descriptors into 12 groups which appeared to describe different aspects of breathing discomfort. Relative to their response to other clusters, COAD patients were more inclined to identify distress, asthma patients to indicate wheeziness, restrictive patients to report rapid breathing, and the cardiac group to describe a need to sigh. A second cluster analysis separated patients into 12 groups based on responses for the descriptor clusters. One group contained the largest number of both COAD and asthma patients; another group included the largest number of restrictive and cardiac patients; however, the next largest number for each diagnostic grouping occurred in a different patient grouping. These findings suggest that further development of this approach in defining a patient's breathlessness may, as with pain, provide clinically useful information relating to the etiology and possibly even the treatment of this distressing symptom.