Relationship Between Dyspnea And Quality Of Life In Hospitalized Patients With Chronic Obstructive Pulmonary Disease

Objective:(1)Describe the status of dyspnea,breathlessness beliefs,,anxiety and depression of hospitalized patients with chronic obstructive pulmonary disease;(2)To analyze the relationship between dyspnea,breathlessness beliefs,anxiety and depression and patients’ quality of life;(3)To explore the mediating role of breathlessness beliefs and anxiety and depression in the effect of dyspnea symptoms on quality of life;It provides a theoretical reference for finding intervention targets for relieving dyspnea and improving patients’ quality of life.Methods:Using a cross-sectional study design,278 patients with chronic obstructive pulmonary disease who were repeatedly hospitalized were recruited from January 2019 to June 2021 in the Department of Respiratory and Critical Care Medicine of a tertiary hospital in Jinan City.The patient’s age,gender,smoking status,marital status,education level,etc.were collected using a general demographic scale;the duration of illness,the number of comorbidities,the type of caregiver,and the frequency of hospitalization for acute exacerbations in the past year were also asked.;Dyspnea Scale(mMRC),Breathlessness Belief Questions(BBQ),Hospital Anxiety and Depression Scale(HADS),and Chronic Obstructive Pulmonary Disease Assessment Test(CAT)were used to evaluate the degree of dyspnea and breathlessness belief of patients.depression degree,quality of life;descriptive statistical methods such as frequency,percentage,mean ± standard deviation were used to analyze the general data of patients;analysis of variance were used to compare groups;correlation statistical software was used to explore symptoms of dyspnea,breathlessness belief,anxiety and depression,and quality of life;using Bootstrap to test the mediating effects of breathlessness belief,anxiety,and depressive negative emotions between dyspnea symptoms and quality of life.Results:(1)A total of 278 patients were included in this study,and 67%of the patients had dyspnea grades of grades 3 and 4;the average score of dyspnea belief was(44.90±4.69)points;the proportion of patients with anxiety was 19.1%;The proportion of patients with depression was 19.4%;87.5%of the patients had a CAT score of≥10,and the average C AT score was(19.44±6.63)points.(2)Dyspnea were positively correlated with quality of life(r=0.848,P<0.01);breathlessness beliefs were positively correlated with quality of life(r=0.567,P<0.01);depression was positively correlated with quality of life(r=0.404),P<0.01);anxiety was positively correlated with quality of life(r=0.462),P<0.01).(3)Breathlessness beliefs and depression the total indirect effect for the two intermediary path-0.037,accounting for 3.7%of the total effect,have examined the bootstrap confidence intervals for(0.005,0.075),P=0.002,the good model fitting(χ2/df=1.735,GFI=0.965,NFI=0.892,IFI=0.951,TLI=0.927,CFI=0.950,RMSEA=0.052).(4)Breathlessness beliefs and depression the total indirect effect for the two intermediary path 0.101,accounting for 10.1%of the total effect,have examined the bootstrap confidence intervals for(0.821,0.875),P=0.002,the good model fitting(χ2/df=1.774,GFI=0.965,NFI=0.955,IFI=0.980,TLI=0.966,CFI=0.980,RMSEA=0.053).Conclusions:(1)Patients with chronic obstructive pulmonary disease who were hospitalized repeatedly had higher levels of dyspnea and breathlessness beliefs and their quality of life was seriously affected by the disease;(2)Patients with chronic obstructive pulmonary disease who were hospitalized repeatedly had dyspnea,breathlessness beliefs,anxiety and depression were all correlated with quality of life;(3)Dyspnea can affect the quality of life through the chain mediating effect of breathlessness beliefs and anxiety and depression.