Physical and affective domains of dyspnoea: emotional response but not sensory quality differs between people with and without moderate to very severe chronic obstructive pulmonary disease
Date
2016
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Lewthwaite, H.
John, D.
Williams, M.
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Respirology, 2016, vol.21, iss.s2, s1, pp.138-138
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Introduction/Aim: Dyspnoea includes physical (sensory quality) and affective (emotional response) dimensions. This study compared dyspnoea in people with and without moderate to very severe COPD (MtVS COPD). Methods: Participants referred to pulmonary rehabilitation recalled breathlessness in daily life using the Dyspnoea‐12 (D‐12, two subdomains (Physical, Affective)) and the Multidimensional Dyspnoea Profile (MDP, two subdomains (Immediate Perception, Emotional Response)). Post‐bronchodilator spirometry was used to classify participants into MtVS COPD (FEV₁/FVC <70%, FEV₁ %predicted < 80) or Comparator (Non‐MtVS FEV₁ %predicted ≥80) groups. Differences in D‐12 and MDP scores between groups were assessed using unpaired t‐tests (P < 0.05 significant), with coefficient of variation (r²) assessing the degree to which FEV1 %predicted, modified Medical Research Council dyspnoea scale (mMRC) and 6‐min distance test (6MDT) explained scores of the D‐12 and MDP (Fisher r to z‐test for differences in associations between groups).
Results: A total of 156 participants completed the study (MtVS COPD group n = 106, FEV₁ %predicted 49 ± 17, FEV₁/FVC 43 ± 15 versus Comparator group n = 50, FEV₁ %predicted 83 ± 13, FEV₁/FVC 74 ± 10 (restrictive = 18, mild COPD = 10, without COPD = 22). With the exception of the MDP Emotional Response sub‐score (MtVS COPD 10.50 ± 11.21 versus Comparator 15.20 ± 14.35, P = 0.03), no significant differences existed between groups for scores for the D‐12 or MDP or associations with FEV₁%pred, mMRC or 6MWD. Modest variation in D‐12 and MDP sub‐scores was explained by mMRC (<30%) and distance achieved in the 6MDT (<20%) with FEV₁%predicted explaining less than 5%. Conclusion: In this sample of participants, the intensity of physical sensations of breathlessness did not differ significantly between groups; however, people with MtVS COPD had significantly lower scores for Emotional Response. Habituation to the sensation of breathlessness or the diagnostic label of COPD may explain these findings.
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Copyright 2016 Wiley