呼吸困难是一种复杂的多维症状，包括感觉感知、情感和功能领域，通常在肺癌患者中持续存在，并损害心理健康和生活质量 (QOL)。然而，缺乏关于呼吸困难的维度或管理呼吸困难的自我效能如何与患者结果相关的数据。评估呼吸困难维度（呼吸困难相关的感官知觉体验、情感困扰和功能影响）和呼吸困难自我效能的关联报告呼吸困难的晚期肺癌患者的抑郁、焦虑和生活质量。我们对基线临床试验数据进行了二次分析，测试了呼吸困难的支持性护理干预措施。报告至少中度呼吸困难（改良医学研究委员会呼吸困难量表≥2）的晚期肺癌患者自我报告的呼吸困难和患者结果测量。分层回归测试了呼吸困难维度与抑郁和焦虑症状（医院焦虑和抑郁量表）和 QOL（癌症治疗肺功能评估）的关联，同时调整已知影响这些结果的变量。呼吸困难的感觉感知体验（努力）与更严重的抑郁症状（b = 0.21，P < 0.01）和生活质量（b = -0.53，P = 0.01）相关。呼吸困难自我效能感与抑郁症状（b = -1.26，P < 0.01）、焦虑症状（b = -1.72，P < 0.01）和生活质量（b = 3.66，P < 0.01）的改善相关。呼吸困难的情感和功能维度与最终模型中的患者结果无关。呼吸困难相关的感觉感知体验和自我效能与肺癌患者的心理健康和生活质量结果相关。检查呼吸困难的多个维度的个体贡献可以对其患者的影响有细致入微的了解。版权所有 © 2024 美国临终关怀和姑息医学学会。由爱思唯尔公司出版。保留所有权利。

Dyspnea is a complex, multidimensional symptom comprising sensory-perceptual, affective, and functional domains that commonly persists in patients with lung cancer and impairs mental health and quality of life (QOL). However, data are lacking on how dyspnea's dimensions or self-efficacy to manage dyspnea are associated with patient outcomes.To assess the associations of dyspnea dimensions (dyspnea-related sensory-perceptual experience, affective distress, and functional impact) and dyspnea self-efficacy with depression, anxiety, and QOL in patients with advanced lung cancer reporting dyspnea.We conducted a secondary analysis of baseline clinical trial data testing a supportive care intervention for dyspnea. Patients with advanced lung cancer reporting at least moderate dyspnea (≥2 on the Modified Medical Research Council Dyspnea Scale) self-reported dyspnea and patient outcome measures. Hierarchical regressions tested the associations of the dyspnea dimensions with depressive and anxiety symptoms (Hospital Anxiety and Depression Scale) and QOL (Functional Assessment of Cancer Therapy-Lung) while adjusting for variables known to affect these outcomes.The sensory-perceptual experience of dyspnea (effort) was associated with worse depressive symptoms (b = 0.21, P < 0.01) and QOL (b = -0.53, P = 0.01). Dyspnea self-efficacy was associated with improved depressive (b = -1.26, P < 0.01) and anxiety symptoms (b = -1.72, P < 0.01) and QOL (b = 3.66, P < 0.01). The affective and functional dimensions of dyspnea were not associated with the patient outcomes in the final models.Dyspnea-related sensory-perceptual experience and self-efficacy were associated with mental health and QOL outcomes in patients with lung cancer. Examining the individual contributions of dyspnea's multiple dimensions provides a nuanced understanding of its patient impact.Copyright © 2024 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.