Influencing factors and the pathway analysis of dyspnea-related fear in patients with chronic obstructive pulmonary disease
Objective To explore the influencing factors and the pathway of dyspnea-related fear in patients with chronic obstructive pulmonary disease(COPD),and to provide a reference for conducting targeted intervention to alleviate their dyspnea-related fear.Methods A total of 376 COPD patients were selected by the convenience sampling method,then they were investigated by utilizing a general information questionnaire,the modified Medical Research Council(mMRC),the Hospital Anxiety and Depression Scale(HADS),the Chinese version of the Breathlessness Catastrophizing Scale(BCS),the COPD Self-efficacy Scale(CSES),and the Breathlessness Beliefs Questionnaire(BBQ).Results The participants'score of dyspnea-related fear was 20.0(17.0,22.0).Mul-tivariate analysis showed that,the scores of BCS,CSES,HADS,and Body Mass Index(BMI)were influencing factors of dyspnea-related fear in COPD patients(all P＜0.05).The results of structural equation model were:x2/df=1.468,RMSEA=0.035,GFI=0.997,AGFI=0.973,NFI=0.999,IFI=1.000,CFI=1.000,TLI=0.997,which showed good fitting.Pathway analysis showed that,the direct affect effects of catastrophizing cognition,self-efficacy,anxiety and depression on dyspnea-related fear were 0.534,-0.362,0.196,-0.113,respectively,and dyspnea indirectly affected dyspnea-related fear via anxiety,depression,catastrophizing cognition and self-efficacy(all P＜0.05).Conclusion Dyspnea-related fear in COPD patients is at a high level,which is influenced by multiple factors.Clinical medical staff should develop personalized intervention strategies by considering pa-tients'individual,psychological and other influencing factors and the pathways,so as to reduce their dyspnea-related fear.
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