Analysis of current status and related influencing factors of dyspnea beliefs in elderly patients with acute stroke after nasal high-flow oxygen therapy
Objective To explore the current status and influencing factors of dyspnea beliefs in patients with acute stroke(CVA)after nasal high-flow oxygen therapy(HFNC).Methods A total of 136 elderly CVA patients with HFNC trea-ted in Beijing Tiantan Hospital Affiliated to Capital Medical University from January 2022 to January 2023 were retrospectively selected as the study subjects.The Breathless Beliefs Questionnaire(BBQ)was used to evaluate the score of dyspnea belief.The score rate =score/full score×100%.Patients with a score rate＜60%of full score were included in the low dyspnea be-lief group,and patients with a score rate≥60%of full score were included in the high dyspnea belief group.The differences in cultural level,gender,Perceived Social Support Scale(PSSS)score,hospital stay,Activities of Daily Living Ability(ADL)and24-item Self-Efficacy Scale(SEES)scores were compared between the two groups.The influencing factors of high dyspnea belief were analyzed by binary logistic regression analysis.Results A total of 136 elderly CVA patients with HFNC were included,including 87 ones in the low dyspnea belief group and 49 ones in the high dyspnea belief group.There were significant differences in age,pulmonary infection control,coma,swallowing function,cough reflex,SEES score,PSSS score,ADL score,whether regular physical exercise,HFNC setting temperature,and treatment time after onset between the low dyspnea belief group and the high dyspnea belief group(P＜0.05).The results of binary Logistic analysis showed that age＞75 years(OR =1.719,P =0.004),worse swallowing function(OR =1.735,P =0.006),worse cough reflex(OR =1.898,P =0.000 4),lower SEES score(OR =1.785,P =0.002),lower PSSS score(OR =1.599,P =0.006),irregular physical exercise(OR =1.634,P =0.003),HFNC setting temperature≥37℃(OR =1.621,P =0.006)were all independent risk factors affecting the dyspnea belief of elderly CVA patients after HFNC(P＜0.05).A risk prediction model for high dyspnea belief in elderly CVA patients after HFNC was constructed.Based on the newly generated probability values of the model,the ROC curve of the prediction model was plotted,and its AUC was0.769 0(95%CI,0.681～0.759)＞0.75.Hosmer Leme-show test was used to evaluate the calibration ability of the model(χ2 =3.543,P =0.896＞0.05).Conclusion The overall level of dyspnea belief in CVA patients after HFNC is relatively low.Clinical workers should early identify the motivation of patients with dyspnea after HFNC,correct their catastrophic understanding of dyspnea,formulate targeted intervention meas-ures,and promote their psychological adjustment and disease recovery.
elderlyacute strokedyspneabeliefnasal high flow oxygen therapyrisk factormodel
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