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Bakshi S, Puar S, Bose PP. The Sisyphean breath: role of anxiety sensitivity and distress tolerance in dyspnea among adults with asthma and COPD. J Asthma 2024:1-9. [PMID: 39087926 DOI: 10.1080/02770903.2024.2387739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/18/2024] [Accepted: 07/29/2024] [Indexed: 08/02/2024]
Abstract
INTRODUCTION Asthma and COPD are among the leading causes of morbidity and mortality, impacting over 260 million people and causing over 3 million deaths globally (Momtaz-Manesh, S. et al., 2023). Pulmonary symptoms can impair tolerance and increase the negative attribution of anxiety sensations. Reciprocally, anxiety associated with dyspnea can induce hyperventilation. This perpetuates a cycle of symptom exacerbation and poor treatment adherence. Managing labored breathing is challenging due to its subjective nature. Dyspnea is a sufferer's endless pursuit to breathe, rendering its experience as truly, "Sisyphean." AIM This study explored the role of anxiety sensitivity and distress tolerance in dyspnea among adults with asthma and COPD (N = 107). A single-group cross-sectional research design was used. Data from pulmonologist-diagnosed adults with asthma and COPD were collected across various clinics in Delhi-NCR. RESULTS It was found that anxiety sensitivity, distress tolerance and dyspnea were strongly correlated. Also, an increase in anxiety sensitivity was strongly predictive of dyspnea severity. Further, distress tolerance acted as a partial mediator between anxiety sensitivity and dyspnea. CONCLUSIONS Improving distress tolerance can act as an adjuvant in effective dyspnea management.
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Affiliation(s)
| | - Sonia Puar
- AIB(H)AS, Amity University, Noida, India
| | - P P Bose
- Pulmonary, Critical Care, Sleep and Rehabilitation, SAANS Foundation and SAKSHAM foundation, New Delhi, India
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Holas P, Figueira-Putresza E, Domagala-Kulawik J. Coping styles with stress and its relations to psychiatric and clinical symptoms in patients with sarcoidosis: A latent profile analysis. Respir Med 2023; 211:107171. [PMID: 36906186 DOI: 10.1016/j.rmed.2023.107171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE Although stress and styles of coping with it can have a major impact on one's health and can determine the course and management of chronic diseases, no previous studies have evaluated coping strategies and their relation to emotional distress and clinical symptoms in sarcoidosis. METHODS In two consecutive studies, we investigated differences in coping styles of sarcoidosis patients in comparison to healthy control subjects and the association of identified profiles to an objective measurement of disease (Forced Vital Capacity) and symptoms such as dyspnoea, pain, anxiety and depressive symptoms in 36 patients with sarcoidosis (study 1) and 93 patients with sarcoidosis (study 2). RESULTS Across two studies we found that patients with sarcoidosis used emotion-focused and avoidant coping significantly less often than healthy individuals, and that in both groups the profile with dominant problem (task)-focus style was the most beneficial in terms of mental health. Further, the profile of sarcoidosis patients characterized by the lowest intensity of all coping strategies was found to be superior in terms of physical health status (dyspnoe, pain and FVC level). CONCLUSION These findings suggest that successful management of sarcoidosis should include coping styles assessment and call for a multidisciplinary approach in diagnosis and treatment of sarcoidosis patients.
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Affiliation(s)
- Pawel Holas
- University of Warsaw, Faculty of Psychology, Poland.
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Sharif Nia H, Akhlaghi E, Torkian S, Khosravi V, Etesami R, Froelicher ES, Pahlevan Sharif S. Predictors of Persistence of Anxiety, Hyperarousal Stress, and Resilience During the COVID-19 Epidemic: A National Study in Iran. Front Psychol 2021; 12:671124. [PMID: 34658994 PMCID: PMC8511821 DOI: 10.3389/fpsyg.2021.671124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The coronavirus pandemic can cause unprecedented global anxiety, and, in contrast, resilience can help the mental health of people in stressful situations. This study aimed to assess anxiety, hyperarousal stress, the resilience of the Iranian population, and their related factors during the coronavirus disease 2019 (COVID-19) epidemic. Methods: A cross-sectional study was conducted in 31 provinces in Iran between March 18 and 25, 2020. A four-part questionnaire, including the demographic information, the State-Trait Anxiety Inventory (STAI-y1-a 20-item standard questionnaire for obvious anxiety), the Connor-Davidson Resilience Scale (CD-RISC-a 25 item standard questionnaire), and the stress hyperarousal subscale from the Impact of Event Scale-Revised (IES-R), was used to collect data. The ordinal multivariable generalized estimating equation (GEE) model was used to identify correlates of the psychological factors mentioned above. The Fisher exact test was used to investigate the relationship between anxiety, stress, resilience, and the COVID-19 outbreak. All analyses were conducted with SPSS 26 and GIS 10.71. Results: The findings show that most people had moderate-to-severe anxiety (80.17%) and a high level of resilience (96.4%) during the COVID-19 epidemic. The majority of participants had a moderate level of stress (58.9%). The lowest and highest prevalences of psychiatric disorders were in Sistan and Baluchestan (3.14 cases per 100,000 people) and Semnan (75.9 cases per 100,000 people) provinces, respectively. Men and unmarried people were the only variables significantly associated with anxiety and resilience. Age, gender, and education were significantly associated with hyperarousal stress. Conclusion: The high and moderate levels of anxiety and stress in Iranians can have negative effects on the well-being and performance of the people and can lead to serious problems. Also, high resilience during negative life events (such as the COVID-19 pandemic) is associated with the well-being in the lives of people. The results of this study can be used in interventions and other psychological studies.
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Affiliation(s)
- Hamid Sharif Nia
- Department of Nursing, Mazandaran University of Medical Science, Sari, Iran
| | - Elham Akhlaghi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Samaneh Torkian
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Khosravi
- Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reza Etesami
- Department of Statistics, Shahid Bahonar University, Kerman, Iran
| | - Erika Sivarajan Froelicher
- Department of Physiological Nursing, Schools of Nursing, University of California, San Francisco, San Francisco, CA, United States
- Department of Epidemiology & Biostatistics, Schools of Medicine, University of California, San Francisco, San Francisco, CA, United States
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Banzett RBB, Sheridan AR, Baker KM, Lansing RW, Stevens JP. 'Scared to death' dyspnoea from the hospitalised patient's perspective. BMJ Open Respir Res 2021; 7:7/1/e000493. [PMID: 32169831 PMCID: PMC7069254 DOI: 10.1136/bmjresp-2019-000493] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/22/2019] [Accepted: 12/05/2019] [Indexed: 11/04/2022] Open
Abstract
Because dyspnoea is seldom experienced by healthy people, it can be hard for clinicians and researchers to comprehend the patient’s experience. We collected patients’ descriptions of dyspnoea in their own words during a parent study in which 156 hospitalised patients completed a quantitative multidimensional dyspnoea questionnaire. These volunteered comments describe the severity and wide range of experiences associated with dyspnoea and its impacts on a patients’ life. They provide insights not conveyed by structured rating scales. We organised these comments into the most prominent themes, which included sensory experiences, emotional responses, self-blame and precipitating events. Patients often mentioned air hunger (‘Not being able to get air is the worst thing that could ever happen to you.’), anxiety, and fear (‘Scared. I thought the world was going to end, like in a box.’). Their value in patient care is suggested by one subject’s comment: ‘They should have doctors experience these symptoms, especially dyspnoea, so they understand what patients are going through.’ Patients’ own words can help to bridge this gap of understanding.
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Affiliation(s)
- Robert B B Banzett
- Pulmonary, Critical Care, and Sleep Medicine, and Department of Nursing, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA .,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew R Sheridan
- Pulmonary, Critical Care, and Sleep Medicine, and Department of Nursing, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Kathy M Baker
- Nursing, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Robert W Lansing
- Pulmonary, Critical Care, and Sleep Medicine, and Department of Nursing, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jennifer P Stevens
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Pulmonary, Critical Care, and Sleep Medicine; Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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Holas P, Kowalski J, Dubaniewicz A, Farnik M, Jarzemska A, Maskey-Warzechowska M, Bielecki M, Domagala-Kulawik J. Relationship of emotional distress and physical concerns with fatigue severity in sarcoidosis. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2018; 35:160-164. [PMID: 32476897 DOI: 10.36141/svdld.v35i2.6604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/11/2017] [Indexed: 11/02/2022]
Abstract
Background: Fatigue is one of the most common and disabling symptoms of sarcoidosis. The cause of fatigue remains unclear and is usually multifactorial. The majority of previous studies evaluated clinical parameters with only few of them including assessment of psychological factors as contributing to the severity of the symptoms. Objective: The aim of this study was to evaluate the relationship of emotional distress, physical concerns, and dyspnea in explaining fatigue in patients with sarcoidosis. Methods: Fifty-seven patients with sarcoidosis were enrolled to the study and filled out measures of fatigue (FAS), dyspnea (MRC), anxiety sensitivity (ASI-3), and anxiety and depression (HADS). Results: Linear regression revealed that distress and physical concerns subscale of ASI are significant predictors of fatigue explaining jointly 53.5% of fatigue variance. Conclusions: The results of the study emphasize the importance of including emotional distress and physical concerns into the diagnostic procedures and management of fatigue in sarcoidosis. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 160-164).
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Affiliation(s)
- Pawel Holas
- University of Warsaw, Faculty of Psychology, Warsaw, Poland
| | | | - Anna Dubaniewicz
- Department of Pneumonology, Medical University of Gdansk, Poland
| | | | - Agnieszka Jarzemska
- Department of Pneumonology, Oncology and Tuberculosis, Collegium Medicum, UMK, Bydgoszcz, Poland
| | | | - Maksymilian Bielecki
- SWPS University of Social Sciences and Humanities, Faculty of Psychology, Warsaw, Poland
| | - Joanna Domagala-Kulawik
- Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Poland
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