The Impact of Dysfunctional Breathing on the Management of Japanese Asthmatics

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  • Maruoka Shuichiro
    Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine Department of Psychosomatic Internal Medicine, Nihon University Itabashi Hospital

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  • 喘息マネジメントにおけるdysfunctional breathingの重要性
  • ゼンソク マネジメント ニ オケル dysfunctional breathing ノ ジュウヨウセイ

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Abstract

<p>Dysfunctional breathing (DB) is a clinical condition characterized by irregular breathing patterns. Asthmatic patients with DB show more severe symptoms, and therefore, early diagnosis and early therapeutic intervention for DB are critical for improving the clinical condition of these patients. The Nijmegen Questionnaire (NQ) has been used as a screening tool for DB, translated into various languages, and used globally. However, a Japanese version of the Nijmegen Questionnaire (JNQ) is not available. The purpose of this study was to develop the JNQ, verify its reliability and validity, and demonstrate its clinical benefits for Japanese patients with asthma. We developed the JNQ with the consent of the NQ author. The answers to self-administered questionnaires, including the JNQ, an asthma control test (ACT), an asthma control rating scale (ACQ), a quality of life (QOL) rating scale for asthmatic patients (MiniAQLQ), and a depression rating scale (PHQ-9), were obtained from 68 consenting asthmatic patients (average age 52.04±12.43) who visited Nihon University Itabashi Hospital. The reliability of the JNQ was assessed using Cronbach's alpha coefficient. A comparative test was conducted for each questionnaire (ACT, ACQ, MiniAQLQ, and PHQ-9), using a JNQ score of 23 as the cutoff value. Patients with a JNQ score of 23 or higher were assigned to the DB group, whereas patients with a JNQ score less than 23 were assigned to the non-DB group. The correlations between the JNQ score and scores for each questionnaire were also analyzed. The JNQ showed sufficient reliability. The JNQ score showed a negative correlation with the MiniAQLQ score and a positive correlation with the PHQ-9 score. Significant differences were observed in the MiniAQLQ and PHQ-9 scores between the DB and non-DB groups. The JNQ was found to be beneficial for evaluating DB in Japanese asthmatic patients and a high JNQ score reflected decreased QOL and a depressive state. Early therapeutic intervention (such as breathing exercises and psychosomatic approaches) for asthmatic patients with DB may prevent the deterioration of their clinical condition.</p>

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