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Respiratory Complaints in Chinese^*

Cultural and Diagnostic Specificities

^* From the Laboratory of Respiratory Psychophysiology (Drs. Han, Zhu, Li, and Chen), Department of Pneumology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing China; the Department of Pneumology (Drs. Put and Van de Woestijne), U Z Gasthuisberg, Leuven, Belgium; and the Department of Psychology (Dr. Van den Bergh), University of Leuven, Leuven, Belgium.

Correspondence to: Jiangna Han, MD, Laboratory of Respiratory Psychophysiology, Department of Pneumology, Peking Union Medical College Hospital, Beijing, 100730, China; e-mail: Janet_Han2000{at}hotmail.com

Study objectives: We investigated the qualitative components of a wide range of Chinese descriptors of dyspnea and associated symptoms, and their relevance for clinical diagnosis.

Measurements: Sixty-one spontaneously reported descriptors were elicited in Chinese patients to make a symptom checklist, which was administered to new groups of patients with different cardiopulmonary diseases, to patients with medically unexplained dyspnea and to healthy subjects.

Results: Test-retest reliability was satisfactory for most of the descriptors. A principal component analysis on 61 descriptors yielded the following eight factors: dyspnea-effort of breathing; dyspnea-affective aspect; wheezing; anxiety; tingling; palpitation; coughing and sputum; and dying experience. Although the descriptors of dyspnea-effort of breathing resembled Western wordings and were shared by patients with a variety of diseases, the descriptors of dyspnea-affective aspect appeared to be more culturally specific and were primarily linked to the diagnosis of medically unexplained dyspnea, whereas wheezing was specifically linked to asthma.

Conclusions: Three factors of breathlessness were found in Chinese. The descriptors of dyspnea-effort of breathing and wheezing appear to be similar to Western descriptors, whereas the dyspnea-affective aspect seems to bear cultural specificity.

Key Words: Chinese • dyspnea • factor analysis • respiratory complaints

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