Latent Profile Analysis and Influencing Factors Associated with the Coping Styles of Dyspnea-Related Fear Among Patients with Chronic Obstructive Pulmonary Disease: A Multicenter Cross-Sectional Study

Xiaolang Miao,* Suxian Jing,* Yanxia Han,* Xiaoliang Jin, Tingting Gao, Jiale Qian, Qian Zhao, Ying Shen, Beilei Zhang, Meie Niu Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Soochow University, Jiangsu, Suzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ying Shen, Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Soochow University, 899th, Pinghai Road, Suzhou, 215006, People’s Republic of China, Tel +86 13814889733, Email [email protected] Beilei Zhang, Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Soochow University, 899th, Pinghai Road, Suzhou, 215006, People’s Republic of China, Tel +86 15312178367, Email [email protected]: To describe and analyze the potential profile characteristics associated with coping styles of dyspnea-related fear among patients with chronic obstructive pulmonary disease (COPD) and to explore the influencing factors of potential categories.Patients and Methods: From March 2023 to August 2024, a cross-sectional study survey, involving 539 COPD patients from four tertiary hospitals, was conducted in Suzhou, China, by convenience sampling. The general information questionnaire, medical coping modes questionnaire, breathlessness beliefs questionnaire, 13-Beck depression inventory, revised COPD anxiety questionnaire, breathlessness catastrophizing scale, COPD self-efficacy scale and the modified medical research council dyspnea scale were employed for data collection. Latent profile analysis was performed to analyze the characteristics on coping styles of dyspnea-related fear among COPD patients, and logistic regression analysis was performed to explore the influencing factors of potential categories.Results: Four profiles of coping styles of dyspnea-related fear were identified, designated as “low fear–confrontation (n = 151, 28.01%)”, “moderate-high fear–acceptance-resignation (n = 126, 23.38%)”, “moderate fear–confrontation (n = 160, 29.69%)”, and “high fear–avoidance (n = 102, 18.92%)”. Logistic regression analysis showed that disease duration, lung function, frequency of acute exacerbation during the previous year, depression, degree of dyspnea, anxiety, comorbidities and disease knowledge were factors influencing the coping styles of dyspnea-related fear in the different subgroups (P < 0.05).Conclusion: There are obvious characteristic profiles on coping styles of dyspnea-related fear among patients with COPD, with differences in disease duration, frequencies of acute exacerbation, lung function, knowledge of COPD, comorbidity, degree of dyspnea, anxiety and depression across subgroups, which provide insight to identify and adopt early intervention strategies.Keywords: COPD, coping style, dyspnea-related fear, depression, latent profile analysis