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ADVANCE Perspective: Respiratory Views

Therapists Must Assess Asthmatics' Stress Levels

Published November 4, 2009 12:13 PM by Vern Enge
Respiratory therapists are generally hard at work in the trenches when it comes time to assess the condition of asthmatics in the ER. But there may be more to the task of treating the patient than simply listening to chest sounds and heart rate, evaluating the patient's color, and administering MDIs or nebulizer treatments.

In the future, therapists might also want to evaluate the patient for neurotic tendencies or exposure to high stress. German researchers, led by Adrian Loerbroks, MD, of Heidelberg University, have found chronic stress in animals alters hormone levels, which can inflame airways. The researchers further argue stress and neurotic character traits exert similar effects in humans. If so, helping people chill out might theoretically reduce their risk of asthma.

Surveying 5,114 men and women over an eight-year time span, researchers found from the get-go there was a link between asthma and neuroticism in men and between asthma and the trauma of unemployment in both sexes. Women who broke off life relationships were associated with asthma as well.

This study, reported in the October edition of the journal Allergy, found about 2 percent of the sample population developed asthma during the course of the data collection. Researchers found highly neurotic men and women were more than three times as likely to develop asthma as were their calmer counterparts. Breaking off a life partnership increased the risk of asthma by more than twofold in women, but not in males.

Although unemployment is a stressor, it did not significantly raise an association level with development of asthma, researchers reported.

"The physical mechanisms by which personality, stress, and emotions might influence the development of asthma," researchers wrote, "are still not well known."

Nonetheless, therapists who clue in to the everyday stress levels of their patients may find they need to provide TLC beyond the norm for stressed out asthmatics. A few calming words may be just as important as the MDI in some instances. And doesn't that assessment skill, which can benefit the healing process, belong in the realm of respiratory care?

Asthma educators in respiratory care ranks in particular can certainly counsel their patients to try to remain calm to ward off asthma exacerbations.

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