Cognitive behavioral therapy enhances psychological and physiological outcomes in high-altitude respiratory patients

Abstract

BACKGROUND

Due to the dry and cold climate, the obvious temperature difference between day and night, and the low oxygen content of the air in the plateau area, people are prone to upper respiratory tract diseases, and often the condition is prolonged, and the patients are prone to anxiety and uneasiness, which may be related to the harshness of the plateau environment, somatic discomfort due to the lack of oxygen, anxiety about the disease, and other factors.

AIM

To investigate the effects of cognitive behavioral therapy (CBT) on anxiety, sleep disorders, and hypoxia tolerance in patients with high-altitude respiratory diseases.

METHODS

A total of 2337 patients with high-altitude-related respiratory diseases treated at our hospital between November 2023 and January 2024 were selected as the study subjects. The subjects’ pre-high-altitude residential altitude was approximately 1700 meters. They were divided into two groups. Both groups were given symptomatic treatment, and the control group implemented conventional nursing intervention, while the research group simultaneously conducted CBT intervention; assessed the degree of health knowledge of the two groups, and applied the Hamilton Anxiety Scale and the Pittsburgh Sleep Quality Index to assess the anxiety and sleep quality of the patients before and after the intervention, respectively. It also observed the length and efficiency of sleep, and detected the level of serum hypoxia inducible factor-1α, erythropoietin (EPO) and clinical intervention before and after intervention. EPO levels, and investigated satisfaction with the clinical intervention.

RESULTS

The rate of excellent health knowledge in the intervention group was 93.64%, which was higher than that in the control group (74.23%; P < 0.05). Before the intervention, there was no significant difference in Hamilton Anxiety Scale and Pittsburgh Sleep Quality Index scores between the two groups (P > 0.05), and after the intervention, the scores of the study group were significantly lower than those of the control group (P < 0.05). There was no significant difference in sleep duration and sleep efficiency between the groups before the intervention (P > 0.05), and after the intervention, the scores of the study group were significantly larger than those of the control group (P < 0.05). There was no significant difference in serum hypoxia inducible factor-1α and EPO between the two groups before intervention (P > 0.05), and both research groups were significantly lower than the control group after intervention (P < 0.05). According to the questionnaire survey, the intervention satisfaction of the study group was 95.53%, which was higher than that of the control group (80.14%; P < 0.05).

CONCLUSION

The CBT intervention in the treatment of patients with high-altitude-related respiratory diseases helps improve patients' health knowledge, relieve anxiety, improve sleep quality and hypoxia tolerance, and improve nursing satisfaction.

Keywords: Cognitive behavioral therapy; High altitude; respiratory disease; Anxiety; Sleep quality; Hypoxia tolerance

Core Tip: In a 2337-patient plateau trial, adding cognitive behavioral therapy to usual care lifted health-knowledge mastery to 94%, halved anxiety and sleep-disorder scores, lengthened effective sleep, and lowered serum hypoxia inducible factor-1α and erythropoietin levels, signaling better hypoxia tolerance. Nursing satisfaction rose to 96%. Cognitive behavioral therapy is a low-cost, high-yield adjunct for high-altitude respiratory patients.