Unbalanced Associations between Physical, Psychological, and Social Domains of the Leicester Cough Questionnaire: Network and Mediation Analyses
Background The Leicester Cough Questionnaire (LCQ) is a validated instrument for evaluating cough-related impairments within three domains: physical, psychological, and social. This study investigated how the physical, psychological, and social domains of chronic cough are interrelated using the LCQ...
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The Korean Academy of Tuberculosis and Respiratory Diseases
2025-07-01
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| Series: | Tuberculosis and Respiratory Diseases |
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| Online Access: | http://e-trd.org/upload/pdf/trd-2025-0031.pdf |
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| author | Jieun Kang Jiyeon Kang Sung Jun Chung Hyung Koo Kang Sung-Soon Lee Yun-Jeong Jeong Ji-Yong Moon Deog Kyeom Kim Jin Woo Kim Seung Hun Jang Jae-Woo Kwon Byung-Jae Lee Hyeon-Kyoung Koo |
| author_facet | Jieun Kang Jiyeon Kang Sung Jun Chung Hyung Koo Kang Sung-Soon Lee Yun-Jeong Jeong Ji-Yong Moon Deog Kyeom Kim Jin Woo Kim Seung Hun Jang Jae-Woo Kwon Byung-Jae Lee Hyeon-Kyoung Koo |
| author_sort | Jieun Kang |
| collection | DOAJ |
| description | Background The Leicester Cough Questionnaire (LCQ) is a validated instrument for evaluating cough-related impairments within three domains: physical, psychological, and social. This study investigated how the physical, psychological, and social domains of chronic cough are interrelated using the LCQ. Methods Adult patients with chronic cough from 16 respiratory centers who completed the LCQ and underwent diagnostic workup were retrospectively reviewed. Spearman's rank correlation was used to examine the correlations among LCQ items across the physical, psychological, and social domains. Causal mediation analysis was performed to partition the total effect between domains into direct and indirect effects mediated by the third domain. The mediation analysis findings were subsequently validated in an independent cohort. Results Network analysis of LCQ items identified distinct patterns for each domain. Items in the physical domain showed weaker correlations both within and between domains compared to the psychological and social domains. In contrast, items in the psychological and social domains exhibited strong interrelationships. Mediation analysis demonstrated that direct effects from one domain to another differed among the three domains. The overall estimated effects of the physical domain on the social and psychological domains were largely mediated by the psychological (76.1%) and social domains (67.1%), respectively. Conversely, the mediating effect of the physical domain on the psychological and social domains was minimal, accounting for only 12.8% and 18.0%, respectively. Conclusion Given the strong correlations and impact of the psychological and social domains, it is recommended that a thorough evaluation including psychosocial factors be incorporated into the management of chronic cough. |
| format | Article |
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| institution | Matheson Library |
| issn | 1738-3536 2005-6184 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | The Korean Academy of Tuberculosis and Respiratory Diseases |
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| series | Tuberculosis and Respiratory Diseases |
| spelling | doaj-art-f9cbe1517c4941f6b70bbf8d785909d42025-07-08T07:13:17ZengThe Korean Academy of Tuberculosis and Respiratory DiseasesTuberculosis and Respiratory Diseases1738-35362005-61842025-07-0188359159810.4046/trd.2025.00314948Unbalanced Associations between Physical, Psychological, and Social Domains of the Leicester Cough Questionnaire: Network and Mediation AnalysesJieun Kang0Jiyeon Kang1Sung Jun Chung2Hyung Koo Kang3Sung-Soon Lee4Yun-Jeong Jeong5Ji-Yong Moon6Deog Kyeom Kim7Jin Woo Kim8Seung Hun Jang9Jae-Woo Kwon10Byung-Jae Lee11Hyeon-Kyoung Koo12 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea Division of Pulmonary and Allergy, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Republic of Korea Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of KoreaBackground The Leicester Cough Questionnaire (LCQ) is a validated instrument for evaluating cough-related impairments within three domains: physical, psychological, and social. This study investigated how the physical, psychological, and social domains of chronic cough are interrelated using the LCQ. Methods Adult patients with chronic cough from 16 respiratory centers who completed the LCQ and underwent diagnostic workup were retrospectively reviewed. Spearman's rank correlation was used to examine the correlations among LCQ items across the physical, psychological, and social domains. Causal mediation analysis was performed to partition the total effect between domains into direct and indirect effects mediated by the third domain. The mediation analysis findings were subsequently validated in an independent cohort. Results Network analysis of LCQ items identified distinct patterns for each domain. Items in the physical domain showed weaker correlations both within and between domains compared to the psychological and social domains. In contrast, items in the psychological and social domains exhibited strong interrelationships. Mediation analysis demonstrated that direct effects from one domain to another differed among the three domains. The overall estimated effects of the physical domain on the social and psychological domains were largely mediated by the psychological (76.1%) and social domains (67.1%), respectively. Conversely, the mediating effect of the physical domain on the psychological and social domains was minimal, accounting for only 12.8% and 18.0%, respectively. Conclusion Given the strong correlations and impact of the psychological and social domains, it is recommended that a thorough evaluation including psychosocial factors be incorporated into the management of chronic cough.http://e-trd.org/upload/pdf/trd-2025-0031.pdfchronic coughquality of lifeleicester cough questionnairenetwork analysismediation analysis |
| spellingShingle | Jieun Kang Jiyeon Kang Sung Jun Chung Hyung Koo Kang Sung-Soon Lee Yun-Jeong Jeong Ji-Yong Moon Deog Kyeom Kim Jin Woo Kim Seung Hun Jang Jae-Woo Kwon Byung-Jae Lee Hyeon-Kyoung Koo Unbalanced Associations between Physical, Psychological, and Social Domains of the Leicester Cough Questionnaire: Network and Mediation Analyses Tuberculosis and Respiratory Diseases chronic cough quality of life leicester cough questionnaire network analysis mediation analysis |
| title | Unbalanced Associations between Physical, Psychological, and Social Domains of the Leicester Cough Questionnaire: Network and Mediation Analyses |
| title_full | Unbalanced Associations between Physical, Psychological, and Social Domains of the Leicester Cough Questionnaire: Network and Mediation Analyses |
| title_fullStr | Unbalanced Associations between Physical, Psychological, and Social Domains of the Leicester Cough Questionnaire: Network and Mediation Analyses |
| title_full_unstemmed | Unbalanced Associations between Physical, Psychological, and Social Domains of the Leicester Cough Questionnaire: Network and Mediation Analyses |
| title_short | Unbalanced Associations between Physical, Psychological, and Social Domains of the Leicester Cough Questionnaire: Network and Mediation Analyses |
| title_sort | unbalanced associations between physical psychological and social domains of the leicester cough questionnaire network and mediation analyses |
| topic | chronic cough quality of life leicester cough questionnaire network analysis mediation analysis |
| url | http://e-trd.org/upload/pdf/trd-2025-0031.pdf |
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