{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:47:44Z","timestamp":1782913664364,"version":"3.54.5"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Objective<\/jats:title>\n Methacholine bronchial challenge testing (MBCT) is important for documenting airway hyperresponsiveness in patients with suspected cough-variant asthma (CVA), yet its procedural quality may be compromised by suboptimal patient maneuver execution and procedure-related anxiety. This study evaluated whether COMFORT-based nurse\u2013patient communication combined with brief mechanical respiratory training improves MBCT procedural quality.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This single-center quasi-experimental study with historical controls followed TREND guidance. Ninety-four adults with suspected CVA were sequentially enrolled: 50 controls received standard visual\/verbal instruction, and 44 patients received COMFORT-based counseling plus supervised inspiratory\/expiratory training before MBCT; one intervention patient dropped out. Propensity score matching (PSM) was used to reduce temporal confounding. Outcomes included first-attempt success rate, in-chamber testing duration, spirometric maneuver quality, SAS\/SDS scores, MBCT positivity, and adverse events.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In the matched cohort (41 pairs), baseline characteristics were well-balanced after PSM. The intervention group showed a higher first-attempt success rate than the control group (75.6% vs. 24.4%,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001) and a shorter in-chamber testing duration (11.85\u202f\u00b1\u202f3.12\u202fmin vs. 16.90\u202f\u00b1\u202f3.85\u202fmin, p\u202f&lt;\u202f0.001). Optimal FVC and FEV1 values were also higher in the intervention group (FVC: 2.95\u202f\u00b1\u202f0.32\u202fL vs. 2.58\u202f\u00b1\u202f0.35\u202fL; FEV1: 2.05\u202f\u00b1\u202f0.25\u202fL vs. 1.70\u202f\u00b1\u202f0.28 L; both\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), consistent with improved maneuver execution. Post-procedure SAS and SDS scores were lower in the intervention group (SAS: 35.10\u202f\u00b1\u202f7.85 vs. 39.50\u202f\u00b1\u202f8.12,\n p<\/jats:italic>\n \u202f=\u202f0.015; SDS: 30.05\u202f\u00b1\u202f5.90 vs. 35.80\u202f\u00b1\u202f6.25,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). Mild procedure-related adverse events were less frequent in the intervention group (7.3% vs. 24.4%,\n p<\/jats:italic>\n \u202f=\u202f0.032). The MBCT positivity rate was numerically higher in the intervention group but did not differ significantly between groups (29.3% vs. 17.1%,\n p<\/jats:italic>\n \u202f=\u202f0.190).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Integrating empathetic nurse\u2013patient communication with targeted respiratory mechanical training significantly improves the procedural quality of MBCTs. This combined approach improved maneuver execution and first-attempt success and reduced in-chamber testing duration, while requiring additional pre-test preparation time. These findings support a procedural-quality intervention for MBCT rather than evidence of improved diagnostic accuracy or immediate physiological improvement in lung function.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1879079","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:14:21Z","timestamp":1782911661000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhancing procedural quality and efficiency of methacholine bronchial challenge tests in patients with suspected cough-variant asthma: a quasi-experimental study utilizing nurse\u2013patient communication and respiratory training"],"prefix":"10.3389","volume":"13","author":[{"given":"Yu","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"He","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enhong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sisi","family":"Chen","sequence":"additional","affiliation":[{"name":"The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beibei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fajiu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuecun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University","place":["Wuhan, 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Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1879079\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T13:14:23Z","timestamp":1782911663000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1879079\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":30,"alternative-id":["10.3389\/fmed.2026.1879079"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1879079","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]},"article-number":"1879079"}}