Breathlessness, fatigue, and anxiety are distressing symptoms for patients with advanced lung cancer, however, they are not relieved by palliative RT and are often viewed as neglected areas of clinical practice. This ...Breathlessness, fatigue, and anxiety are distressing symptoms for patients with advanced lung cancer, however, they are not relieved by palliative RT and are often viewed as neglected areas of clinical practice. This paper aims to review def initions of, and explore patients' experiences of, breathlessness, fatigue, and anxiety. Further, it will outline existing approaches, both pharmacological and non-pharmacological, to treat them. Current treatments and perceptions of these symptoms will be discussed in the context of Hong Kong health care service. The review of literature also shows that breathlessness, fatigue and anxiety appears to have similar emotional origins. A contemporary approach of using a common pyschoeducational intervention to treat these symptoms together as a cluster in end of life care will be discussed.展开更多
Background The current theory of dyspnea perception presumes a multidimensional conception of dyspnea. However, its validity in patients with cardiopulmonary dyspnea has not been investigated. Methods A respiratory sy...Background The current theory of dyspnea perception presumes a multidimensional conception of dyspnea. However, its validity in patients with cardiopulmonary dyspnea has not been investigated. Methods A respiratory symptom checklist incorporating spontaneously reported descriptors of sensory experiences of breathing discomfort, affective aspects, and behavioral items was administered to 396 patients with asthma, chronic obstructive pulmonary disease （COPD）, diffuse parenchymal lung disease, pulmonary vascular disease, chronic heart failure, and medically unexplained dyspnea. Symptom factors measuring different qualitative components of dyspnea were derived by a principal component analysis. The separation of patient groups was achieved by a variance analysis on symptom factors. Results Seven factors appeared to measure three dimensions of dyspnea： sensory （difficulty breathing and phase of respiration, depth and frequency of breathing, urge to breathe, wheeze）, affective （chest tightness, anxiety）, and behavioral （refraining from physical activity） dimensions. Difficulty breathing and phase of respiration occurred more often in COPD, followed by asthma （R2=0.12）. Urge to breathe was unique for patients with medically unexplained dyspnea （R2=0.12）. Wheeze occurred most frequently in asthma, followed by COPD and heart failure （R2=0.17）. Chest tightness was specifically linked to medically unexplained dyspnea and asthma （R2=0.04）. Anxiety characterized medically unexplained dyspnea （R2=0.08）. Refraining from physical activity appeared more often in heart failure, pulmonary vascular disease, and COPD （R2=0.15）. Conclusions Three dimensions with seven qualitative components of dyspnea appeared in cardiopulmonary disease and the components under each dimension allowed separation of different patient groups. These findings may serve as a validation on the multiple dimensions of cardiopulmonary dyspnea.展开更多
Dyspnea(or breathlessness) is a symptom describing a perceived experience of breathing discomfort. Children's awareness of dyspnea is variable and there is only a poor correlation between the objective respiratory...Dyspnea(or breathlessness) is a symptom describing a perceived experience of breathing discomfort. Children's awareness of dyspnea is variable and there is only a poor correlation between the objective respiratory distress measurements and the subjectively awareness of dyspnea. Those who do not perceive dyspnea may not be motivated to comply with their daily prophylactic treatment. Since dyspnea is the main symptom of asthma, and disease management is based largely on the description of symptoms between clinic visits, unreliable symptom report may mislead decision-making for longterm treatment of asthma. Thus, therapeutic decisions should not be taken solely on patients' perception and description of dyspnea.展开更多
文摘Breathlessness, fatigue, and anxiety are distressing symptoms for patients with advanced lung cancer, however, they are not relieved by palliative RT and are often viewed as neglected areas of clinical practice. This paper aims to review def initions of, and explore patients' experiences of, breathlessness, fatigue, and anxiety. Further, it will outline existing approaches, both pharmacological and non-pharmacological, to treat them. Current treatments and perceptions of these symptoms will be discussed in the context of Hong Kong health care service. The review of literature also shows that breathlessness, fatigue and anxiety appears to have similar emotional origins. A contemporary approach of using a common pyschoeducational intervention to treat these symptoms together as a cluster in end of life care will be discussed.
文摘Background The current theory of dyspnea perception presumes a multidimensional conception of dyspnea. However, its validity in patients with cardiopulmonary dyspnea has not been investigated. Methods A respiratory symptom checklist incorporating spontaneously reported descriptors of sensory experiences of breathing discomfort, affective aspects, and behavioral items was administered to 396 patients with asthma, chronic obstructive pulmonary disease （COPD）, diffuse parenchymal lung disease, pulmonary vascular disease, chronic heart failure, and medically unexplained dyspnea. Symptom factors measuring different qualitative components of dyspnea were derived by a principal component analysis. The separation of patient groups was achieved by a variance analysis on symptom factors. Results Seven factors appeared to measure three dimensions of dyspnea： sensory （difficulty breathing and phase of respiration, depth and frequency of breathing, urge to breathe, wheeze）, affective （chest tightness, anxiety）, and behavioral （refraining from physical activity） dimensions. Difficulty breathing and phase of respiration occurred more often in COPD, followed by asthma （R2=0.12）. Urge to breathe was unique for patients with medically unexplained dyspnea （R2=0.12）. Wheeze occurred most frequently in asthma, followed by COPD and heart failure （R2=0.17）. Chest tightness was specifically linked to medically unexplained dyspnea and asthma （R2=0.04）. Anxiety characterized medically unexplained dyspnea （R2=0.08）. Refraining from physical activity appeared more often in heart failure, pulmonary vascular disease, and COPD （R2=0.15）. Conclusions Three dimensions with seven qualitative components of dyspnea appeared in cardiopulmonary disease and the components under each dimension allowed separation of different patient groups. These findings may serve as a validation on the multiple dimensions of cardiopulmonary dyspnea.
文摘Dyspnea(or breathlessness) is a symptom describing a perceived experience of breathing discomfort. Children's awareness of dyspnea is variable and there is only a poor correlation between the objective respiratory distress measurements and the subjectively awareness of dyspnea. Those who do not perceive dyspnea may not be motivated to comply with their daily prophylactic treatment. Since dyspnea is the main symptom of asthma, and disease management is based largely on the description of symptoms between clinic visits, unreliable symptom report may mislead decision-making for longterm treatment of asthma. Thus, therapeutic decisions should not be taken solely on patients' perception and description of dyspnea.
