An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

Parshall, Mark B.; Schwartzstein, Richard M.; Adams, Lewis; Banzett, Robert B.; Manning, Harold L.; Bourbeau, Jean; Calverley, P. M. A.; Gift, Audrey G.; Harver, Andrew; Lareau, Suzanne C.; Mahler, Donald A.; Meek, Paula; O’Donnell, Denis E.

doi:10.1164/rccm.201111-2042st

Cited by 1,414 publications

(1,342 citation statements)

References 288 publications

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“…The literature on psychological interventions that target self-efficacy for managing dyspnea has not been sufficiently addressed (6), and these results provide specific intervention targets for future investigations. Interventions to enhance confidence in managing dyspnea in situations involving depression, anxiety, excitement, and physical exertion may provide the largest potential benefit for the physical and mental health of patients with COPD.…”

Section: Original Researchmentioning

confidence: 99%

“…Indeed, evidence suggests that self-efficacy in managing dyspnea predicts physical functioning as well as survival among patients with COPD (4,5). However, the role of psychological interventions to enhance self-efficacy for managing dyspnea has received little attention (6). Previous studies of self-efficacy among patients with COPD have been limited by small sample sizes and use of aggregate measures (5,(7)(8)(9)(10).…”

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confidence: 99%

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Domain-Specific Self-Efficacy Is Associated with Measures of Functional Capacity and Quality of Life among Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease

et al. 2014

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The relationship between self-efficacy and health behaviors is well established. However, little is known about the relationship between self-efficacy and health-related indicators among patients with chronic obstructive pulmonary disease (COPD).Objectives: The purpose of this cross-sectional cohort study was to test the hypothesis that the total score and specific subdomain scores of the COPD Self-Efficacy Scale (CSES) are associated with functional capacity and quality of life in a group of patients with moderate to severe COPD.Methods: Relationships were examined in a cross-sectional study of baseline data collected as part of a randomized trial. Self-efficacy was measured using the five domains of the CSES: negative affect, emotional arousal, physical exertion, weather/environment, and behavioral. Measures of quality of life and functional capacity included SF-12: physical and mental composite scores, Chronic Respiratory Questionnaire dyspnea domain, and the 6-minutewalk test. Statistical analyses included Spearman correlation and categorical analyses of self-efficacy ("confident" vs. "not confident") using general linear models adjusting for potential confounders.Measurements and Main Results: There were 325 patients enrolled with a mean age (standard deviation) of 68.5 (9.48) years, 49.5% male, and 91.69% non-Hispanic white. The negative affect, emotional arousal, and physical exertion domains were moderately correlated (range, 0.3-0.7) with the SF-12 mental composite score and Chronic Respiratory Questionnaire dyspnea domain. In models exploring each CSES domain as "confident" versus "not confident" and adjusting for age, sex, race, pack-years, and airflow obstruction severity, there were multiple clinically and statistically significant associations between the negative affect, emotional arousal, and physical exertion domains with functional capacity and quality of life. Conclusions:The aggregated total CSES score was associated with better quality of life and functional capacity. Our analysis of subdomains revealed that the physical exertion, negative affect, and emotional arousal subdomains had the largest associations with functional capacity and quality of life indicators. These findings suggest that interventions to enhance self-efficacy may improve the functional capacity and quality of life of patients with moderate to severe COPD.Keywords: COPD; dyspnea; self-efficacy; quality of life Author Contributions: B.E.J., D.B.C., J.A., K.P.S., and S.B. were involved in the conception, hypothesis generation, and design of the study. B.E.J., K.P.S., M.U., and S.B. were involved in the statistical analysis. D.B.C., R.R., and J.P. were involved in the acquisition of data and interpretation of results.Correspondence and requests for reprints should be addressed to Bradford E. Jackson, Ph.D.,

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Section: Original Researchmentioning

confidence: 99%

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confidence: 99%

Domain-Specific Self-Efficacy Is Associated with Measures of Functional Capacity and Quality of Life among Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease

et al. 2014

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“…3 As this statement concludes, 3 dyspnea appears not to be a single sensation. At least, there would be three distinct sensations of dyspnea; 1) work/ effort ("breathing takes work or effort"); 2) tightness ("chest is constricted, chest feels tight"; 3) air hunger (unsatisfied inspiration, urge to breathe and starved for air).…”

Section: The Definition and Sensory Quality Of Dyspneamentioning

confidence: 94%

Recent Advances in Assessment of Dyspnea

Kanezaki¹

2017

Pulm Res Respir Med Open J

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As pulmonary rehabilitation can provide various benefits on managing the symptoms of dyspnea, alleviating dyspnea represents a major goal in pulmonary rehabilitation. Dyspnea appears not to be just a single sensation, as it includes the three sensory quality of dyspnea; work/effort, air-hunger and chest tightness. In addition to sensation of dyspnea, complex emotions including anxiety, attention and fear can involve through processing of the limbic system. Recent studies emphasized the multidimensional nature of dyspnea in the sensory-perceptual (intensity and quality), affective distress and impact domains. This review focused on the underlying mechanism of dyspnea and recent advances in assessment in pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD).

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“…The perception of dyspnea is complex and depends on a variety of somatic and psychological factors such as deconditioning, underweight, anxiety, depression and other comorbidities such as cardiac disease [35]. Dyspnea is closely related to QOL and treatment and relief of dyspnea is of major importance.…”

Section: Dyspneamentioning

confidence: 99%

Danish respiratory society position paper: palliative care in patients with chronic progressive non-malignant lung diseases

Marsaa

Gundestrup

Lange

et al. 2018

European Clinical Respiratory Journal

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Background: Chronic non-malignant lung diseases such as chronic obstructive pulmonary disease (COPD) and interstitial lung diseases (ILD) result in reduced quality of life (QoL), a high symptom burden and reduced survival. Patients with chronic non-malignant lung disease often have limited access to palliative care. The symptom burden and the QoL of these patients resembles patients with cancer and the general palliative approach is similar. However, the disease trajectory is often slow and unpredictable, and the palliative effort must be built on accessibility, continuity and professional competences. The Danish Health Authority as well as the WHO recommends that there is access to palliative care for all patients with life-threatening diseases regardless of diagnosis. In 2011, the Danish Health Authority requested that the national medical societies would to formulate guidelines for palliation. Methods: In 2015, a group of members of the Danish Respiratory Society (DRS) was appointed for this purpose. It was composed of experienced ILD and COPD researchers as well as clinicians from different parts of Denmark. A literature review was made, a draft was prepared, and all recommendations were agreed upon unanimously. Results: The Danish version of the position paper was finally submitted for review and accepted by all members of DRS. Conclusion: In this position paper we provide recommendations on the terminology of chronic and terminal lung failure, rehabilitation and palliative care, advanced care planning, informal caregivers and bereavement, symptom management, the imminently dying patient, and organization of palliative care for patients with chronic non-malignant lung diseases.

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An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

Cited by 1,414 publications

References 288 publications

Domain-Specific Self-Efficacy Is Associated with Measures of Functional Capacity and Quality of Life among Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease

Domain-Specific Self-Efficacy Is Associated with Measures of Functional Capacity and Quality of Life among Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease

Recent Advances in Assessment of Dyspnea

Danish respiratory society position paper: palliative care in patients with chronic progressive non-malignant lung diseases

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