Dyspnea management in palliative home care: A case series in Malaysia

Thongkhamcharoen, Rojanasak; Breaden, Katrina; Agar, Meera; Hamzah, Ednin

doi:10.4103/0973-1075.100835

Cited by 3 publications

(2 citation statements)

References 28 publications

(38 reference statements)

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“…The effectiveness of resistance inspiratory muscle training (IMT) was demonstrated in a two-arm, non-blinded, randomized controlled, proof-of-principle study in Cyprus and the United Kingdom in the home setting ( 27 ). The use of fans, preferably hand-held fans, directed to the face was also found to be effective ( 12 , 15 , 20 , 28 ). Other methods include the use of mechanical ventilation techniques, e.g., CPAP, BiPAP, neuroelectrical stimulation, and chest vibration ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Developing and Assessing the Effectiveness of a Nurse-Led Home-Based Educational Programme for Managing Breathlessness in Lung Cancer Patients. A Feasibility Study

et al. 2020

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Introduction: Breathlessness is the most common and refractory symptom in lung cancer patients. Even though various educational programmes have been developed, only a few were intended for implementation in the home setting for its management. Aim: Feasibility of a study for implementing a nurse-led educational programme for breathlessness management of lung cancer patients at home. Method: A randomized feasibility study was undertaken between February 2017 and October 2018. Patients were recruited through referral from oncologists from two oncology centers in Cyprus under certain inclusion and exclusion criteria. Patients were randomized in the intervention or control group via a computer programme, and their named family caregivers (f.c.) were allocated in the same group. Participants were not blinded to group assignment. The intervention consisted of a PowerPoint presentation and implementation of three non-pharmacological interventions. The control group received usual care. Patients were assessed for breathlessness, anxiety, and depression levels, whereas f.c. were assessed for anxiety, depression, and burden levels. F.c. also assessed patients' dyspnea level. The duration of the study process for both the intervention and control group was over a period of 4 weeks. Results: Twenty-four patients and their f.c. ( n = 24) were allocated equally in the intervention and control group. Five patients withdrew, and the final sample entered analysis was 19 patients and 19 family caregivers. In the intervention group n = 11 + 11, and in the control group n = 8 + 8. In the intervention group patients' breathlessness and anxiety levels showed improvement and their f.c.s in the anxiety and burden levels. Major consideration was the sample size and the recruitment of the patients by the referring oncologists. Attrition was minor during the study process. No harm was recorded by the participants of the study. Conclusions: The study provided evidence of the feasibility of the implementation of the educational programme. For the future definitive study major consideration should be patients' recruitment method in order to achieve adequate sample size. Moreover, qualitative data should be collected in relation to the intervention and the involvement of f.c. The feasibility study was registered to the Cyprus Bioethics Committee with the registration number 2016/16. There was no funding of the study.

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Section: Introductionmentioning

confidence: 99%

Developing and Assessing the Effectiveness of a Nurse-Led Home-Based Educational Programme for Managing Breathlessness in Lung Cancer Patients. A Feasibility Study

et al. 2020

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“…It may also be an expression used to describe chest tightness (Cachia & Ahmedzai, 2008;Loveridge & White, 2012). Further, Thongkhamcharoen et al (2012) and Ahmadi et al (2014) described patients' experience in breathlessness in different terms such as weakness, tiredness, fatigue, feeling run-down, having insomnia, stress, or anxiety. Those expressions or feelings related to breathlessness are categorized into limited physical ability, psychological burdens, social life barriers, and environmental factors.…”

Section: Introductionmentioning

confidence: 99%

Non-Pharmacological Breathlessness Management in Older Patients: A Review Study

Yodang

2019

JCCNC

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Background: Breathlessness is a multifactorial problem caused by multiple pathways and thus lends itself to a range of interventions, each targeting a specific mechanism. For a start, the aging process affects respiratory function and decreases lung elasticity and respiratory muscle strength, which results in forced vital capacity reduction. Moreover, many conditions, such as chronic obstructive pulmonary disease, can cause breathlessness. There is no single intervention to relieve breathlessness, particularly when we are dealing with chronic refractory breathlessness. This study aimed at conducting a review of studies on non-pharmacological breathlessness management in older patients. Methods: This review study used the (Preferred Reporting Items for Systematic Reviews and Metaanalyses) PRISMA protocol to select appropriate resources. Two journal databases of CINAHL and MEDLINE were searched in this regard. The inclusion criteria were as follows: original articles available in full-text, peer-reviewed articles written in English from 2008 to 2018, articles focus on non-pharmacological interventions with samples of the older people or patients (≥65 years old) complaining of dyspnea or breathlessness. Results: There were five articles which met all the above criteria. They used non-pharmacological treatments of (Transcutaneous Electrical Nerve Simulation on acupoints) Acu-TENS, cognitive behavior therapy, inspiratory muscle training, and yoga. Most of these interventions had been applied in older patients with Chronic Obstructive Pulmonary Disease (COPD), and then patients with thoracic malignancy and lung cancer in that order. Conclusion: Based on the results, these non-pharmacological treatments show potential benefits in improving breathlessness for older patients. However, issues such as characteristic of the sample, including co-morbidities and smoking history, and the size of the sample should be considered.

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Patient beliefs associated with medication hesitancy in palliative care: A systematic review using the theory of planned behavior

Musa

et al. 2022

Pall Supp Care

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Context The demand of palliative care is increasing due to the aging population and treatment hesitancy or intentional avoidance compromises symptom management. Objectives To identify patient beliefs associated with medication hesitancy by using the theory of planned behavior (TPB) namely, attitudes, subjective norms, behavioral intention, and perceived behavioral control associated with medication hesitancy or intentional noncompliance by avoidance. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was followed to conduct a systematic literature search involving the CINAHL, Embase, MEDLINE, and PsycINFO databases from inception until March 2022. Hand-searched articles from reference lists and gray literature were included. Thematic analysis was conducted on qualitative data and triangulated with quantitative data. Results About 554 articles were retrieved from the literature search and 17 articles were included based on the eligibility criteria. Three subthemes that were identified under TPB constructs were attitude: negative attitude toward medications, passive attitude toward illness and inaccurate information about disease or medication; one subtheme was identified under subjective norms: perceived negative opinions from others; and one subtheme was identified under perceived behavioral control: perception of manageable symptoms. Quantitative data provided triangulation of qualitative findings related to fear of addiction and side effects, feelings of hopelessness, unclear direction and information, social stigma, endurable symptoms, and illness as determinants for medication avoidance. Significance of results This systematic review highlighted some patient beliefs related to medication hesitancy or avoidance. Clinicians should take patient beliefs and concerns into consideration when creating treatment regimens for people receiving palliative care to optimize medication adherence and the quality of care.

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Dyspnea management in palliative home care: A case series in Malaysia

Cited by 3 publications

References 28 publications

Developing and Assessing the Effectiveness of a Nurse-Led Home-Based Educational Programme for Managing Breathlessness in Lung Cancer Patients. A Feasibility Study

Developing and Assessing the Effectiveness of a Nurse-Led Home-Based Educational Programme for Managing Breathlessness in Lung Cancer Patients. A Feasibility Study

Non-Pharmacological Breathlessness Management in Older Patients: A Review Study

Patient beliefs associated with medication hesitancy in palliative care: A systematic review using the theory of planned behavior

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