Fan Therapy for the Relief of Dyspnea in Adults with Advanced Disease and Terminal Illness: A Meta-Analysis of Randomized Controlled Trials

Yu, Shui; Sun, Kai; Xing, Xiufang; Zhong, Yinbo; Yan, Xuemei; Qiu, Weidong; Yan, Min

doi:10.1089/jpm.2019.0140

Cited by 17 publications

(21 citation statements)

References 22 publications

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“…Reports of fan-related benefit from clinicians participating in the current study are consistent with research showing that patients perceive benefits to breathlessness intensity, physical activity and functioning, and anxiety [ 3 , 4 , 7 , 8 ]. Participants’ perceptions of disadvantages were also mostly consistent with previous research, which has similarly suggested that these are limited to an unproven concern regarding transmission of COVID-19 and other airborne infections, and—for a small number of patients—perceptions of stigma [ 8 ].…”

Section: Discussionsupporting

confidence: 86%

“…One such intervention is the battery-operated hand-held fan (‘fan’). Four meta-analyses, conducted across chronic diseases [ 3 , 4 ] and in advanced cancer more specifically [ 5 , 6 ], have suggested that the fan decreases breathlessness intensity. In a pooled analysis of two trials, it was also found that more than half of patients reported an increase in physical activity [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Implementing the battery-operated hand-held fan as an evidence-based, non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD): a qualitative study of the views of specialist respiratory clinicians

et al. 2022

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Introduction The battery-operated hand-held fan (‘fan’) is an inexpensive and portable non-pharmacological intervention for chronic breathlessness. Evidence from randomised controlled trials suggests the fan reduces breathlessness intensity and improves physical activity in patients with a range of advanced chronic conditions. Qualitative data from these trials suggests the fan may also reduce anxiety and improve daily functioning for many patients. This study aimed to explore barriers and facilitators to the fan’s implementation in specialist respiratory care as a non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD). Methods A qualitative approach was taken, using focus groups. Participants were clinicians from any discipline working in specialist respiratory care at two hospitals. Questions asked about current fan-related practice and perceptions regarding benefits, harms and mechanisms, and factors influencing its implementation. Analysis used a mixed inductive/deductive approach. Results Forty-nine participants from nursing (n = 30), medical (n = 13) and allied health (n = 6) disciplines participated across 9 focus groups. The most influential facilitator was a belief that the fan’s benefits outweighed disadvantages. Clinicians’ beliefs about the fan’s mechanisms determined which patient sub-groups they targeted, for example anxious or palliative/end-stage patients. Barriers to implementation included a lack of clarity about whose role it was to implement the fan, what advice to provide patients, and limited access to fans in hospitals. Few clinicians implemented the fan for acute-on-chronic breathlessness or in combination with other interventions. Conclusion Implementation of the fan in specialist respiratory care may require service- and clinician-level interventions to ensure it is routinely recommended as a first-line intervention for chronic breathlessness in patients for whom this symptom is of concern, regardless of COPD stage.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Implementing the battery-operated hand-held fan as an evidence-based, non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD): a qualitative study of the views of specialist respiratory clinicians

et al. 2022

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“…61,62 Notably, the significant reduction in dyspnea began immediately upon airflow administration and continued to reduce dyspnea 10 minutes afterward. 63 However, regular airflow administration over the course of a month did not reduce the severity of the chronic breathlessness, indicating that airflow is an immediate, albeit short-term means of palliating dyspnea in advanced cancer patients. 63 There are few adverse effects of providing facial airflow via fans, with the exception of patients reporting not appreciating the airflow's cooling effect on their skin and the social implications of having a handheld fan in social settings.…”

Section: Non-pharmacologic Management: Facial Airflowmentioning

confidence: 94%

Pharmacologic and Non-Pharmacologic Dyspnea Management in Advanced Cancer Patients

Zemel

2021

Am J Hosp Palliat Care

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As there is a high propensity for patients with advanced malignancy to experience refractory dyspnea, it is necessary for physicians to be well-versed in the management of these patients’ dyspneic symptoms. For symptomatic treatment of cancer patients with dyspnea, both pharmacologic and non-pharmacologic methods should be considered. The main source of pharmacologic symptom management for dyspnea is oral and parenteral opioids; benzodiazepines and corticosteroids may serve as helpful adjuncts alongside opioid treatments. However, oxygen administration and nebulized loop diuretics have not been shown to clinically benefit dyspneic cancer patients. Applying non-pharmacologic dyspnea management methods may be valuable palliative therapies for advanced cancer patients, as they provide benefit with negligible harm to the patient. Advantageous and minimally harmful non-pharmacologic dyspnea therapies include facial airflow, acupuncture and/or acupressure, breathing exercises, cognitive behavioral therapy, music therapy, and spiritual interventions. Thus, it is vital that physicians are prepared to provide symptomatic care for dyspnea in advanced cancer patients as to minimize suffering in this patient population during definitive cancer treatments or hospice care.

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“…Literatür taramasında dispnenin yönetiminde yüze soğuk hava akımının ve el fanı uygulanmasının etkisini inceleyen üç yarı deneysel (18,21,25), yedi randomize kontrollü (14-17, 19, 20, 23), iki sistematik derleme (8, 31) ve iki metaanaliz (32,33)…”

Section: Di̇spneni̇n Yöneti̇mde El Faninin Etki̇si̇ni̇ İnceleyen çAlişmalarunclassified

The Effect Of The Hand Held Fan In Management Of The Dyspnea

Kocatepe¹,

Can²

2021

Acibadem Universitesi Saglik Bilimleri Dergisi

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Dispnenin yönetiminde farmakolojik yaklaşımların yanı sıra farklı non farmakolojik yaklaşımlar da kullanılmaktadır. Yüze soğuk hava uygulamasının 2. ve 3. trigeminal sinirlere soğutma ve hava akışı sağlayarak nefes darlığını azaltıp, egzersiz toleransını arttırdığı belirtilmiştir. Bu mekanizmanın nazal ya da hava yolu mukozasının soğutulması ya da yüz derisinin serinletilmesi ile ortaya çıktığı düşünülmektedir. Farklı bir bakış açısı ise el fanının solunum afferent sinirlerinden gelen sinyallerin beyin tarafından algılanmasını değiştirerek psikolojik ve duygusal yönetimi sağladığıdır. Yapılan çalışmalarda orta ve şiddetli dispneli hastalara beş dakika boyunca, 15 cm uzaktan, burnun iki yanı ve üst dudağın üst kısımlarına fan uygulanmasının etkili bir yaklaşım olabileceği bildirilmiştir. Bazı çalışmalarda el fanı uygulamasının dispne ile birlikte solunum sayısı ve oksijen saturasyonunu da etkilediği görülmüştür. Pil ile çalışan el fanları hem ucuz hem de taşıması kolay olması ile hastaların tercih edeceği bir araçtır. El fanı uygulamasının yan etkilerinin olmaması ve uygulanabilirliğinin kolay olması hastanın yaşam kalitesini arttırabilir. Bu derlemenin amacı dispnenin yöentiminde el fanının etkisini tartışmaktır.

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Fan Therapy for the Relief of Dyspnea in Adults with Advanced Disease and Terminal Illness: A Meta-Analysis of Randomized Controlled Trials

Cited by 17 publications

References 22 publications

Implementing the battery-operated hand-held fan as an evidence-based, non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD): a qualitative study of the views of specialist respiratory clinicians

Implementing the battery-operated hand-held fan as an evidence-based, non-pharmacological intervention for chronic breathlessness in patients with chronic obstructive pulmonary disease (COPD): a qualitative study of the views of specialist respiratory clinicians

Pharmacologic and Non-Pharmacologic Dyspnea Management in Advanced Cancer Patients

The Effect Of The Hand Held Fan In Management Of The Dyspnea

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