Measuring dyspnoea: new multidimensional instruments to match our 21st century understanding

Banzett, Robert B.; Moosavi, Shakeeb H.

doi:10.1183/13993003.02473-2016

Cited by 29 publications

(19 citation statements)

References 51 publications

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“…Moreover, changes in these dimensions differed over the course of pulmonary rehabilitation. Significant group mean improvements were only observed in the ratings of breathlessness anxiety, and only these were further correlated with improvements in clinical dyspnoea ratings as measured with the D-12 [36]. This observation by HERIGSTAD et al [34] extends earlier findings demonstrating larger treatment responses for the affective compared to the sensory dimension of dyspnoea in COPD patients to learned dyspnoea-related associations [30,37,38].…”

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confidence: 58%

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Treating anxious expectations can improve dyspnoea in patients with COPD

Leupoldt

2017

Eur Respir J

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]. Chronic obstructive pulmonary disease (COPD) is a worldwide leading cause of morbidity and mortality and associated with great individual, societal and economic burden [1]. Dyspnoea is the threatening cardinal symptom and related to a worse course of COPD, including drastic reductions in quality of life and even increased mortality risk [2, 3]. Dyspnoea is a multi-dimensional subjective experience that encompasses not only the perception of sensory signals (dyspnoea intensity), but also important immediate and long-term affective aspects (dyspnoea unpleasantness, dyspnoea anxiety, suffering) [2-4]. In many patients, dyspnoea can be persistent, despite optimal treatment efforts, which was recently termed "chronic breathlessness syndrome" [5]. Notwithstanding, reducing dyspnoea is a major treatment goal in COPD [6] and neglecting it has previously been discussed in a thought-provoking article in this journal as a potential violation of human rights [7]. In addition to the prominent pulmonary manifestations of COPD, patients often suffer from various extrapulmonary symptoms and comorbidities, which further add to the burden of the disease [8, 9]. Among these, psychological symptoms, such as anxiety and depression, are very common in COPD and related to various negative health outcomes, including greater dyspnoea [10-12]. For example, COPD patients with high anxiety levels report more dyspnoea during everyday life [13], during pulmonary rehabilitation [14], and during resistive loaded breathing tests [15] compared to patients with low anxiety levels. Alarmingly, comorbid psychological symptoms remain undiagnosed in the majority of COPD patients and, thus, untreated [11]. But how can psychological symptoms such as anxiety lead to greater dyspnoea in COPD patients? Although several potential physiological and behavioural pathways have been suggested [11, 16], respective knowledge remains still limited. Some authors have emphasised that after repeated aversive experiences of dyspnoea, patients develop fear and anxiety and subsequently avoid respective dyspnoea-related situations and contexts such as physical activities. This maladaptive avoidance behaviour can result in progressive deconditioning and physiological deterioration, which further increases dyspnoea at even lower activity levels and contributes to disease progression [17, 18]. Following successful models in other symptom domains, such as the fear-avoidance model of chronic pain [19], especially the anxious expectation or

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confidence: 58%

“…If the latter dimension is amplified, this can increase the overall dyspnoea experience in the absence of sensory changes. Therefore, these different dimensions of dyspnoea should be assessed routinely with available and validated instruments [36].…”

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confidence: 99%

Treating anxious expectations can improve dyspnoea in patients with COPD

Leupoldt

2017

Eur Respir J

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“…These include negative effects of obesity or malnutrition, anxiety and depression, and impairment in cardiocirculatory and musculoskeletal function. The symptom of dyspnea is a uniquely personal experience and difficult to quantify numerically with magnitude-of-tasks questionnaires (mMRC) or even multicomponent questionnaires which evaluate intensity, quality, affective dimension, and impact on quality of life (BDI-TDI) [98,100,101]. Patients with COPD may present with very different individual dyspnea profiles (Fig.…”

Section: Challenges Of Dyspnea Management In Copdmentioning

confidence: 99%

Dyspnea in COPD: New Mechanistic Insights and Management Implications

et al. 2019

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Dyspnea is the most common symptom experienced by patients with chronic obstructive pulmonary disease (COPD). To avoid exertional dyspnea, many patients adopt a sedentary lifestyle which predictably leads to extensive skeletal muscle deconditioning, social isolation, and its negative psychological sequalae. This ''dyspnea spiral'' is well documented and it is no surprise that alleviation of this distressing symptom has become a key objective highlighted across COPD guidelines. In reality, this important goal is often difficult to achieve, and successful symptom management awaits a Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.9970322.

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“…Die Untergruppen der Bereiche (SQ, A2) können einzeln ausgewertet werden. Es ist auch möglich, sich nur auf die rein deskriptive Komponente der sensorischen Qualität von Luftnot zu beschränken (SQ) [3,17]. Neben dem MDP existiert im Englischen ein weiterer Fragebogen zur multidimensionalen Erfassung von Dyspnoe: Der Dyspnea-12.…”

Section: Auswertung Des Mdpunclassified

“…In einer kürzlich erschienenen Stellungnahme gehen beide Autoren auf Vor-und Nachteile der jeweiligen Fragebögen ein [3].…”

Section: Auswertung Des Mdpunclassified

Deutsche Übersetzung und sprachliche Validierung des multidimensionalen Dyspnoe-Profils (MDP)

et al. 2019

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Zusammenfassung Hintergrund Luftnot ist als subjektive Wahrnehmung von Atembeschwerden charakterisiert. Dazu gehören verschiedene sensorische Qualitäten mit unterschiedlichen Intensitäten. Die Erfassung der verschiedenen Qualitäten und Quantifizierung gestaltet sich sehr schwierig. Bislang ist in deutscher Sprache kein validiertes Instrument zur multidimensionalen Erfassung von Luftnot verfügbar. Das Multidimensional Dyspnea Profile (MDP) wurde 2015 von Banzett et al. entwickelt, um dieser Vielschichtigkeit gerecht zu werden und diese erkrankungsübergreifend sowie zeit- oder situationsspezifisch zu erfassen. Methodik In dieser Arbeit stellen wir die deutsche Übersetzung des MDP vor. Das Mapi Research Trust hat die deutsche Version anhand international anerkannter Richtlinien zur interkulturellen Adaption von Patientenfragebögen erzeugt. Dies beinhaltete auch eine sprachliche Validierung an betroffenen Patienten. Ergebnisse Das Instrument misst die Intensität der allgemein durch Luftnot hervorgerufenen Unannehmlichkeit. Es prüft das Vorhandensein von 5 sensorischen, Luftnot beschreibenden Qualitäten und misst deren jeweilige Intensität. Zusätzlich wird die Intensität von 5 möglichen emotionalen Reaktionen erfasst. Die Datenerhebung erfolgt zeit- oder situationsspezifisch. Schlussfolgerung Die Autoren stellen den Fragebogen in englischer Sprache zur freien Verfügung. Auch der deutsche Fragebogen steht zur akademischen Nutzung frei zur Verfügung und ist im klinischen Alltag und in der Forschung nutzbar. Ein Vergleich mit internationalen Studien wird möglich.

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Measuring dyspnoea: new multidimensional instruments to match our 21st century understanding

Cited by 29 publications

References 51 publications

Treating anxious expectations can improve dyspnoea in patients with COPD

Treating anxious expectations can improve dyspnoea in patients with COPD

Dyspnea in COPD: New Mechanistic Insights and Management Implications

Deutsche Übersetzung und sprachliche Validierung des multidimensionalen Dyspnoe-Profils (MDP)

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