Personality Profiles and Breathlessness Perception in  Outpatients with Different Gradings of Asthma

Chetta, Alfredo; Gerra, Gilberto; Foresi, Antonio; Zaimovic, Amir; Donno, Mario Del; Chittolini, Beatrice; Malorgio, Roberto; Castagnaro, Antonio; Olivieri, Dario

doi:10.1164/ajrccm.157.1.9702093

Cited by 96 publications

(63 citation statements)

References 29 publications

(38 reference statements)

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“…Most studies performed on adults have shown that poor perceivers were not charac-terized as a distinct group based on gender, age or baseline FEV 1 (1,3,14,24,26). These findings were confirmed in children by Fritz et al (11) and in our study.…”

Section: Discussionsupporting

confidence: 88%

“…Apter et al (1) reported that patients with lower forced expiratory flow between 25% and 75% of the vital capacity (FEF ) tended to be less accurate perceivers. Chetta et al (24) found that poor perception was associated with asthma severity and Bijl-Hofland et al (25) reported that low baseline forced expiratory volume in 1 s (FEV 1 ) and high hyperresponsiveness were associated with a low perceptiveness of bronchoconstriction. In contrast, Pfeiffer et al (14) concluded that good and poor perceivers did not differ in terms of the severity or duration of asthma and Fritz et al (11) reported that children s perceptual accuracy of symptoms was not related to severity.…”

Section: Discussionmentioning

confidence: 99%

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Effect of asthma severity on symptom perception in childhood asthma

Cabral

Conceição

Saldiva

et al. 2002

Braz J Med Biol Res

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Individual ability to perceive airway obstruction varies substantially. The factors influencing the perception of asthma are probably numerous and not well established in children. The present study was designed to examine the influence of asthma severity, use of preventive medication, age and gender on the association between respiratory symptoms (RS) and peak expiratory flow (PEF) rates in asthmatic children. We followed 92 asthmatic children, aged 6 to 16 years, for five months. Symptom scores were recorded daily and PEF was measured twice a day. The correlations among variables at the withinperson level over time were analyzed for each child and for the pooled data by multivariate analysis. After pooling the data, there was a significant (P<0.05) correlation between each symptom and PEF; 60% of the children were accurate perceivers (defined by a statistically significant correlation between symptoms and PEF across time) for diurnal symptoms and 37% for nocturnal symptoms. The accuracy of perception was independent of asthma severity, age, gender or the use of preventive medication. Symptom perception is inaccurate in a substantial number of asthmatic children, independently of clinical severity, age, gender or use of preventive medication. It is not clear why some asthmatic patients are capable of accurately perceiving the severity of airway obstruction while others are not.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Effect of asthma severity on symptom perception in childhood asthma

Cabral

Conceição

Saldiva

et al. 2002

Braz J Med Biol Res

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“…Indeed, there is a weak correlation between symptoms on the one hand and bronchial hyperresponsiveness and airways inflammation on the other. Several investigators have highlighted the possibility of diminished perception of dyspnoea in subjects with more severe grades of asthma, potentially leading to undertreatment in these subjects [7][8][9]. Such an inverse relationship is not a consistent finding [10].…”

Section: Discussionmentioning

confidence: 99%

“…The relationship between dyspnoea perception and other indices of asthmatic severity, such as the degree of bronchoconstriction, is poor [5,6]. Conversely, impaired dyspnoea perception is especially believed to play a role in severe asthma [7][8][9]. Poor perception of airflow obstruction may lead to undertreatment of asthma [10].…”

mentioning

confidence: 99%

Dyspnoea perception during clinical remission of atopic asthma

Toorn¹,

Overbeek²,

Hoogsteden³

et al. 2002

European Respiratory Journal

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Symptoms of atopic asthma often disappear around puberty. The authors recently demonstrated that this clinical remission is accompanied with ongoing airways inflammation in most subjects. The discrepancy between lack of symptoms and persistent airway inflammation suggests that perception of the symptoms is unclear. In the present study, young adults in clinical remission of atopic asthma assigned themselves a modified Borg score during methacholine and adenosine-59-monophosphate induced bronchoconstriction. Borg scores of subjects in clinical remission were compared with those of symptomatic asthmatic subjects. A marked variation in the Borg scores at a 20% fall in the forced expiratory volume in one second was found. Significant differences in Borg scores between remission patients and asthmatics could not be detected.It was concluded that perception of dyspnoea, induced with methacholine and adenosine challenge, is similar in young adults in clinical remission of atopic asthma compared to that of patients with symptomatic asthma. Hence, an unclear perception seems to be an unlikely explanation for the discrepancy between lack of symptoms and ongoing inflammation. Other factors, including both physical and psychological ones, may play a role in the apparent absence of symptoms, thereby potentially leading to undertreatment.

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“…(7) Although patients with stable asthma always recognize an increase in the degree of dyspnea due to induced bronchospasm, there is a wide range in the magnitude of dyspnea perception for the same value of FEV 1 . (7,8) It has been suggested that this variability is attributable to certain pathophysiological and psychological factors. (9) To determine the level of dyspnea perception, various types of scales have been devised, including visual analog scales, verbal category scales, and hybrid scales.…”

Section: Introductionmentioning

confidence: 99%

Desempenho de uma escala analógica visual legendada na determinação do grau de dispneia durante teste de broncoespasmo induzido por exercício em crianças e adolescentes asmáticos

et al. 2010

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Objective: There is an indirect relationship between airway obstruction in asthma and the intensity of breathlessness (dyspnea). A word labeled visual analog dyspnea scale with a 0-3 score has been widely used for the assessment of the degree of bronchoconstriction, although the perception of such obstruction varies considerably. The objective of this study was to determine whether children and adolescents are able to perceive acute exercise-induced bronchoconstriction (EIB), as well as to measure the discriminatory power of a word labeled visual analog dyspnea scale in relation to the intensity of the EIB. Methods: A cross-sectional study involving 134 children and adolescents with asthma and submitted to a six-minute steady-state exercise test on a cycle ergometer. The intensity of dyspnea was determined using a word labeled visual analog dyspnea scale prior to each determination of FEV 1 . The scale is scored from 0 to 3, with a logical sequence of pictures, ranging from "no symptoms" to "severe dyspnea". Variables were determined at baseline, as well as at 5, 10, and 20 min after the exercise test. The accuracy of the dyspnea scale in identifying the degree of EIB was determined by means of ROC curves for the post-exercise fall in FEV 1 , using cut-off points of 10%, 20%, 30%, and 40%. Results: Of the patients selected, 111 finished the study, and 52 (46.8%) presented with EIB. The area under the ROC curve increased in direct proportion to increases in the degree of bronchoconstriction. Conclusions: Among children and adolescents with asthma, the accuracy of this dyspnea scale improves as the post-exercise percentage fall in FEV 1 increases. However, the predictive value of the scale is suboptimal when the percentage fall in FEV 1 is lower.Keywords: Asthma; Asthma, exercise-induced; Dyspnea. ResumoObjetivo: Existe uma relação indireta entre a obstrução das vias aéreas em asma e a intensidade de falta de ar (dispneia). Uma escala visual analógica legendada de dispneia com escore de 0-3 pontos tem sido amplamente utilizada na avaliação da broncoconstrição, embora a percepção de tal obstrução seja muito variável. O objetivo deste estudo foi determinar se crianças e adolescentes são capazes de perceber a broncoconstrição aguda induzida por exercício (BAIE), bem como medir o poder discriminatório de uma escala visual analógica legendada de dispneia em relação à intensidade de BAIE. Métodos: Estudo transversal com 134 crianças e adolescentes asmáticos que foram submetidos a um teste de broncoespasmo induzido por seis minutos de exercício em um cicloergômetro. A intensidade da dispneia foi determinada utilizando-se uma escala visual analógica legendada de dispneia antes de cada determinação de VEF 1 . A escala tem um escore de 0-3 pontos, com desenhos em uma sequência lógica variando entre "sem sintomas" e "dispneia grave". As variáveis foram determinadas no momento basal, assim como em 5, 10 e 20 minutos após o término do teste de exercício. A acurácia da escala de dispneia em detectar o grau de BAIE foi d...

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Personality Profiles and Breathlessness Perception in Outpatients with Different Gradings of Asthma

Cited by 96 publications

References 29 publications

Effect of asthma severity on symptom perception in childhood asthma

Effect of asthma severity on symptom perception in childhood asthma

Dyspnoea perception during clinical remission of atopic asthma

Desempenho de uma escala analógica visual legendada na determinação do grau de dispneia durante teste de broncoespasmo induzido por exercício em crianças e adolescentes asmáticos

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