Validation of a three-factor measurement model of dyspnea in hospitalized adults with heart failure

Dyspnoea: a multidimensional and multidisciplinary approach

“…Finally, there is still an enormous amount of work to be done in developing proper measurement tools for dyspnoea. While progress has been made, with the development of dyspnoea scales that incorporate the affective dimensions [24,[55][56][57][58], there is still room for a better understanding of the language of dyspnoea (for example, similarities and discrepancies between qualitative descriptors of dyspnoea such as ''air hunger'' and ''unsatisfied inspiration'' in cardiorespiratory diseases) and how it can help identify the underlying physiological processes. Other studies in languages other than English are also needed as expression of dyspnoea may vary; for example, air hunger dyspnoea is translated in French as ''soif d'air'' or ''air thirst'' [149].…”

“…Several questionnaires have been developed over the years to evaluate dyspnoea sensory quality, including SIMON et al [51,52]'s descriptors and modifications thereof [23,53,54]. More recently, instruments such as the Multidimensional Dyspnoea Profile (MDP) [24,55,56] and the Dyspnoea-12 [57,58] have incorporated intensity ratings for sensory quality and affective descriptors. The results from several studies in healthy individuals [52,59,60] and cardiopulmonary patients [23,51,[53][54][55][56][58][59][60][61] reveal that patients with cardiopulmonary disease are capable of discriminating among different sensory and affective breathing descriptors, and that there are differences between patients and healthy individuals.…”

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

“…Qualities of clinical dyspnea are not limited to the foregoing categories. Rather, sensations of effort, tightness, and air hunger are more reliably characterized than others (e.g., rapid or heavy breathing) (36,69,97,114,125). In addition, the mechanisms described above do not provide a good explanation for dyspnea arising from vascular problems such as congestive heart failure and pulmonary hypertension.…”

“…Although multiple distinguishable sensations varying in intensity are central to the definition of dyspnea, these separate sensations seldom, if ever, occur in a pure or isolated fashion in the real world. Multiple uncomfortable sensations are often present in patients (27,31,32,36,114,116,125,(129)(130)(131)(132)(133) and together produce the overall perception of dyspnea, as described in THE DYSPNEIC PATIENT: CONNECTING PATH-OPHYSIOLOGY TO NEURAL MECHANISM. Even laboratory stimuli designed to be specific generally stimulate more than one afferent pathway.…”

“…Even laboratory stimuli designed to be specific generally stimulate more than one afferent pathway. Assessment of perceived sensory qualities with magnitude scales, rather than binary choice (114,116,125), may be more sensitive in picking up qualities of sensation, but in general reports of dyspnea are not as consistent as, for example, reports of colors or sounds.…”