Relationship between Dyspnea Descriptors and Underlying Causes of the Symptom; a Cross-sectional Study
Archives of Academic Emergency Medicine,
Vol. 5 No. 1 (2017),
1 January 2017
,
Page e62
https://doi.org/10.22037/aaem.v5i1.187
Abstract
Introduction: History taking and physical examination help clinicians identify the patient’s problem and effectively treat it. This study aimed to evaluate the descriptors of dyspnea in patients presenting to emergency department (ED) with asthma, congestive heart failure (CHF), and chronic obstructive pulmonary disease (COPD). Method: This cross-sectional study was conducted on all patients presenting to ED with chief complaint of dyspnea, during 2 years. The patients were asked to describe their dyspnea by choosing three items from the valid and reliable questionnaire or articulating their sensation. The relationship between dyspnea descriptors and underlying cause of symptom was evaluated using SPSS version 16. Results: 312 patients with the mean age of 60.96±17.01 years were evaluated (53.2% male). Most of the patients were > 65 years old (48.7%) and had basic level of education (76.9%). "My breath doesn’t go out all the way" with 83.1%, “My chest feels tight " with 45.8%, and "I feel that my airway is obstructed" with 40.7%, were the most frequent dyspnea descriptors in asthma patients. "My breathing requires work" with 46.3%, "I feel that I am suffocating" with 31.5%, and "My breath doesn’t go out all the way" with 29.6%, were the most frequent dyspnea descriptors in COPD patients. "My breathing is heavy" with 74.4%, "A hunger for more air†with 24.4%, and "I cannot get enough air" with 23.2%, were the most frequent dyspnea descriptors in CHF patients. Except for “My breath does not go in all the wayâ€, there was significant correlation between studied dyspnea descriptors and underlying disease (p = 0.001 for all analyses). Conclusion: It seems that dyspnea descriptors along with other findings from history and physical examination could be helpful in differentiating the causes of the symptom in patients presenting to ED suffering from dyspnea.
Â
Â
- Dyspnea
- Asthma
- Pulmonary Disease
- Chronic Obstructive
- Heart Failure
- Symptom Assessment
How to Cite
References
Mahler DA, Fierro-Carrion G, Baird JC. Evaluation of dyspnea in the elderly. Clinics in geriatric medicine. 2003;19(1):19-33.
O'Donnell DE, Banzett RB, Carrieri-Kohlman V, Casaburi R, Davenport PW, Gandevia SC, et al. Pathophysiology of dyspnea in chronic obstructive pulmonary disease: a roundtable. Proceedings of the American Thoracic Society. 2007;4(2):145-68.
Wilcock A, Crosby V, Hughes A, Fielding K, Corcoran R, Tattersfield AE. Descriptors of breathlessness in patients with cancer and other cardiorespiratory diseases. Journal of pain and symptom management. 2002;23(3):182-9.
Yoos HL, Kitzman H, McMullen A, Sidora-Arcoleo K, Anson E. The language of breathlessness: do families and health care providers speak the same language when describing asthma symptoms? Journal of Pediatric Health Care. 2005;19(4):197-205.
von Leupoldt A, Balewski S, Petersen S, Taube K, Schubert-Heukeshoven S, Magnussen H, et al. Verbal descriptors of dyspnea in patients with COPD at different intensity levels of dyspnea. CHEST Journal. 2007;132(1):141-7.
Teixeira CA, Rodrigues Júnior AL, Straccia LC, Vianna ÉdSO, Silva GAd, Martinez JAB. Dyspnea descriptors developed in Brazil: application in obese patients and in patients with cardiorespiratory diseases. Jornal Brasileiro de Pneumologia. 2011;37(4):446-54.
Scano G, Stendardi L, Grazzini M. Understanding dyspnoea by its language. European Respiratory Journal. 2005;25(2):380-5.
Williams M, Cafarella P, Olds T, Petkov J, Frith P. The language of breathlessness differentiates between patients with COPD and age-matched adults. CHEST Journal. 2008;134(3):489-96.
Yorke J, Moosavi SH, Shuldham C, Jones PW. Quantification of dyspnoea using descriptors: development and initial testing of the Dyspnoea-12. Thorax. 2010;65(1):21-6.
Carrieriâ€Kohlman V, Doneskyâ€Cuenco D, Park SK, Mackin L, Nguyen HQ, Paul SM. Additional evidence for the affective dimension of dyspnea in patients with COPD. Research in nursing & health. 2010;33(1):4-19.
Harver A, Schwartzstein RM, Kotses H, Humphries CT, Schmaling KB, Mullin ML. Descriptors of breathlessness in children with persistent asthma. CHEST Journal. 2011;139(4):832-8.
Hardie GE, Janson S, Gold WM, Carrieri-Kohlman V, Boushey HA. Ethnic differences: word descriptors used by African-American and white asthma patients during induced bronchoconstriction. CHEST Journal. 2000;117(4):935-43.
Trochtenberg DS, BeLue R. Descriptors and perception of dyspnea in African-American asthmatics. Journal of Asthma. 2007;44(10):811-5.
Trochtenberg DS, BeLue R, Piphus S, Washington N. Differing reports of asthma symptoms in African Americans and Caucasians. Journal of Asthma. 2008;45(2):165-70.
Han J, Zhu Y, Li S, Chen X, Put C, Van de Woestijne KP, et al. Respiratory complaints in Chinese: cultural and diagnostic specificities. CHEST Journal. 2005;127(6):1942-51.
Barbaro MPF, Lacedonia D, Palladino GP, Bergantino L, Ruggeri C, Martinelli D, et al. Dyspnea perception in asthma: Role of airways inflammation, age and emotional status. Respiratory medicine. 2011;105(2):195-203.
Chang A, Waterman L, Mahler D. Prospective Assessment Of Descriptors Of Dyspnea In Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2014;189:A2456.
Chang AS, Munson J, Gifford AH, Mahler DA. Prospective Use of Descriptors of Dyspnea to Diagnose Common Respiratory Diseases. CHEST Journal. 2015; 148 (4): 895- 902.
Rutgers S, Ten Hacken N, Koeter G, Postma D. Borg scores before and after challenge with adenosine 5'-monophosphate and methacholine in subjects with COPD and asthma. European Respiratory Journal. 2000;16(3):486-90.
de Souza Caroci A, Lareau SC. Descriptors of dyspnea by patients with chronic obstructive pulmonary disease versus congestive heart failure. Heart & Lung: The Journal of Acute and Critical Care. 2004;33(2):102-10.
- Abstract Viewed: 258 times
- PDF Downloaded: 149 times
- HTML Downloaded: 68 times