The sensation of pulmonary dyspnea in school-age children

The purpose of this investigation was to describe the sensation of dyspnea in a sample of 39 school-age children with asthma and to identify strategies used to cope with the symptom. In addition, three methods to measure dyspnea intensity in children were tested and compared. Breathing on a "bad breathing day" was used as a proxy variable to represent dyspnea. The most frequent description of how breathing feels on a bad day was "it is hard to breathe." Words chosen most frequently from a checklist of sensations were "wheezy," "short of breath," "tight," and physical sensations such as "throwing up," "hurting," and "stuffiness." The children's feelings on a bad breathing day were categorized as negative moods or emotions, a wish for change, or physical symptoms. Ratings of breathing on "good", "bad," and "usual breathing" days on word descriptor, visual analogue, and color scales provided evidence of concurrent validity for the three measures of dyspnea intensity. The most frequent strategies used to cope with dyspnea were medications, change in position, decreased activity, fluids, relaxation, distraction, and social support. The findings were very similar to those previously described for an adult sample.