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Dyspnea: assessment and treatment
1Queensway-Carleton Hospital, Nepean, Ontario, Canada.
Summary
Dyspnea (breathlessness) is common in terminal cancer patients and often underassessed. Using specific scales revealed significant shortness of breath in over 75% of patients, impacting their quality of life.
Area of Science:
- Palliative Care
- Symptom Management
- Oncology Nursing
Background:
- Dyspnea is a prevalent and distressing symptom in terminal cancer patients, frequently underdiagnosed and undertreated due to poor assessment.
- This study evaluates various dyspnea assessment tools and their application in a hospital audit.
Discussion:
- The Modified Medical Research Council Dyspnea Scale and Oxygen Cost Diagram Scale identified significant dyspnea in 75.6% and 78.5% of patients, respectively, far exceeding rates from Linear Analogue Scale Assessment and Borg Scale.
- Patients experiencing dyspnea reported other severe symptoms more frequently (55% increase) and were 39% more likely to report other symptoms compared to those without dyspnea.
Key Insights:
- Standard assessment tools may underestimate the prevalence and severity of dyspnea in terminal cancer.
- Dyspnea is strongly associated with increased reporting and severity of other concurrent symptoms.
Outlook:
- Further research should focus on validating and integrating more sensitive dyspnea assessment tools into routine palliative care.
- A shift towards a 'breathing comfortably' approach is recommended for end-of-life care when formal assessment is not feasible, prioritizing patient and family comfort.