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The influence of respiratory sounds on breathlessness in children with asthma: a symptom-perception approach
S Rietveld1, A M Kolk, P J Prins
1Department of Clinical Psychology, University of Amsterdam, The Netherlands.
Insights
Asthmatic children
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Psychology
Background:
- Asthma symptom perception is complex, with a notable discordance between objective measures and subjective experiences.
- This discrepancy impacts asthma medication adherence and management strategies.
- Understanding the role of respiratory sounds in perceived breathlessness is crucial for pediatric asthma care.
Purpose of the Study:
- To investigate the influence of respiratory sounds on symptom perception, specifically breathlessness, in children with asthma.
- To examine the relationship between wheezing sounds, lung function, and reported breathlessness.
- To assess the effect of auditory feedback of wheezing on perceived asthma severity.
Main Methods:
- Experiment 1: Recorded wheezing sounds in 16 children with asthma during histamine-induced airway obstruction.
- Experiment 2: 45 asthmatic and 45 non-asthmatic children received auditory feedback (false wheezing, quiet sounds, or no sound) after exercise.
- Measured breathlessness and lung function in relation to auditory stimuli.
Main Results:
- Breathlessness in asthmatic children correlated with wheezing intensity but not lung function in Experiment 1.
- Asthmatic children reported significantly higher breathlessness when exposed to false wheezing feedback compared to no sound in Experiment 2.
- Auditory perception of wheezing significantly influenced asthmatic children's estimation of breathlessness and asthma severity.
Conclusions:
- Wheezing sounds play a significant role in how asthmatic children perceive their breathlessness and asthma severity.
- Interventions aimed at managing asthma perception should consider the impact of respiratory sounds.
- Addressing the subjective experience of breathlessness, influenced by wheezing, is vital for effective asthma management in children.
Abstract:
The discordance between the objective and subjective symptoms of asthma has major effects on proper medication and management. In 2 studies the influence of respiratory sounds in the process of symptom perception underlying breathlessness was investigated in children aged 7-17 years. In Experiment 1, asthmatic wheezing sounds were recorded in 16 children during histamine-induced airway obstruction. Breathlessness correlated significantly with rank order of amount of wheezing, but not with lung function. In Experiment 2, after standardized physical exercise, 45 asthmatic and 45 nonasthmatic children were randomly assigned to (a) false feedback of wheezing, (b) quiet respiratory sounds, or (c) no sound. Asthmatic children reported significantly more breathlessness in the 1st versus the 3rd condition. In conclusion, many asthmatic children were easily influenced by wheezing in their estimation of asthma severity, reflected in breathlessness.