Department of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom.
J Pain Symptom Manage. 2013 Jun;45(6):1019-29. doi: 10.1016/j.jpainsymman.2012.06.008. Epub 2012 Sep 25.
Unlike pain, where the concept of breakthrough and background pain has been widely characterized and defined, breathlessness as a symptom has not yet been fully explored and has been rarely categorized.
To explore patients' experiences and descriptions of breathlessness to categorize breathlessness.
Qualitative study using in-depth interviews with patients suffering from four life-limiting and advanced diseases (chronic heart failure, chronic obstructive pulmonary disease, lung cancer, and motor neuron disease). Interviews were tape-recorded, transcribed verbatim, and analyzed using Framework analysis.
A total of 51 participants were interviewed (mean ± SD age 68.2 ± 11.6 years; 30 of 51 male; median Karnofsky 60%; mean ± SD breathlessness intensity 3.2 ± 1.7 of 10). Episodic breathlessness and continuous breathlessness were the main categories, with subcategories of triggered and non-triggered episodic breathlessness and continuous breathlessness for short and long periods. Episodic breathlessness triggered by exertion, non-triggered episodic breathlessness, and continuous breathlessness for a long period ("constant variable") were the most frequent and important categories with a high impact on daily living. Exertional breathlessness occurred in nearly all participants. Participants could differentiate episodic breathlessness (seconds, minutes, or hours) and continuous breathlessness (days, weeks, or months) by time. Episodic breathlessness occurred in isolation or in conjunction with continuous breathlessness.
Participants categorize their breathlessness by time and triggers. The categorization needs further verification, similar to that already established in pain, and can be used as a new evidence-based categorization to advance our understanding of this under-researched, yet high impact, symptom to optimize management.
与疼痛不同，突破性疼痛和背景性疼痛的概念已经得到广泛的描述和定义，而呼吸困难作为一种症状尚未得到充分的探索，也很少被分类。
探索患者对呼吸困难的体验和描述，对呼吸困难进行分类。
采用定性研究方法，对患有四种生命终末期和进展性疾病（慢性心力衰竭、慢性阻塞性肺疾病、肺癌和运动神经元病）的患者进行深入访谈。访谈进行录音，逐字转录，并使用框架分析法进行分析。
共对 51 名参与者进行了访谈（平均年龄 68.2±11.6 岁；30 名男性；卡诺夫斯基中位数 60%；平均±标准差呼吸困难强度 3.2±1.7 分）。间歇性呼吸困难和持续性呼吸困难是主要类别，其下分为触发和非触发的间歇性呼吸困难以及短时间和长时间的持续性呼吸困难。由运动引起的触发的间歇性呼吸困难、非触发的间歇性呼吸困难和长时间的持续性呼吸困难（“恒变”）是最常见和最重要的类别，对日常生活影响最大。几乎所有参与者都出现了运动性呼吸困难。参与者可以根据时间区分间歇性呼吸困难（数秒、数分钟或数小时）和持续性呼吸困难（数天、数周或数月）。间歇性呼吸困难单独出现或与持续性呼吸困难同时出现。
参与者根据时间和触发因素对呼吸困难进行分类。这种分类需要进一步验证，类似于已经在疼痛中建立的分类，可作为一种新的基于证据的分类方法，以深入了解这种研究不足但影响较大的症状，从而优化管理。
