Kako Jun, Morita Tatsuya, Yamaguchi Takuhiro, Sekimoto Asuko, Kobayashi Masamitsu, Kinoshita Hiroya, Ogawa Asao, Zenda Sadamoto, Uchitomi Yosuke, Inoguchi Hironobu, Matsushima Eisuke
1 Nursing Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
2 Section of Liaison Psychiatry and Palliative Medicine, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Yushima, Tokyo, Japan.
Am J Hosp Palliat Care. 2018 Feb;35(2):293-296. doi: 10.1177/1049909117707905. Epub 2017 May 3.
To clarify the duration required for dyspnea to return to baseline severity after fan therapy, to evaluate whether fan-to-legs therapy or no fan therapy would be a suitable control therapy, and to investigate changes in patients' face surface temperature after fan therapy.
In this pilot study, all participants received 3 interventions in the following order: no fan, fan to legs, and fan to face. Participants used a fan for 5 minutes, and they scored their dyspnea at 10-minute intervals for 60 minutes or until the score had returned to its baseline value, whichever occurred first. Nine patients with advanced cancer admitted to a palliative care unit were included; they had dyspnea at rest and rated its severity as at least 3 points on a 0- to 10-point numerical rating scale. Descriptive statistics and the Wilcoxon signed rank test were used to analyze the data.
All patients completed the study. Of the 9 participants, 6 experienced a clinical benefit from using a fan to their faces. Of these patients, only 2 participants' (2 of 6) dyspnea scores returned to baseline by the end of the 60-minute assessment period after exposure to fan-to-face therapy. In fan-to-legs and no fan settings, there was no change in the dyspnea scores. There were significant differences between the baseline face surface temperature and that after fan-to-face and fan-to-legs settings.
When using a crossover design to investigate the effect of fan therapy on dyspnea, 1 hour is an insufficient washout period.
明确风扇疗法后呼吸困难恢复至基线严重程度所需的时间,评估腿部吹风疗法或不使用风扇疗法是否为合适的对照疗法,并研究风扇疗法后患者面部表面温度的变化。
在这项初步研究中,所有参与者按以下顺序接受3种干预:不使用风扇、腿部吹风、面部吹风。参与者使用风扇5分钟,然后每隔10分钟对呼吸困难程度进行评分,共60分钟,或直至评分恢复到基线值,以先达到者为准。纳入9名入住姑息治疗病房的晚期癌症患者;他们静息时存在呼吸困难,且在0至10分数字评分量表上对其严重程度的评分至少为3分。采用描述性统计和Wilcoxon符号秩检验分析数据。
所有患者均完成研究。9名参与者中,6名通过面部吹风获得了临床益处。在这些患者中,仅2名参与者(6名中的2名)在接受面部吹风疗法后的60分钟评估期结束时呼吸困难评分恢复到基线。在腿部吹风和不使用风扇的情况下,呼吸困难评分没有变化。基线面部表面温度与面部吹风和腿部吹风后的温度之间存在显著差异。
采用交叉设计研究风扇疗法对呼吸困难的影响时,1小时的洗脱期不足。