Tsai Jing-Jing, Chen Kee-Hsin, Fang Hui-Fen, Huang Tsai-Wei
School of Nursing, College of Nursing, 38032Taipei Medical University, Taipei, Taiwan.
Department of Nursing, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Am J Hosp Palliat Care. 2022 Aug;39(8):977-985. doi: 10.1177/10499091211056327. Epub 2021 Dec 4.
Breathlessness is common among terminally ill patients with cardiorespiratory disease or cancer. The experience may induce secondary physiological and behavioral responses that limit patient well-being and independence and cause emotional distress.
We conducted a meta-analysis on randomized controlled trials (RCTs) that examined the effectiveness of fan blowing on breathlessness among patients with cardiorespiratory diseases or cancer. The PubMed, Cochrane Library, Embase, SCOPUS, and CINAHL databases were searched to retrieve potential articles. The primary outcome was breathlessness severity. The secondary outcomes were SpO, anxiety, depression, and quality of life. Also, we presented the changes of vital signs and subjective feeling of a male patient who used fan blowing for relieving his breathlessness.
Eight RCTs were available for analysis. The pooled results demonstrated no significant difference in breathlessness severity between fan-to-face blowing and control methods (standard mean difference: -0.21, 95% confidence interval: -.59 to .17); however, a significant reduction in breathlessness severity was observed in the short-time intervention compared with long-time intervention. A trend occurred toward significance in the reduction of respiratory rate in fan-to-face blowing compared with control methods (MD: -.64, 95% CI: -1.37 to .09). No differences were observed between groups in oxygen saturation, anxiety, depression, or QoL. The male patient who used fan blowing showed an improved vital signs and a satisfied subjective feeling.
Consistent short-time fan-to-face blowing is effective for relieving breathlessness among conscious terminally ill patients with cardiorespiratory diseases or cancer. The use of this convenient method for relieving breathlessness symptoms in terminally ill patients is recommended.
呼吸困难在患有心肺疾病或癌症的晚期患者中很常见。这种体验可能会引发继发性生理和行为反应，从而限制患者的幸福感和独立性，并导致情绪困扰。
我们对随机对照试验（RCT）进行了荟萃分析，这些试验研究了风扇吹拂对患有心肺疾病或癌症患者呼吸困难的有效性。检索了PubMed、Cochrane图书馆、Embase、SCOPUS和CINAHL数据库以获取潜在文章。主要结局是呼吸困难严重程度。次要结局是血氧饱和度、焦虑、抑郁和生活质量。此外，我们展示了一名使用风扇吹拂缓解呼吸困难的男性患者的生命体征变化和主观感受。
有八项随机对照试验可供分析。汇总结果表明，风扇对着面部吹拂与对照方法在呼吸困难严重程度上无显著差异（标准平均差：-0.21，95%置信区间：-0.59至0.17）；然而，与长时间干预相比，短时间干预中呼吸困难严重程度显著降低。与对照方法相比，风扇对着面部吹拂在降低呼吸频率方面有显著趋势（平均差：-0.64，95%置信区间：-1.37至0.09）。两组在血氧饱和度、焦虑、抑郁或生活质量方面未观察到差异。使用风扇吹拂的男性患者生命体征有所改善，主观感受良好。
持续的短时间风扇对着面部吹拂对缓解患有心肺疾病或癌症的意识清醒晚期患者的呼吸困难有效。建议使用这种方便的方法缓解晚期患者的呼吸困难症状。
