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呼吸困难无国界:呼吁开展全球呼吸困难研究。

Breathlessness without borders: a call to action for global breathlessness research.

机构信息

Wolfson Palliative Care Research Centre, University of Hull, Hull, UK.

Respiratory Research Group, Hull York Medical School, University of Hull and Hull University Teaching Hospitals NHS Trust, Hull, UK.

出版信息

NPJ Prim Care Respir Med. 2024 Sep 30;34(1):26. doi: 10.1038/s41533-024-00384-9.

Abstract

It is likely that the burden of breathlessness in low and middle-income countries (LMICs) is much higher than has been estimated using calculations of disease burden and expected prevalence of the symptom. However, most breathlessness research has been conducted in high-income countries and may not be relevant to LMICs. To address this issue, we convened an international breathlessness and global health workshop. Our multidisciplinary team of experts (global palliative care, respiratory medicine, epidemiology, palliative medicine, psychiatry, sport science, global public health and health economics) met at the University of Hull for a two-day workshop in May 2024. We had 8 presentations on key issues relevant to global breathlessness research. Our discussions focussed on unexplored questions and links between breathlessness and other health and social issues, in order to develop an agenda for global breathlessness research. Our discussions highlighted (1) the global burden of breathlessness generated by a range of lifestyle, environmental, disease and poverty-related factors, (2) the need for a global healthcare workforce that can address modifiable causes and the symptoms of breathlessness together using an integrated approach, (3) the value of information over clinical effectiveness when considering implementation of breathlessness self-management interventions, (4) Addressing non-clinical outcomes which are meaningful to individuals and families and (5) Developing a language for global breathlessness research which does not assume that the cause of breathlessness is diagnosed or treated. We present our discussions and recommendations for new approaches and paradigms for global breathlessness research to generate discussion—not to provide empirical evidence.

摘要

在中低收入国家(LMICs),呼吸困难的负担很可能比使用疾病负担和症状预期流行率的计算方法所估计的要高得多。然而,大多数呼吸困难的研究都是在高收入国家进行的,可能与 LMICs 无关。为了解决这个问题,我们召集了一次国际呼吸困难和全球健康研讨会。我们的多学科专家团队(全球姑息治疗、呼吸医学、流行病学、姑息医学、精神病学、运动科学、全球公共卫生和卫生经济学)于 2024 年 5 月在赫尔大学举行了为期两天的研讨会。我们有 8 个关于与全球呼吸困难研究相关的关键问题的演讲。我们的讨论集中在未探索的问题和呼吸困难与其他健康和社会问题之间的联系上,以制定全球呼吸困难研究议程。我们的讨论强调了以下几点:(1)由一系列生活方式、环境、疾病和贫困相关因素引起的全球呼吸困难负担;(2)需要一支能够综合解决可改变的原因和呼吸困难症状的全球医疗保健劳动力;(3)在考虑实施呼吸困难自我管理干预措施时,信息比临床效果更有价值;(4)解决对个人和家庭有意义的非临床结果;(5)为全球呼吸困难研究开发一种不假设呼吸困难的原因已被诊断或治疗的语言。我们提出了我们的讨论和建议,以寻求新的方法和范式来进行全球呼吸困难研究,以引发讨论——而不是提供经验证据。

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本文引用的文献

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Burden of respiratory problems in low-income and middle-income countries.低收入和中等收入国家的呼吸问题负担。
Curr Opin Support Palliat Care. 2022 Dec 1;16(4):210-215. doi: 10.1097/SPC.0000000000000615. Epub 2022 Sep 13.

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