A retrospective study of breathlessness supportive therapy on chronic refractory breathlessness in a palliative care unit.

Q3 Medicine

Medical Journal of Malaysia Pub Date : 2024-03-01

K T Tay, N N Nik Isahak, N Kasinathan, C L Yeat, N D Saad

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引用次数: 0

Abstract

Introduction: Chronic refractory breathlessness is a debilitating symptom which negatively affects quality of life with profound impact on physical and psychosocial functioning of patients and/or carers. Multidisciplinary based interventions which focus on non-pharmacological approach have shown to be effective. We developed a breathlessness intervention service called breathlessness supportive therapy (BST) in a palliative care unit with limited resources. The aim is to evaluate the feasibility of developing a BST service and to study the characteristics and outcome of patients with chronic refractory breathlessness.

Materials and methods: This is a retrospective study of patients with chronic refractory breathlessness and Modified Medical Research Council (mMRC) dyspnoea scale grade ≥ 2 who attended the BST clinic over 1 year period. BST consists of two clinic sessions 2 weeks apart. Data was retrieved from patients' medical notes and analysis done using Microsoft Excel.

Results: A total of 21 patients were identified. Median age was 69 years with 52% of females. 72% had non-malignant diagnoses. Median Charlson's Comorbidity Index score was 6.5. Median mMRC dyspnoea scale was 3. 47.6% had long term oxygen usage. Median Australian Karnofsky Performance Scale (AKPS) was 65 and the median baseline breathlessness visual analogue scale (VAS) was 2. 62% completed two sessions, the remaining 38% completed only one session. Mean time from BST intervention to death was 18.26 weeks, median was 22 weeks. 72% died at home, whilst 28% died in the hospital. All the patients scored 4 (somewhat agree) and 5 (strongly agree) on the overall feedback score.

Conclusions: Development of a breathlessness intervention service is feasible in a resource limited setting and generally accepted by most patients. More research and prospective studies are needed to evaluate the effectiveness of BST in the future.

本刊更多论文

在姑息治疗病房对慢性难治性呼吸困难进行的呼吸困难支持疗法回顾性研究。

简介慢性难治性呼吸困难是一种使人衰弱的症状，会对生活质量产生负面影响，并对患者和/或照护者的身体和社会心理功能产生深远影响。以非药物疗法为重点的多学科干预已被证明是有效的。我们在一个资源有限的姑息治疗病房开发了一种名为 "憋气支持疗法（BST）"的憋气干预服务。我们的目的是评估开展呼吸支持疗法服务的可行性，并研究慢性难治性呼吸困难患者的特点和治疗效果：这是一项回顾性研究，研究对象为慢性难治性呼吸困难患者和呼吸困难量表（mMRC）分级≥ 2 级的患者，他们在一年内接受了 BST 诊疗。BST 包括两次门诊，每次间隔 2 周。数据取自患者的医疗记录，并使用 Microsoft Excel 进行分析：结果：共发现 21 名患者。中位年龄为 69 岁，女性占 52%。72%的患者被诊断为非恶性肿瘤。夏尔森合并症指数中位数为 6.5。mMRC 呼吸困难量表中位数为 3。47.6% 的患者长期使用氧气。澳大利亚卡诺夫斯基表现量表（AKPS）中位数为 65，基线呼吸困难视觉模拟量表（VAS）中位数为 2。从 BST 干预到死亡的平均时间为 18.26 周，中位数为 22 周。72%的患者死于家中，28%死于医院。所有患者的总体反馈得分均为4分（有点同意）和5分（非常同意）：结论：在资源有限的情况下发展窒息干预服务是可行的，大多数患者也普遍接受。未来需要开展更多研究和前瞻性研究，以评估呼吸暂停干预服务的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Journal of Malaysia Medicine-Medicine (all)

CiteScore

1.20

自引率

0.00%

发文量

165

期刊介绍： Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.