Psychologic and physiologic factors related to dyspnea in subjects with chronic obstructive pulmonary disease.
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Aged↗
Biomedical subjects
A G Gift
Publications and source records attributed to A G Gift.
Validation of a vertical visual analogue scale as a measure of clinical dyspnea.
The purpose of this study was to validate a vertical visual analogue scale (VVAS) as a measure of clinical dyspnea. Concurrent validity was demonstrated by having asthmatics score their dyspnea intensity on both a VVAS and a horizontal visual analogue scale (HVAS), and then measuring their peak expiratory flow rate (PEFR). Correlation between the VVAS and HVAS was r = .97; between the VVAS and the PEFR, correlation was r = -.85, demonstrating the concurrent validity of the VVAS as a measure of dyspnea. Construct validity then was established, using the contrasted-groups approach with repeated measures. Both asthmatics and those with chronic obstructive lung disease (COPD) rated their dyspnea on the VVAS during times of severe and little airway obstruction. The dyspnea ratings at times of severe versus low obstruction were found to be different for both the asthmatic and COPD subjects. The VVAS was shown to have both concurrent and construct validity as a measure of dyspnea.
Asthma↗
The effects of a program of systematic movement on COPD patients.
The intent of the study described in this article was to determine (a) if patients with chronic obstructive pulmonary disease (COPD) who regularly participate in less vigorous exercise programs, such as the program of systematic movement sponsored by the American Lung Association, differ from those who do not participate; and (b) whether these differences, if they exist, persist over time. Two convenience samples of COPD patients--those who practice systematic movement by participating in a pulmonary exercise program (PEP) and those who do not--were obtained through the American Lung Association of Maryland. Demographic information and health history were obtained from the participants and their physicians. They all completed the vertical visual analogue dyspnea scale (VADS) and the Beck Depression Inventory (BDI) on two occasions 8 weeks apart and described the strategies they used in dealing with their illness. Differences were found between the groups on the BDI and VADS at both measurement times. Those who participated in the program had lower depression (5.9 versus 17.75) and lower dyspnea (58.9 versus 78.8). These findings persisted 8 weeks later, with exercisers having depression levels of 5.5 versus 19 for the nonexercisers and dyspnea levels of 55.2 versus 79.4 for the nonexercisers. Exercisers used fewer emotion-focused coping strategies than nonexercisers. These findings have implications for the rehabilitation of COPD patients.
Aged↗
Clinical measurement of dyspnea.
How often have you had a patient turn to you in distress, complaining of shortness of breath and wanting you to provide relief? This situation is often as distressing for the nurse as it is for the patient because there are few recommended nursing interventions designed to assist such patients. The author presents a nursing assessment tool for the dyspneic individual, which can be used to document the effectiveness of interventions for these patients.
Dyspnea↗
Fatigue and other symptoms in patients with chronic obstructive pulmonary disease: do women and men differ?
OBJECTIVE: Describe the symptoms experienced by patients with chronic obstructive pulmonary disease (COPD), compare women and men with regard to their physical and psychologic symptoms, and determine the predictors of fatigue for the group as a whole and for women separately. DESIGN: Correlational, predictive. PARTICIPANTS: One hundred four (48 women/56 men) outpatients with severe COPD and a mean age of 60 years. MEASURES: Self-report of fatigue using the SF-36 energy/fatigue subscale and a "lack of energy" question. Self-report of dyspnea, general symptoms using the Memorial Symptom Assessment Scale, and psychologic symptoms using the Brief Symptom Inventory. Pulmonary function tests and arterial blood gas levels. RESULTS: Patients reported a moderate level of fatigue (mean of 44 on the SF-36), with no difference in the reports of men and women. When reporting their "lack of energy" during the past week, women reported more fatigue than did men. Other symptoms in descending order of reporting were dyspnea and cough. More women reported "don't look like myself" than did men. Women and men were similar in their psychologic symptoms except anxiety, which was higher in women (t = 2.64, p < .01). Predictors of fatigue (SF-36 subscale) for the group as a whole were found to be dyspnea and physical symptoms, predicting 42% of the variance. For the women alone, dyspnea and physical symptoms entered the equation, to predict 67% of the variance in fatigue. CONCLUSIONS: Predictors of fatigue were similar for women compared to the group as a whole, with symptoms having more of an impact on fatigue than did physiologic variables.
Adult↗
Dyspnea: a case for nursing diagnosis status.
Dyspnea, the unpleasant subjective sensation of difficult breathing, is one of the most common symptoms experienced by patients with pulmonary and cardiac disorders. This article reviews the research concerning dyspnea and proposes it for consideration as a nursing diagnosis. The etiologies are categorized according to the neurosensory, neurochemical, cognitive, and affective mechanisms. The defining characteristics include the subjective words describing dyspnea, such as shortness of breath, suffocation, and tightness. The most supported objective sign of dyspnea in the literature is an increased use of accessory muscles of respiration. Nursing interventions for dyspnea relief are geared toward reducing the afferent activity from receptors in the respiratory muscles and dealing with the affective component of dyspnea. These interventions include pacing activities, breathing techniques, and inducing the relaxation response. Because most research for interventions to reduce dyspnea have focused on patients with obstructive lung disorders who have chronic dyspnea, recommendations for further research include using acutely ill patients and those with a variety of medical conditions.
Dyspnea↗
Relaxation to reduce dyspnea and anxiety in COPD patients.
The purpose of this study was to test the effectiveness of a taped relaxation message in reducing dyspnea and anxiety in chronic obstructive pulmonary disease (COPD) patients. Twenty-six adult COPD patients with dyspnea were randomly assigned to two groups. The treatment group was taught relaxation using a prerecorded tape while the control group was instructed to sit quietly. Skin temperature, heart rate, and respiratory rate were recorded for all subjects during a total of four weekly sessions. Anxiety, dyspnea, and airway obstruction were measured at the beginning and end of the study. The relaxation group achieved the preset relaxation criteria. Dyspnea, anxiety, and airway obstruction were reduced in the relaxation group while the control group remained the same or became worse.
Adult↗
Psychologic and physiologic aspects of acute dyspnea in asthmatics.
The purpose of this study was to compare psychologic and physiologic variables during intense dyspnea to those at times of no or low dyspnea in people with asthma. Thirty-six adults ranging from 19 to 76 years old were tested when they first came to the emergency department in acute dyspnea and again when they had no or low dyspnea just prior to discharge. Clinical signs found to be higher during high dyspnea than low dyspnea were respiratory rate, pulse, wheezing, and accessory muscle use. Peak expiratory flow rates and oxygen saturation were significantly lower, while anxiety, depression, somatization, and hostility were higher during times of high dyspnea. The panic/fear, fatigue, dyspnea, hyperventilation/hypocapnia, congestion, and rapid breathing subscales of the Asthma Symptom Checklist were also higher during high dyspnea compared to low dyspnea.
Adult↗
Visual analogue scales: measurement of subjective phenomena.
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Clinical Nursing Research↗
Coping in spouses of patients with acute myocardial infarction in Taiwan.
OBJECTIVE: The purpose of this study was to determine the usage and perceived effectiveness of coping strategies of spouses of patients with acute myocardial infarction in Taiwan, the Republic of China, during the acute phase of the illness. DESIGN: Survey. SETTING: Visitors room for a coronary care unit in Taiwan, the Republic of China. SUBJECTS: Twenty-one female and 10 male spouses of patients with acute myocardial infarction. OUTCOME MEASURES: The Revised Ways of Coping Scale was modified to assess both frequency of use and perceived effectiveness of coping strategies. It was also translated into Chinese. RESULTS: Seeking Social Support was the most frequently used coping strategy, whereas Confrontive Coping was used the least. There were significant positive relationships between the extent of usage of coping strategies and their perceived effectiveness. Men used Planful Problem-Solving more often and found it be more effective than did women; they also found the Self-Controlling and Accepting Responsibility strategies to be more effective than did women. Older spouses reported the Planful Problem-Solving strategy to be more effective than did younger subjects. The more family members living with a spouse, the less Accepting Responsibility was used as a coping strategy. CONCLUSIONS: Spouses of patients with acute myocardial infarction in Taiwan, the Republic of China, report using a variety of coping strategies. Those used most often are perceived to be the most effective.
Adaptation, Psychological↗
Depression in patients with COPD.
Patients with chronic obstructive pulmonary disease (COPD) can have an accompanying depression that interferes with nursing management and reduces patients' quality of life. Nurses need to understand more about that depression, how depression can be manifested and measured in older adults, and how depression in those with COPD differs from that seen in other chronic diseases. Self-report questionnaires can be used to identify depression initially and determine the need for further assessment. The DSM III-R criteria is recommended for those who wish to use a clinical evaluation tool. Treatment for the depression seen in COPD can include pharmacologic therapy and life changes, as well as individual and family therapies.
Adjustment Disorders↗