Individual breathlessness trajectories do not match summary trajectories in advanced cancer and chronic obstructive pulmonary disease: results from a longitudinal study

Palliative Medicine - Tập 24 Số 8 - Trang 777-786 - 2010
Claudia Bausewein1, Sara Booth2, Marjolein Gysels3, Robert Kühnbach4, B Haberland4, Irene J Higginson1
1Department of Palliative Care, Policy & Rehabilitation, Kings' College London, UK
2Addenbrooke's Hospital, UK
3Department of Palliative Care, Policy & Rehabilitation, Kings' College London, UK, Barcelona Centre for International Health Research, Universitat de Barcelona, Spain
4Interdisciplinary Centre for Palliative Medicine, Munich University Hospital, Germany.

Tóm tắt

Breathlessness is a distressing symptom in advanced disease. Little is known about the trajectories of this symptom over time and towards death. This study aimed to describe and compare the summary and individual trajectories of breathlessness and overall symptom burden over time and towards the end of life following patients with advanced cancer or severe chronic obstructive pulmonary disease (COPD) in inpatient and outpatient health care settings in Germany. The modified Borg Scale, Memorial Symptom Assessment Scale Short Form and Palliative Outcome Scale were used as outcome measures. Data were collected at baseline and then monthly over six months or until death. Forty-nine cancer and 60 COPD patients were included. Both groups had similar demographics. Thirty out of the 49 cancer and 6/60 COPD patients died, 7/49 cancer and 20/60 COPD patients dropped out due to physical deterioration or questionnaire fatigue. In cancer patients, breathlessness increased towards death. In COPD patients, breathlessness increased over time. Twenty-one cancer and 43 COPD patients provided data for individual breathlessness trajectories. These revealed wide individual variations with four different patterns: fluctuation, increasing, stable and decreasing breathlessness. Symptom trajectories on the population level reflecting the whole group mask individual variation, which is reflected in distinct symptom trajectories with different patterns.

Từ khóa


Tài liệu tham khảo

10.1016/j.jpainsymman.2005.06.007

10.1191/026921600701536192

Hansen-Flaschen J., 2004, Respir Care, 49, 90

10.1016/S0140-6736(06)69350-1

National Institutes of Health., 2004, National Institutes of Health state-of-the-science conference statement on improving end-of-life care

10.1001/jama.289.18.2387

10.1089/109662101753381593

10.1136/bmj.330.7498.1007

10.1177/0269216307076348

10.1002/pon.694

Burdon JGW, 1982, Am Rev Respir Dis, 126, 825

10.1378/chest.107.6.1590

10.1016/S0099-1767(00)90093-X

10.1164/ajrccm.153.5.8630595

10.1042/cs0800309

10.1007/s005200050254

10.1002/1097-0142(20000901)89:5<1162::AID-CNCR26>3.0.CO;2-Y

10.1016/j.jpainsymman.2008.07.006

10.1136/qshc.8.4.219

10.1111/j.1600-0447.1983.tb09716.x

10.1093/acprof:oso/9780195152968.003.0001

10.1097/01.NNR.0000270029.82736.5a

10.1081/COPD-200050655

Altman DG, 1991, Practical statistics for medical research

10.1016/j.jpainsymman.2003.11.009

Higginson IJ, 1992, J Public Health Med, 14, 50

10.1177/0269216306073112

10.1007/BF00435222

10.1016/j.rmed.2006.04.001

10.1016/S0147-9563(99)70044-0

10.1378/chest.89.2.234

10.1007/s00520-008-0477-2

10.1016/j.jpainsymman.2006.12.005

10.1002/cncr.20958

10.1016/j.jpainsymman.2008.03.008

10.1200/JCO.2006.08.7874

10.1164/rccm.200708-1290OC

Thông tin
Thông tin xuất bản

Palliative Medicine

Tập 24 Số 8

777-786

Thông tin tác giả