Evaluation of the Appropriate Washout Period Following Fan Therapy for Dyspnea in Patients With Advanced Cancer: A Pilot Study

• Published in: American journal of hospice & palliative medicine 2018-02, Vol.35 (2), p.293-296
• Main Authors: Kako, Jun, Morita, Tatsuya, Yamaguchi, Takuhiro, Sekimoto, Asuko, Kobayashi, Masamitsu, Kinoshita, Hiroya, Ogawa, Asao, Zenda, Sadamoto, Uchitomi, Yosuke, Inoguchi, Hironobu, Matsushima, Eisuke
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Dyspnea - etiology; Dyspnea - therapy; Face; Female; Humans; Leg; Male; Middle Aged; Neoplasms - complications; Nursing; Palliative Care - methods; Pilot Projects; Severity of Illness Index; Ventilation - methods
• ISSN: 1049-9091; 1938-2715
• DOI: 10.1177/1049909117707905

Objectives: To clarify the duration required for dyspnea to return to baseline severity after fan therapy, to evaluate whether fan-to-legs therapy or no fan therapy would be a suitable control therapy, and to investigate changes in patients’ face surface temperature after fan therapy. Methods: In this pilot study, all participants received 3 interventions in the following order: no fan, fan to legs, and fan to face. Participants used a fan for 5 minutes, and they scored their dyspnea at 10-minute intervals for 60 minutes or until the score had returned to its baseline value, whichever occurred first. Nine patients with advanced cancer admitted to a palliative care unit were included; they had dyspnea at rest and rated its severity as at least 3 points on a 0- to 10-point numerical rating scale. Descriptive statistics and the Wilcoxon signed rank test were used to analyze the data. Results: All patients completed the study. Of the 9 participants, 6 experienced a clinical benefit from using a fan to their faces. Of these patients, only 2 participants’ (2 of 6) dyspnea scores returned to baseline by the end of the 60-minute assessment period after exposure to fan-to-face therapy. In fan-to-legs and no fan settings, there was no change in the dyspnea scores. There were significant differences between the baseline face surface temperature and that after fan-to-face and fan-to-legs settings. Conclusion: When using a crossover design to investigate the effect of fan therapy on dyspnea, 1 hour is an insufficient washout period.