Is the Presence of Dyspnea a Risk Factor for Morbidity in Cancer Patients?

Data collected from six home palliative care teams in Ireland were analyzed to determine the prevalence of dyspnea in the population studied and to identify factors associated with the presence of dyspnea that might impact on future care. The prevalence of mild, moderate, or severe dyspnea, as measu...

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Bibliographic Details
Published in:Journal of pain and symptom management 2000, Vol.19 (1), p.15-22
Main Authors: Edmonds, Polly, Higginson, Irene, Altmann, Dan, Sen-Gupta, Georges, McDonnell, Maura
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Child
Child, Preschool
Dyspnea
Dyspnea - epidemiology
Dyspnea - etiology
Female
hospice
Humans
Male
Medical sciences
Middle Aged
Morbidity
Multiple tumors. Solid tumors. Tumors in childhood (general aspects)
Neoplasms - complications
palliative care
prevalence
Risk Factors
Tumors
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Summary:Data collected from six home palliative care teams in Ireland were analyzed to determine the prevalence of dyspnea in the population studied and to identify factors associated with the presence of dyspnea that might impact on future care. The prevalence of mild, moderate, or severe dyspnea, as measured by the Support Team Assessment Schedule (STAS), fell from 39% at referral in 327 evaluable patients to 23%. The presence of dyspnea at referral was positively correlated with severity of patient spiritual distress (Spearman ρ = 0.110, P = 0.042) and weakness (Spearman ρ = 0.105, P = 0.008) at referral. In analysis of contingency tables, dyspnea was also significantly associated with low patient (χ 2 9.5, P = 0.002) and family (χ 2 50.78, P < 0.001) well-being, high staff anxiety (χ 2 4.14, P = 0.04), male sex (χ 2 8.9, P = 0.003), a diagnosis of lung cancer (χ 2 59.88, P < 0.001), and dying in hospital rather than hospice or nursing home (χ 2 18.03, P = 0.001). In adjusting for covariates using a logistic regression analysis, however, only the presence of low family well-being, a diagnosis of lung cancer, and increased likelihood of a hospital death remained significantly associated with the presence of dyspnea at referral. These data suggest that the presence of dyspnea may be associated with increased family distress, which may influence place of death.
ISSN:0885-3924
1873-6513
DOI:10.1016/S0885-3924(99)00145-1