Measuring shortness of breath in heart failure (SOB-HF): development and validation of a new dyspnoea assessment tool.
ABSTRACT To validate a previously developed instrument for measurement of breathlessness in patients with acute heart failure (HF).
We tested descriptors of breathlessness among 190 patients seeking care at the emergency department (ED) for acute shortness of breath. Out of 115 patients with confirmed HF, 107 (94%) had dyspnoea as their main symptom. There were no significant differences between those patients with HF and those who were not diagnosed as heart failure (NHF) (n = 75) in the descriptors of breathlessness, although patients with HF scored significantly (P = 0.03) higher on a visual analogue scale (VAS). In addition, they had significantly (P = 0.03) higher breathing frequency than NHF patients and they were significantly (P < 0.001) more likely to be treated with >40 mg furosemide.
Assessment of acute dyspnoea using a VAS is useful in distinguishing HF from NHF, and may be a more valid approach as compared with using descriptors of intensity of breathlessness in the acute setting.
Article: Relaxing from dyspnoea.European Heart Journal 01/2014; · 14.72 Impact Factor
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ABSTRACT: In the assessment of dyspnea one has to take into account both the patient's own experience of the symptom and the clinicians observations of breathing rates, sounds and effort to get a complete picture. In addition, to choose appropriate treatment, the underlying cause of dyspnea needs to be assessed. While tools for clinical evaluation of heart failure have gained great interest in research and found a place in guidelines and clinical practice, the same cannot be said for instruments to assess patient self-reported dyspnea. To date, no specific dyspnea rating tool has been recommend over another. Reports from clinical practice are lacking and large; international studies in this field are warranted.Current Heart Failure Reports 06/2013;
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ABSTRACT: OBJECTIVES:The only treatment for celiac disease (CD) is life-long adherence to a gluten-free diet (GFD). Noncompliance is associated with signs and symptoms of CD, yet long-term adherence rates are poor. It is not known how the burden of the GFD compares with other medical treatments, and there are limited data on the socioeconomic factors influencing treatment adherence. In this study, we compared treatment burden and health state in CD compared with other chronic illnesses and evaluated the relationship between treatment burden and adherence.METHODS:Survey was mailed to participants with CD, gastroesophageal reflux disease (GERD), irritable bowel syndrome, inflammatory bowel disease, hypertension (HTN), diabetes mellitus (DM), congestive heart failure, and end-stage renal disease (ESRD) on dialysis. Surveys included demographic information and visual analog scales measuring treatment burden, importance of treatment, disease-specific health status, and overall health status.RESULTS:We collected surveys from 341 celiac and 368 non-celiac participants. Celiac participants reported high treatment burden, greater than participants with GERD or HTN and comparable to ESRD. Conversely, patients with CD reported the highest health state of all groups. Factors associated with high treatment burden in CD included poor adherence, concern regarding food cost, eating outside the home, higher income, lack of college education, and time limitations in preparing food. Poor adherence in CD was associated with increased symptoms, income, and low perceived importance of treatment.CONCLUSIONS:Participants with CD have high treatment burden but also excellent overall health status in comparison with other chronic medical conditions. The significant burden of dietary therapy for CD argues for the need for safe adjuvant treatment, as well as interventions designed to lower the perceived burden of the GFD.Am J Gastroenterol advance online publication, 1 July 2014; doi:10.1038/ajg.2014.29.The American journal of gastroenterology. 07/2014;