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Thomas, Loris A. "COPD dyspnea management by family caregivers". [Tampa, Fla.] : University of South Florida, 2004. http://purl.fcla.edu/fcla/etd/SFE0000541.
Pełny tekst źródłaMeek, Paula M. "The cognitive dimension of breathlessness". Diss., The University of Arizona, 1993. http://hdl.handle.net/10150/186540.
Pełny tekst źródłaGarske, Luke Albert. "Determinants of dyspnea associated with pleural effusion". Thesis, Queensland University of Technology, 2018. https://eprints.qut.edu.au/122900/1/Luke_Garske_Thesis.pdf.
Pełny tekst źródłaPELLEGRINO, GIULIA MICHELA. "LUNG FUNCTION AND DYSPNEA IN NEUROMUSCULAR DISEASES". Doctoral thesis, Università degli Studi di Milano, 2021. http://hdl.handle.net/2434/842435.
Pełny tekst źródłaBurke, Susan P. (Susan Patricia). "Dyspnea and the mechanics of breathing during progressive exercise". Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=57002.
Pełny tekst źródłaSubjects demonstrated two patterns of dyspnea response to changes in esophageal (pleural) pressure. All athletes, two normals and five patients were termed "low dyspnea responders", (LDR), whereas the remaining subjects were termed "high dyspnea responders", (HDR).
LDR demonstrated large, rapid negative gastric pressure swings, coupled with outward abdominal displacement during early inspiration when compared to HDR, suggesting that LDR utilized abdominal muscle relaxation at the onset of inspiration. This mechanism appears to provide an extra inspiratory force, contributing to the increasing pleural pressures required. This breathing pattern appears to diminish the sensation of dyspnea at a given pleural pressure.
Miura, Cinthya Tamie Passos 1983. "Adaptação cultural e validação do instrumento Modified Dyspnea Index". [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308903.
Pełny tekst źródłaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-16T05:22:23Z (GMT). No. of bitstreams: 1 Miura_CinthyaTamiePassos_M.pdf: 2254405 bytes, checksum: 18a9c2640fe77f3688ab765ee00381d3 (MD5) Previous issue date: 2010
Resumo: A dispnéia é um dos sintomas cardeais das doenças cardiovasculares, as quais constituem importante causa de morbi e mortalidade no mundo. A subjetividade desse sintoma dificulta sua quantificação acurada, levando ao desenvolvimento de questionários, como o Modified Dyspnea Index (MDI), com o objetivo de avaliar mais especificamente o sintoma. Objetivos: Este estudo teve como objetivo realizar a adaptação cultural do instrumento Modified Dyspnea Index para a língua portuguesa do Brasil; testar sua confiabilidade e sua validade convergente por meio da correlação com o esforço percebido (aplicação da Escala Modificada de Borg), avaliação da força muscular respiratória e avaliação da qualidade de vida relacionada à saúde (aplicação do questionário Minnesota Living with Heart Failure). Metodologia: O processo de adaptação cultural seguiu metodologia recomendada internacionalmente, com as etapas de tradução-retrotradução e avaliação, por comitê de juízes, das equivalências: semântica, idiomática, cultural/experimental, conceitual e metabólica. O Índice de Validade de Conteúdo foi utilizado para avaliar a proporção de concordância entre os juízes. Como se trata de instrumento para uso do profissional de saúde, foi desenvolvido e validado um roteiro para nortear a aplicação do MDI. A confiabilidade foi avaliada segundo o critério da equivalência inter-observador, com aplicação simultânea do instrumento por dois profissionais de saúde (fisioterapeuta e enfermeiro) a pacientes portadores de doença cardiovascular com queixa de dispnéia. A validade foi testada segundo o critério da validade convergente, por meio da correlação entre MDI e: Escala Modificada de Borg, qualidade de vida relacionada à saúde (versão brasileira do Minnesota Living with Heart Failure - LHFQ) e valores de Pressão inspiratória máxima (Pi máx) e Pressão expiratória máxima (Pe máx). Os instrumentos foram aplicados por um único pesquisador, sob forma de entrevista; em seguida, os pacientes foram submetidos à mensuração da Pe máx e Pi máx. A concordância entre os avaliadores independentes, junto a 31 pacientes, foi avaliada por meio do coeficiente Kappa e para o teste das correlações entre o MDI e demais medidas (n=151) foi empregado coeficiente de correlação de Spearman. Foi adotado p? 0,05 como nível de significância. Resultados: O MDI sofreu alterações de acordo com a avaliação da validade de conteúdo. Foi constatado elevado coeficiente de concordância entre os observadores quanto ao escore total do MDI (k= 0,960). Foi observada correlação negativa significativa, embora de pequena magnitude entre MDI e Escala de Borg Modificada (r= -0,29, p=0,0003) e entre MDI e Pi máx e Pe máx (r= 0,26, p=0,0001; e r= 0,28, p=0,0006; respectivamente). A correlação entre o MDI e a medida de qualidade de vida, entretanto, foi de forte magnitude, considerando-se o escore total do LHFQ e sua dimensão física (r= -0,53, p=<0,0001; r= -0,59, p=<0,0001, respectivamente); e de moderada magnitude com a dimensão emocional (r= -0,30, p=<0,0001). A adaptação do MDI para a cultura brasilleira foi realizada com rigor e a análise de sua confiabilidade e validade aponta fortes evidências de ser uma ferramenta útil para avaliação da dispnéia em pesquisa e na prática clínica.
Abstract: Dyspnea is an important symptom in cardiovascular diseases, which are important cause of morbidity and mortality worldwide. The subjectiveness of the symptom hampers its accurate quantification. Thus, questionnaires, as the Modified Dyspnea Index (MDI), have been developed in order to provide a more specific evaluation of the symptom. Objectives: The aim of this study were to cross-culturally adapt the instrument Modified Dyspnea Index for the Portuguese language of Brazil, to test its reliability and convergent validity by correlation of its scores with perceived exertion (Modified Borg Scale), respiratory muscle strength evaluation and assessment of health-related quality of life (Minnesota Living with Heart Failure). Methodology: The process of cultural adaptation followed rigorous methodology and included the steps of translation, back translation and evaluation of semantic, idiomatic, cultural and metabolic equivalence by a committee of experts. The Index of Content Validity was used to estimate the proportion of agreement among the judges. As the MDI is designed to be answered by health professionals based on an the evaluation of the patient, a User's Guide for administering the Brazilian-MDI in Portuguese was prepared, with purpose of standardizing its administration and rating. Reliability was assessed according to the criterion of inter-observer equivalence, evaluating the agreement between two health care providers (one nurse and one physiotherapist) regarding individual and total scores of patients with cardiovascular disease with dyspnea. Validity was tested according to the criterion of convergent validity, by the correlation between Brazilian-MDI and: Modified Borg Scale, health-related quality of life (Brazilian version of the Minnesota Living with Heart Failure - LHFQ) and maximal inspiratory (MIP) and maximal expiratory pressure (MEP). The instruments were interviewer- administered by a single researcher, due to the low educational level of the target population. Afterwards, the patients were submitted to the measurement of MIP and MEP. The agreement between the independent observers in 31 patients was evaluated with Kappa's coefficient; Spearman coefficients were used to test the correlations between Brazilian-MDI and the other measures (n=151). The significance level used was p <0.05. Results: Evaluation of the content validity resulted in the rewording of some sentences of the MDI. The coefficient of agreement between the independent observers was k = 0.960.The Brazilian-MDI was negatively and significant but weakly correlated to the Modified Borg Scale (r= -0.29; p=0.0003) and to the Brazilian-MDI and MIP and MEP measures (r= 0.26; p=0.0001 and r= 0.28; p=0.0006; respectively). However, the Brazilian-MDI was highly correlated to the scores of health-related quality of life, considering the LHFQ total score and the physical subscale, (r= -0.53, p=<0.0001; r= -0.59, p=<0.0001, respectively); and the emotional domain (r= -0.30; p=<0,0001). The adaptation of the MDI for use in a Brazilian population has been undertaken with rigor and the tests of its reliability and validity points to strong evidences of being a useful tool for use in research and clinical settings in evaluating dyspnea.
Mestrado
Enfermagem e Trabalho
Mestre em Farmacologia
Park, Soo Kyung. "The dyspnea experience in Korean immigrants with asthma and COPD". Diss., Search in ProQuest Dissertations & Theses. UC Only, 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3378502.
Pełny tekst źródłaGrant, Christina L. "Anxiety sensitivity and subjective feelings of dyspnea in asthmatic children". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq20829.pdf.
Pełny tekst źródłaBalen, Frédéric. "Evaluation précoce de la dyspnée aiguë de l'adulte en médecine d'urgence". Electronic Thesis or Diss., Université de Toulouse (2023-....), 2024. http://www.theses.fr/2024TLSES060.
Pełny tekst źródłaAcute dyspnea is a subjective symptom perceived by the patient as a "sensation of respiratory discomfort" that has been evolving for less than two weeks. Dyspnea is a symptom of cardiorespiratory failure. The range of diagnoses to be considered is vast. The most serious pathologies frequently encountered in emergency medicine are bacterial pneumoniae (18 to 25%), acute heart failure (18 to 24%), exacerbation of Chronic Obstructive Pulmonary Disease (COPD) (16 to 18%), acute asthma (10 to 11%) and pulmonary embolism (1%). Dyspnea is an important symptom for emergency medicine, in all its aspects (telephone regulation and out-of-hospital and in-hospital management). In fact, it is a frequent reason for referral to out-of-hospital and in-hospital emergency services, the diagnostic process is complex and error-prone, and in-hospital mortality is high (5 to 15%). The objectives of this study are to identify the most severe patients as soon as they call for help, then to identify patients at risk of inappropriate treatment for the diagnosis of their dyspnea, and to propose tools to reduce the rate of inappropriate treatment. In order to identify the most severe patients from the time of the telephone call, we set up a retrospective cohort of 1387 patients aged over 15 years who contacted emergency services (call to the "112"/"911") for dyspnea from July 1, 2019 to December 31, 2019 and were admitted to the emergency department or died before admission. Two hundred and eight (15%) required early respiratory support. Factors predictive of the need for early respiratory support that could be identified on call were: having background ß2-mimetic therapy, polypnoea, inability to speak, cyanosis, sweating and altered consciousness. It seems relevant to investigate these elements during first call for help, in order to adapt the rescue resources to be engaged. In order to identify patients at risk of inappropriate treatment for the diagnosis of their dyspnea, we set up a retrospective cohort of 2123 patients aged over 15 admitted to an emergency department for dyspnea from July 1, 2019 to December 31, 2019. Eight hundred and nine (38%) had inappropriate treatment of the final diagnosis of their dyspnea, compared with internationally recommended treatments. Risk factors for inappropriate treatment were: age over 75, cardiac or respiratory history, SpO2 < 90%, pulmonary auscultation finding bilateral crackles, a crackle focus or wheezing. This population should be the subject of further studies to reduce the rate of inappropriate treatment. We also studied the diagnostic performance of lung ultrasound (LUS) in the early diagnosis of elderly patients (over 65) admitted to the emergency department for dyspnea. The prospective cohort recruited 116 patients. The performance of LUS, available immediately at the patient's bedside, was comparable to the usual strategy (including clinical examination and laboratory results) available at 2 hours, for the diagnosis of heart failure and pneumopathy. The use of LUS should make it possible to approach the final diagnosis at an early stage, and perhaps reduce inappropriate treatment. We propose a future research protocol on this topic. Dyspnea represents an important challenge for emergency medicine. Our current and future work should enable us to optimize pre-hospital and in-hospital management
Steele, Bonnie Gail. "Dimensions of dyspnea in chronic obstructive pulmonary disease : a nociceptive model /". Thesis, Connect to this title online; UW restricted, 1991. http://hdl.handle.net/1773/7347.
Pełny tekst źródłaWebel, Allison R. "Thirty-day analysis of dyspnea and edema in heart failure subjects". Connect to this title online, 2004. https://kb.osu.edu/dspace/handle/1811/176.
Pełny tekst źródłaTitle from first page of PDF file. Document formatted into pages; contains 31 p.; also includes graphics. Includes bibliographical references (p. 22-23). Available online via Ohio State University's Knowledge Bank.
Decavèle, Maxens César. "Caractérisation de la réponse émotionnelle à la dyspnée : des corrélats observationnels physio-cliniques à la reconnaissance des expressions faciales". Electronic Thesis or Diss., Sorbonne université, 2024. http://www.theses.fr/2024SORUS026.
Pełny tekst źródłaMuch worse than pain, dyspnea in intensive care unit (ICU) patients receiving mechanical ventilation is a major cause of suffering, conveying a terrifying sensation of an asphyxial threat, without being able to control it (powerlessness), or escape it, or even report it to caregivers (helplessness). It participates independently in the onset of post-traumatic stress syndrome in survivors of ICU stay. The lack of attention paid by caregivers to patients' dyspnea and the difficulty patients have in communicating their symptoms with caregivers are at the origin of a crucial care issue, conceptualized under the term "invisibility" of dyspnea, which remains an under-assessed and an under-treated suffering in daily practice. This science thesis proposes a transversal approach to observing the respiratory suffering of “another person” in order to provide elements of response to the problem of the invisibility of patients' dyspnea. An educational approach suggests that caregivers' level of empathy influences their ability to feel what patients are experiencing and to estimate the intensity of patients' dyspnea. A clinical approach allowed the development and validation of an observational dyspnea scale, the MV-RDOS, making it possible to strongly suspect dyspnea in noncommunicative, mechanically ventilated patients. Finally, in a fundamental approach, these investigations provide an original description of the facial expressions associated with dyspnea as well as an intelligent method for automatic facial recognition of the main facial expressions of dyspnea. This thesis work opens avenues for developing tools for continuous monitoring of respiratory suffering in the ICU in order to restore the “visibility” of dyspnea and better relieve it
Rossi, Stephanie. "COPD patients responding to Tiotropium with dyspnea relief: a proof of efficacy?" Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=66898.
Pełny tekst źródłaLes caractéristics des patients MPOC qui répondent au tiotropium par un soulagement de dyspnée Rossi, S., Baril, J., Gladis, C., Perrault, H. et Bourbeau, J., Épidémiologie respiratoire et Unité de recherches cliniques, Institut thoracique de Montréal, Université McGill, Montréal, Québec, Canada. Introduction : Notre pratique en matière de prescription est basée essentiellement sur le soulagement de dyspnée exprimé par le patient. Objectif : Évaluer si les patients MPOC qui ont rapporté un soulagement de dyspnée, « répondeur tiotropium », fournissent une réponse semblable sur la tentative répétée du traitement, et examiner les causes déterminantes physiologiques de la réponse. Méthode : La période de deux traitements (deux semaines chacun) randomisés (TIO ou placebo) à double anonymat croisé, en utilisant des patients caractérisés en tant que « répondeur » basé sur leurs rapports individuels de soulagement dyspnée et de la diminution d'un point sur le TDI après la période initiale d'élimination de deux semaines. Les patients prenaient Atrovent® et continuaient leur médicament habituel excepté le TIO. La capacité pulmonaire totale (TLC) et la capacité inspiratoire (IC) ont été obtenues au repos (hyperinflation statique) tandis que l'IC, la fréquence de respiration (BF), le volume courant (VT), la ventilation (VE), et les pointages de dyspnée de Borg ont été obtenus pendant effort constant à 40 % et à 75 % de puissance maximale pour les deux traitements. Le test t pour échantillons appariés et une analyse non-paramétrique ont été faites sur tous les résultats physiologiques contre les pointages de dyspnée évaluée par le TDI et le CRQ à chaque visite. Résultats : Des 21 patients recrutés, 7 patients (± 69 7 ans; FEV1 33 que le ± 15 % pred) ont lâché en raison de la détérioration des symptômes respiratoires pendant la période d'élimin
Halank, Michael, Christiane Jakob, Martin Kolditz, Gerd Höffken, Utz Kappert, Gerhard Ehninger i Matthias Weise. "Intimal Pulmonary Artery Sarcoma Presenting as Severe Dyspnea and Right Heart Insufficiency". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-134918.
Pełny tekst źródłaHintergrund: Das Pulmonalarteriensarkom ist eine seltene Erkrankung mit einer schlechten Prognose. Fallbericht: Wir berichten über einen 64-jährigen Mann mit einem intimalen Pulmonalarteriensarkom, der sich mit starker Luftnot trotz hoher Sauerstoffsubstitution und einem Gewichtsverlust von 12 kg in den letzten 6 Monaten vorstellte. Echokardiographisch fielen eine Rechtsherzinsuffizienz, ein deutlich erhöhter rechtsventrikulärer Druck, ein Druckgradient über dem rechten Ausflusstrakt und eine Tumormasse im Bereich des Trunkus pulmonalis mit Kontakt zur Gefäßwand auf. Die mittels Echokardiographie erhobene Verdachtsdiagnose lautete Pulmonalarteriensarkom. Die Computertomographie des Thorax und die 18-Flur-Desoxyglukose-Positron-Emissionstomographie erbrachten den Befund eines lokal fortgeschrittenen Tumors. Die chirurgische Resektion des Tumors, die zur Verbesserung der Hämodynamik durchgeführt wurde, bestätigte die Diagnose. Schlussfolgerungen: Das Pulmonalarteriensarkom sollte differenzialdiagnostisch als eine seltene Ursache der Luftnot im Rahmen einer Rechtsherzinsuffizienz, insbesondere bei zusätzlichem Gewichtsverlust, in Erwägung gezogen werden. Die Echokardiographie stellt eine wertvolle initiale Untersuchungsmethode bei der Diagnosestellung dar
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich
Marines-Price, Rubria. "Sensory and Affective Dimensions of Dyspnea on Exertion in Young Obese Women". Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/595631.
Pełny tekst źródłaPEARSON, SHERIDAN LEIGH. "SPEAKING DYSPNEA: EFFECT OF BREATHING DISCOMFORT ON SPEAKING IN PEOPLE WITH COPD". Thesis, The University of Arizona, 2016. http://hdl.handle.net/10150/613387.
Pełny tekst źródłaHalank, Michael, Christiane Jakob, Martin Kolditz, Gerd Höffken, Utz Kappert, Gerhard Ehninger i Matthias Weise. "Intimal Pulmonary Artery Sarcoma Presenting as Severe Dyspnea and Right Heart Insufficiency". Karger, 2010. https://tud.qucosa.de/id/qucosa%3A27604.
Pełny tekst źródłaHintergrund: Das Pulmonalarteriensarkom ist eine seltene Erkrankung mit einer schlechten Prognose. Fallbericht: Wir berichten über einen 64-jährigen Mann mit einem intimalen Pulmonalarteriensarkom, der sich mit starker Luftnot trotz hoher Sauerstoffsubstitution und einem Gewichtsverlust von 12 kg in den letzten 6 Monaten vorstellte. Echokardiographisch fielen eine Rechtsherzinsuffizienz, ein deutlich erhöhter rechtsventrikulärer Druck, ein Druckgradient über dem rechten Ausflusstrakt und eine Tumormasse im Bereich des Trunkus pulmonalis mit Kontakt zur Gefäßwand auf. Die mittels Echokardiographie erhobene Verdachtsdiagnose lautete Pulmonalarteriensarkom. Die Computertomographie des Thorax und die 18-Flur-Desoxyglukose-Positron-Emissionstomographie erbrachten den Befund eines lokal fortgeschrittenen Tumors. Die chirurgische Resektion des Tumors, die zur Verbesserung der Hämodynamik durchgeführt wurde, bestätigte die Diagnose. Schlussfolgerungen: Das Pulmonalarteriensarkom sollte differenzialdiagnostisch als eine seltene Ursache der Luftnot im Rahmen einer Rechtsherzinsuffizienz, insbesondere bei zusätzlichem Gewichtsverlust, in Erwägung gezogen werden. Die Echokardiographie stellt eine wertvolle initiale Untersuchungsmethode bei der Diagnosestellung dar.
Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
Harper, Megan. "Mechanisms of exertional dyspnea in postsurgical patients with non-small cell lung cancer". Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/55676.
Pełny tekst źródłaGraduate Studies, College of (Okanagan)
Graduate
Rycroft, Ashley McLean. "Development of a constant rate step test to assess exertional dyspnea in the primary care setting in patients with chronic obstructive pulmonary disease (COPD)". Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=112359.
Pełny tekst źródłaMethods. This test involved 4 stepping rates (18, 22, 26, 32 steps.min-1) equivalent to approximately 4.5, 5.3, 6.0, and 7.2 MET with the ultimate goal that in its final development, the assessment will be made a single stepping rate based on disease severity. Stable COPD patients (N = 43; 65 +/- 6.5 years; FEV1 = 49 +/- 16% pred.; SpO2 (%) rest: 95 +/- 2) were equipped with a portable Jaeger Oxycon MobileRTM metabolic system and followed an audio signal for stepping up and down a single 20 cm step for 3 minutes. Borg dyspnea scores were obtained at the end each stepping bout. A 10-min rest was given between each stepping bout.
Results. Of the 43 patients, 80% completed stages 1 and 2, 74 and 37% stages 3 and 4 while no patient of MRC class 4 or 5 (N = 8) completed stage 1. Breathing frequency (breaths.min-1) spanned from 26.5 +/- 4.1 to 39.0 +/- 6.4 but VT (L) remained unchanged (1.4 +/- 0.3 vs. 1.5 +/- 0.4) from stage 1 to 4 while Borg scores were 3 +/- 1, 4 +/- 1, 5 +/- 2, 6 +/- 3 respectively and SpO2 (%) were 92 +/- 5, 91 +/- 4, 91 +/- 4 and 90 +/- 4.
Conclusions. Preliminary findings indicate that a 3-minute constant rate step test may present a feasible alternative to laboratory testing to assess exertional dyspnea in moderately severe COPD. In this population, a stepping rate of 26 steps.min-1 could be sustained by the majority of patients while producing a level of dyspnea potentially amenable to therapy.
This study was supported by an unrestricted grant from Boehringer-Ingelheim/Pfizer.
Henophy, Sara Catherine 1983. "Test-re-test reproducibility of constant rate step and shuttle walking tests for the assessment of exertional dyspnea in patients with chronic obstructive pulmonary disease (COPD)". Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=116085.
Pełny tekst źródłaMethods: Stable COPD patients (N=43; 65 +/- 6.5 years; FEV1 = 49 +/- 16% pred.) equipped with a portable Jaeger Oxycon MobileRTM metabolic system repeated the walking or stepping tests on two occasions separated by 7 to 14 days. At each visit, participants performed, in a randomized order, four externally paced 3-min bouts of shuttle walking at speeds of 1.5, 2.5, 4.0 and 6.0 km·h-1 or of stepping at a constant rate of 18, 22, 26 and 32 steps·min-1, respectively. Each exercise bout was separated by a 10-min rest period. Ventilation, heart rate, gas exchange parameters and Borg dyspnea score were obtained for each bout during the last 30-seconds of exercise.
Results: The majority of patients completed stepping or walking at the slowest cadence but only 33% completed walking at 6.0 km·h -1 and 40% completed stepping at 32 steps·min-1. Test-retest Pearson correlation coefficients for ventilation, heart rate, gas exchange parameters and dyspnea scores over the four exercise bouts, all exceeded 0.80 with the highest coefficient found for ventilation (r≥.95). Intra-class correlation coefficients were similar to Pearson. Bland & Altman representation showed that a similar proportion of dyspnea data points (92 vs. 96%) lied within 2 SD of the mean difference between test-retest values for dyspnea Borg scores during walking and stepping.
Conclusion: Results show very good reproducibility for both 3-min shuttle walking and stepping exercise protocols in patients with COPD.
This study was supported by an unrestricted grant from Boehringer-Ingelheim/Pfizer.
Henoch, Ingela. "Dyspnea experience and quality of life : among persons with lung cancer in palliative care /". Göteborg : Institute of Health and Care Sciences, Sahlgrenska Academy at Göteborg University, 2007. http://hdl.handle.net/2077/887.
Pełny tekst źródłaTakeda, Tomoshi. "Relationship between Small Airway Function and Health Status, Dyspnea and Disease Control in Asthma". Kyoto University, 2010. http://hdl.handle.net/2433/120545.
Pełny tekst źródłaHajiro, Takashi. "Analysis of clinical methods used to evaluate dyspnea in patients with chronic obstructive pulmonarydisease". Kyoto University, 2001. http://hdl.handle.net/2433/150187.
Pełny tekst źródłaSchaeffer, Michele. "Physiological mechanisms of sex differences in exertional dyspnea: role of neural respiratory motor drive". Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=119732.
Pełny tekst źródłaLa dyspnée, définie comme la conscience d'une augmentation de gêne respiratoire, est souvent connu pendant l'activité physique chez les sujets sains ainsi que chez les patients ayant une maladie cardio-pulmonaire. Il est bien établi que l'intensité de la dyspnée perçue est systématiquement plus élevée au cours de l'exercice chez les femmes en bonne santé par rapport aux hommes, indépendamment de l'âge, de la taille et du poids. Cependant le/les mécanisme(s) de cette différence sont mal compris et la clarification de ceux-ci comportent l'objet principal de la thèse en question.Comparativement aux hommes, les femmes ont de plus petits poumons, des voies respiratoires plus étroites et des muscles respiratoires plus faibles. Ces différences anatomiques se manifestent par de plus grandes contraintes mécaniques sur la ventilation, en particulier pendant le stress de l'exercice lorsque les besoins ventilatoires sont élevés. Par conséquent, le travail que les muscles respiratoires doivent effectuer afin de déplacer un volume défini d'air dans les poumons pendant l'exercice est considérablement plus élevé chez les femmes que chez les hommes. En raison de ces différences, nous prévoyons que le système nerveux central doit activer les muscles respiratoires (notamment le diaphragme) dans une plus grande mesure chez les femmes pour atteindre le même niveau de ventilation et que cette activation supérieure peut expliquer la perception accrue de la dyspnée liée à l'activité chez les femmes. Même s'il n'est pas possible de mesurer directement les signaux envoyés par le centre de contrôle respiratoire chez l'homme, le contrôle moteur de la respiration peut être évalué indirectement en quantifiant l'électromyogramme du diaphragme crural (EMGdi) en utilisant un cathéter à électrode spécialisée placée dans l'oesophage d'un individu. À ce jour, aucune étude n'a examiné si la combinaison de contraintes ventilatoires mécaniques plus grandes et d'un EMGdi plus élevé pendant l'exercice chez les femmes est responsable des différences de sexe dans la dyspnée liée à l'activité. Nous avons donc comparé des évaluations détaillées de EMGdi, de fonction musculaire respiratoire, de ventilation, de modèle de respiration, de volumes pulmonaires opérationnels, de fonction cardio-métabolique, et d'intensité de la dyspnée et des cotes de désagréments lors de tests d'exercice incrémental de vélo dans 25 jeunes (20-40 yrs) femmes saines et 25 hommes sains du même âge. Nos résultats démontrent des contraintes mécaniques sur l'expansion du volume courant pendant l'exercice plus fortes chez les femmes par rapport aux hommes. La présente étude est la première à démontrer que les mesures de cathéter à électrodes œsophagiennes dérivés de EMGdi étaient systématiquement plus élevés peu importe le niveau de ventilation au cours de l'exercice chez les femmes par rapport aux hommes et que ces différences reflètent, en grande partie, la présence de contraintes ventilatoires mécaniques dynamiques relativement plus grande chez les femmes. En accord avec les résultats d'études antérieures, l'intensité sensorielle et le désagrément de dyspnée ont été supérieurs à n'importe quelle ventilation donnée au cours de l'exercice sous-maximal chez les femmes par rapport aux hommes. Cependant, contrairement à notre hypothèse a priori, ces différences de perception ne peuvent être facilement expliquées par un plus grand découplage neuromécanique du système respiratoire et reflètent la conscience d'une EMGdi relativement élevée (ou moteur d'entraînement respiratoire neural central) nécessaire pour atteindre une ventilation donnée pendant l'exercice dans le cadre de contraintes ventilatoires mécaniques dynamiques plus grande chez les femmes. Ces résultats pourraient avoir des implications dans notre compréhension des mécanismes de différences de sexe dans la dyspnée liée à l'activité dans les variantes de la santé et chez les patients ayant une maladie cardio-pulmonaire.
Sundström, Robert, i Jesper Forsell. "Sjuksköterskans omvårdnadsåtgärder för patienter med andningssvikt i slutenvården : en litteraturöversikt". Thesis, Sophiahemmet Högskola, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-3607.
Pełny tekst źródłaBackground Respiratory insufficiency is a condition that is caused by problems related to the gas exchange that occurs in the body. Respiratory insufficiency is caused by numerous respiratory diseases like asthma and chronic obstructive pulmonary disease. Patients with respiratory insufficiency often experience an accompanied suffering and may need incare hospital care. Nurses’ professional responsibility therefore includes nursing care for the symptom of the condition such as dyspnea, and a work towards alleviating the patients suffering. Aim The aim of this literature review was to highlight nursing care towards adult patients with identified respiratory insufficiency within incare hospital setting. Method The applied method was a literature review. A search was performed in the bibliographic databases PubMed and CINAHL, and 15 articles was included in the literature review. These articles were reviewed by the authors separately and together. Quantitative and qualitative articles were included, both kinds were analyzed with the method integrated analysis according to Kristensson (2014). Results The data analysis resulted in three categories. These were “Nurses’ condition for good identification and assessment of respiratory insufficiency”, “Documentation of respiratory insufficiency” and “nursing interventions in respiratory insufficiency”. The results showed that nurses have inadequate knowledge about respiratory insufficiency, don’t use evidence-based interventions and underestimate the level of dyspnea among patients. Nursing care was improved with assessments in regularity, documentation requirements, or with the use of measuring instruments or protocols. Conclusions Assessment is an important aspect in nursing care for respiratory insufficiency and should be performed regularly and in liaison with care. There is a broad variety of assessment tools and protocols, and they improve nursing care for patients with respiratory insufficiency. These tools are cheap, easy to use and can lead to a sustainable environment in healthcare.
Woo, Kevin Y. "The relationships between dyspnea, physical activity, and fatigue in patients with chronic obstructive pulmonary disease". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq28794.pdf.
Pełny tekst źródłaAloush, Sami Mohammad. "Predictors of Exercise Tolerance, Severity of Dyspnea and Quality of Life in Pulmonary Rehabilitation Patients". Case Western Reserve University School of Graduate Studies / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=case1372853967.
Pełny tekst źródłaLiou, Chiou-Fang. "The Role of Anxiety in the Relationship between Breathing Effort and Cancer-Related Dyspnea Sensation". Case Western Reserve University School of Graduate Studies / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=case1196435748.
Pełny tekst źródłaMorris, Jason. "Non‐invasive testing to determine cardiac or non‐cardiac etiology of dyspnea in the ED". Thesis, The University of Arizona, 2014. http://hdl.handle.net/10150/315906.
Pełny tekst źródłaObjectives: There were two main objectives of this study. The first was to determine the diagnostic threshold of hemodynamic values derived from impedance cardiography (ICG) and whether these thresholds are sex specific in determining the etiology of shortness of breath (dyspnea) in patients presenting to the emergency department (ED). The second was to compare ICG hemodynamic values with the results of bedside cardiothoracic ultrasonography and B-type natriuretic peptide (BNP) levels in patients with dyspnea in the ED. Methods: A prospective cohort of 50 adult patients presenting to the Maricopa Medical Center ED with dyspnea were evaluated using ICG, bedside cardiothoracic ultrasound, and BNP to determine the etiology of their complaint. The final etiology was determined through review of the treating practitioner’s final diagnosis and evaluation of the data available from the patient’s ED visit. Cardiac and non-cardiac groups were then compared to determine the accuracy, sensitivity, and specificity of ICG, bedside cardiothoracic ultrasound and BNP in identifying the etiology of their complaint. Results: BNP at a threshold of 164 pg/mL proved to be the most accurate with a sensitivity of 84.21%, a specificity of 79.17% and an area under the curve (AUC) of 0.8684 when plotted on a receiver operating characteristics (ROC) curve. Right ventricle diameter during systole was the most accurate bedside ultrasound parameter; at a threshold of 1.71 cm it showed a sensitivity of 77.78%, a specificity of 60.00% and an AUC of 0.7489. Heather index (HI) was the most accurate ICG parameter; at a threshold of 9.2 Ohm/sec2 it showed a sensitivity of 72.41%, a specificity of 85.00%, and an AUC of 0.8405. Only HI showed a significant difference between male and female patients. HI in females at a threshold of 10.4 Ohm/sec2 was 87.50% sensitive and 87.50% specific with an AUC of 0.9297. In males a HI threshold of 6.9 Ohm/sec2 was 69.23% sensitive and 66.67% specific with an AUC of 0.7564. Conclusion: Bedside cardiac ultrasound was technically challenging and the least accurate modality. ICG demonstrated some sex specific thresholds and while an easy to use modality, it was slightly less accurate than BNP which proved to be a simple and accurate modality for determining a cardiac or non-cardiac etiology of dyspnea.
Newton, Phillip J. "The management of dyspnoea in advanced heart failure". Thesis, View thesis, 2008. http://handle.uws.edu.au:8081/1959.7/35551.
Pełny tekst źródłaBeaumont, Marc. "Effet de l'entraînement des muscles inspiratoires sur la dyspnée chez des patients atteints de BPCO, en réhabilitation respiratoire". Thesis, Brest, 2017. http://www.theses.fr/2017BRES0044/document.
Pełny tekst źródłaDuring a pulmonary rehabilitation program (PRP) in COPD patients, French and international respiratory societies recommend to include inspiratory muscles training (IMT) in patients with an objective inspiratory muscles weakness. This recommendation follows upon a meta-analysis which suggests that IMT would be beneficial when the maximal Inspiratory pressure (PImax) is lower than 60 cm H2O. IMT improves the strength and the endurance of the inspiratory muscles, the exercise capacity and the dyspnea. In the last meta-analysis, the authors specifies that, when IMT is associated to a PRP, it is not certain that IMT improves more the dyspnea compared with a PRP alone.The initial question of this work is: does IMT during a PRP allow decreasing more the dyspnea than a PRP alone?In the first randomized controlled trial, we show that during a PRP, IMT in COPD patients with normal inspiratory muscles strength does not improve more the dyspnea, compared to a PRP alone. However, an analysis in sub-groups tends to show that in severe or very severe COPD patients (VEMS < 50 % of predictive value), IMT would allow a higher improvement of the dyspnea.The second study is the most important randomized controlled trial about the effect of IMT on the dyspnea during pulmonary rehabilitation. In this study we used three different tools to estimate the dyspnea of the patients, of which the multidimensional Dyspnea Profile questionnaire (MDP). We show that IMT added to a PRP does not improve significantly more dyspnea compared to a PRP alone. So the clinical interest of IMT during a PRP seems questionnable
Nelson, Christy L. "Branched-chain amino acid nutrition and respiratory stability in premature infants". free to MU campus, others may purchase free online, 2002. http://wwwlib.umi.com/cr/mo/preview?3074432.
Pełny tekst źródłaNewton, Phillip J. "The management of dyspnoea in advanced heart failure". View thesis, 2008. http://handle.uws.edu.au:8081/1959.7/35551.
Pełny tekst źródłaA thesis submitted to the University of Western Sydney, College of Health and Science, School of Nursing in fulfilment of the requirements for the degree of Doctor of Philosophy. Includes bibliographical references.
Luketic, Jamie Eileen. "THE EFFECT OF INSPIRATORY MUSCLE STRENGTH TRAINING ON VENTILATION AND DYSPNEA DURING SIMULTANEOUS EXERCISE AND SPEECH". Miami University / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=miami1177035858.
Pełny tekst źródłaDangers, Laurence. "Application du principe de contre-irritation à l'étude des mécanismes neurophysiologiques de la dyspnée : de la physiologie à la thérapeutique". Thesis, Paris 6, 2016. http://www.theses.fr/2016PA066132/document.
Pełny tekst źródłaDyspnea – pain counter – irritation, namely the inhibition of nociceptive sensation by dyspneic sensation, indicates that dyspnea and pain share some mechanisms. Dyspnea of the work/effort type inhibits the spinal flexion reflex, meaning that it involves C-Fibers. This thesis aims at improving knowledge in this field. It shows that dyspnea of the air hunger type has analgesics properties proceeding from central mechanisms: “air hunger” indeed inhibits laser evoked potentials that depends on the pain-related activation of cortical networks. It also evaluates the effect of a non-opioid first step analgesic, nefopam, on an experimental dyspnea of the “work-effort” type, and shows that although nefopam acts on C-fibers, it does not attenuate dyspnea and does not modify dyspnea-pain counter-irritation as evaluated by laser-evoked potentials. Finally, the thesis brings the first evidence of dyspnea-pain interactions in the clinical setting, by showing that ALS patients treated by non-invasive ventilation exhibit heightened pain sensitivity concomitant to the relief of dyspnea. These data advance the current understanding of dyspnea mechanisms and open new perspectives for treatment evaluation
Suzuki, Masao. "A Randomized, Placebo-Controlled Trial of Acupuncture in Patients With Chronic Obstructive Pulmonary Disease (COPD): the COPD-Acupuncture Trial (CAT)". Kyoto University, 2015. http://hdl.handle.net/2433/202643.
Pełny tekst źródłaChouihed, Tahar. "Identification des profils congestifs de l'insuffisance cardiaque aiguë pour guider les stratégies diagnostiques et thérapeutiques de prise en charge en urgence". Thesis, Université de Lorraine, 2018. http://www.theses.fr/2018LORR0065/document.
Pełny tekst źródłaAcute dyspnea due to pulmonary congestion in acute heart failure (AHF) is a common reason for admission to the ER. Currently, AHF is twice as common and associated with a twofold higher risk of death (8%) than acute coronary syndromes (ACS). Pre-hospital and emergency care has become the cornerstone of care of these patients. In recent years, new paradigms have emerged surrounding AHF management, highlighting the complexity of this disease. Hence the use of the term acute heart failure syndrome (AHFS), a terminology underscoring the plurality of clinical situations and the diversity of congestive profiles. However, the assessment of congestion distribution during an AHFS is currently predominantly based on clinical arguments in spite of limited data. Alternatively, lung ultrasound (LUS) and estimation of plasma volume (ePVS, based on hemoglobin and hematocrit) could allow for a better assessment of congestive profiles. Several studies report that the rapid and accurate etiological diagnosis of acute dyspnea is associated with prognosis. Despite the availability of diagnostic tools including clinical exam, biomarkers and radiology, there is still considerable uncertainty regarding etiological diagnosis in the emergency department (ED) setting, hence rendering it difficult in reducing the « Time to therapy » advocated by the recommendations of the European Cardiology Society 2016 for AHF. The objectives of the present work were to identify distinct congestion profiles of AHF, to clarify the diagnostic and prognostic value of these profiles in the context of acute dyspnea, and to determine whether the therapeutic effect of initial emergency management modalities is dependent on these congestive profiles. In the course of our work, we were able to demonstrate in the DeFSSICA cohort that the tools allowing a better assessment of the patient's congestive profile (particularly LUS and ePVS) are rarely used in ED. In a second study, we showed in the PARADISE cohort (NCT02800122) - designed as part of this PhD research project - that impaired renal function, hyponatremia and dysglycemia are significantly associated with prognosis in patients with acute dyspnea. In a third study, we showed that the ePVS is an effective AHF diagnostic tool and that a higher congestion level assessed by ePVS is associated with higher in-hospital mortality of patients admitted for acute dyspnea. Our work also enabled us to design and initiate the PURPLE (Pathway and Urgent caRe of dyspneic Patients at the emergency department in LorrainE district - NCT03194243) study, which collects clinical and paraclinical data of patients admitted for acute dyspnea on a prospective basis. Lastly, this PhD research project enabled designing and obtain funding for the EMERALD-US project (Evaluation of the feasibility of implementing and performance of an Emergency Echography algorithm for the diagnosis of Acute Dyspnea-UltraSound) which aims to validate an original algorithm specific to emergency situations using lung, cardiac and vascular ultrasound for the etiological diagnosis of acute dyspnea
Simsic, Aline Aparecida. "Tradução e validação da escala Dyspnoea-12 para o português falado no Brasil em pacientes com DPOC e hipertensão pulmonar". Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/17/17138/tde-30032017-135743/.
Pełny tekst źródłaObjective: To translate and to adapt for the Portuguese spoken in Brazil the scale Dyspnoea-12. To obtain validation data, regarding the use of this scale in patients with COPD and pulmonary hypertension (PH). Methods: The English version of the scale Dyspnoea-12 received a formal translation process and the final version was called Dispneia-12-Pt. The latter was applied to 51 COPD patients (33 men; age: 66.4±8.1 years; FEV1: 48.7±17.2 % pred) and 15 subjects with PH from different etiologies (12 women; age: 45.8±12.7 years; systolic pulmonary arterial pressure: 88±33.2 mmHg). The volunteers also answered the Medical Research Council dyspnea scale (MRC), the basal dyspnea index (DBI), the hospital scale of anxiety and depression, the Saint George Respiratory Questionnaire (SGRQ), respiratory functional evaluation and the six minute walk test (6 MWT). Sixty volunteers also answered the Dispneia-12-Pt scale about two weeks after the first evaluation. Results: In the COPD group the Dispneia-12-Br showed significant correlations with the scales MRC (r=0.4641; p=0.0006), BDI (0.515; p<0.0001), SGRQ (r=0.8113; p<0.0001), anxiety (r=0.4714; p=0.0005), depression (0.4139; p=0.0025) and walked distance in the 6 MWT (r=0.3293; p= 0.0255). In the HP group the scale showed significant correlations with the scales MRC (r=0.5774; p=0.0005), SGRQ (r=0.6907; p=0.0044), walked distance in the 6 MWT (0.7193; p=0.0025) and carbon dioxide diffusion capacity (r=0.564; p=0.0447). Cronbach´s alpha calculated for all volunteers evaluated as a whole was 0.927 while the intraclass correlation coefficient was 0.8456. Conclusions: The Dispneia-12-Pt exhibits acceptable biometric properties and may be used as a tool in Brazilian patients with dyspnea of different etiologies.
Schwietering, Laura Ann. "Speech and Breathing Characteristics in Patients with Upper Airway Disorders: A Comparative Study". Miami University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=miami1367278513.
Pełny tekst źródłaSharma, Pramod. "The Effect of Experimental Changes in Physiological and Psychological Factors on Perception of Exertional Dyspnea in Healthy Individuals". Thesis, Griffith University, 2015. http://hdl.handle.net/10072/365245.
Pełny tekst źródłaThesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Allied Health
Griffith Health
Full Text
Baille, Guillaume. "Atteinte ventilatoire dans la maladie de Parkinson : du symptôme à l’atteinte objective". Thesis, Lille 2, 2019. http://www.theses.fr/2019LIL2S023.
Pełny tekst źródłaParkinson’s disease (PD) is the second most common neurodegenerative disease. Among the numerous signs reported by the patients and observed by the physicians, respiratory manifestations are one the least explored.Firstly, dyspnea, debilitating symptom that can impair the quality of life, seems to be frequent in PD, but its prevalence and its clinical characteristics (perceptive aspect and emotional response) need to be determined. The objective of the DYSPARK project was to define the clinical profile of dyspneic PD patients, the consequence of the shortness of breath and to correlate its clinical features with the motor and non-motor aspects of the disease.Secondly, objective ventilatory abnormalities (pulmonary function testings – PFT) and the change over time are not well defined in PD. A diminution of lung volumes or impaired respiratory muscles could influence the outcome of the disease. The aim of the analysis of a group of patients from the PRODIGY-PARK cohort was to prospectively assess (5 years follow-up) the PFT data and their possible prognostic impact
Koblick, Heather. "EFFECTS OF SIMULTANEOUS EXERCISE AND SPEECH TASKS ON THE PERCEPTION OF". Master's thesis, University of Central Florida, 2004. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/2965.
Pełny tekst źródłaM.A.
Department of Communicative Disorders
Health and Public Affairs
Communicative Disorders
Ezeani, Nkiru Ezeani. "Guideline Use in Asthma Management in Primary Care Setting: A Systematic Review". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2813.
Pełny tekst źródłaNicot, Frédéric. "Contributions à l’exploration fonctionnelle respiratoire de l’enfant : mesure de la force des muscles respiratoires et étude de la perception d’une charge respiratoire par les potentiels évoqués respiratoires". Thesis, Paris Est, 2010. http://www.theses.fr/2010PEST0047.
Pełny tekst źródłaSome children with chronic lung and neuromuscular diseases showed abnormal values of respiratory muscle strength and misjudge their dyspneic state. These breathing difficulties allow us to hypothesize an abnormal integration of cortical somatosensory afferents. A new neurophysiological approach, Respiratory Related Evoked Potentials (RREPs) caused by upper airways occlusion allows to investigate this pathway.Volitional manoeuvres assessment of the strength of respiratory muscles (Sniff and SNIP) and non-volitional (Magnetic stimulation) and RREPs were recorded in healthy and children suffering from respiratory and neuromuscular diseases.Respiratory muscle strength values recorded in different groups by these techniques were similar. The components of RREPs recorded at C3-Cz and C4-Cz have all been found in healthy children and patients. Only N1 and P2 were more often collected from patients with neuromuscular diseases than in children with lung disease (p <0.005).These studies have shown that muscle strength breathing can be assessed by different manoeuvres in children with chronic lung diseases, neuromuscular diseases and thatChildren show alterations of RREPs
Perry, Sarah Elizabeth. "The effect of different interventions on the sensory and affective dimensions of dyspnea in patients with COPD during exercise". Thesis, University of British Columbia, 2012. http://hdl.handle.net/2429/43187.
Pełny tekst źródłaLaches, Lisa A. "The Relationships Among Pain, Dyspnea, Constipation and Quality of Life in Lung Cancer Patients Enrolled in a Hospice Program". Scholar Commons, 2007. http://scholarcommons.usf.edu/etd/3926.
Pełny tekst źródłaMiura, Cinthya Tamie Passos 1983. "Avaliação da dispneia : validação da versão brasileira do Modified Dyspnea Index em pacientes portadores de doença pulmonar obstrutiva crônica". [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/283896.
Pełny tekst źródłaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Enfermagem
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Resumo: Este estudo teve como objetivo evidenciar a aplicabilidade clínica da versão brasileira do Modified Dyspnea Index (MDI), junto a pacientes portadores de Doença Pulmonar Obstrutiva Crônica (DPOC), a partir da análise de sua validade convergente. Foi verificada a validade convergente do instrumento por meio da correlação com dados da função pulmonar, da capacidade física submáxima, qualidade de vida relacionada à saúde (QVRS) e outra medida de dispneia. Métodos: A coleta de dados foi realizada no período de agosto de 2012 a outubro de 2013, de forma individual, em ambiente privativo, em uma única etapa, por meio de consulta ao prontuário e entrevista individualizada, com aplicação do MDI a seguir dos demais questionários, em sequência aleatória. Posteriormente os pacientes foram submetidos à avaliação da força muscular respiratória, da capacidade funcional e da função pulmonar. A função pulmonar foi analisada por meio da espirometria e da força muscular respiratória. Os seguintes dados foram obtidos a partir da espirometria: volume expiratório forçado no primeiro segundo (VEF1); capacidade vital forçada (CVF) e relação VEF1/CVF. Todos os dados da espirometria foram expressos como valores obtidos e porcentagem do predito. A força muscular respiratória foi avaliada por meio da manovacuometria, sendo mensuradas as pressões inspiratória e expiratória máximas (PI máx e PE máx). A capacidade física submáxima foi avaliada objetivamente por meio do teste de caminhada de 6 minutos (TC6M) e pelo autorrelato, com emprego do instrumento Veterans Specific Activity Questionnaire (VSAQ). A QVRS foi avaliada por meio de uma medida genérica - Medical Outcomes Study Short Form-36 (SF-36), e outra específica para doença pulmonar - versão modificada do Questionário do Hospital Saint George na Doença Respiratória- SGRQm. A Escala Modificada de Borg foi utilizada como outra medida de dispneia. Análise de Dados: Os dados foram submetidos inicialmente à análise descritiva. O teste de correlação parcial, com controle das variáveis: sexo, idade e IMC, foi utilizado para verificar a correlação da versão brasileira do MDI com os valores obtidos na avaliação da função pulmonar, da capacidade física submáxima, da qualidade de vida e da outra medida de dispneia. A análise de outliers uni e multivariados descartou a presença de valores extremos das variáveis de interesse. A correção de Bonferrroni foi adotada com finalidade de evitar os erros do tipo I. Resultados: Correlações positivas, de magnitude modesta a moderada, foram observadas entre o MDI e a capacidade respiratória: VEF1 (r = 0,25, p<0,01) e PI máx (r = 0,36, p<0,01). Correlações positivas, de moderada a forte magnitude, foram observadas com a capacidade física: TC6M ¿ distância (r = 0,34, p<0,01); e VSAQ (r =0,63, p<0,01). Correlação negativa foi observada com a Escala modificada de Borg (dispneia) (r=-0,46, p<0,01). Além disso, fortes correlações positivas foram observadas entre a pontuação total do MDI e medidas de QVRS, especificamente com os domínios de avaliação da capacidade física: SF-36 (r = 0,72, p<0,01) e o SGRQm (r = 0,63, p<0,01). Conclusão: Nossos dados demonstraram evidências de validade convergente da versão brasileira do MDI entre os pacientes com DPOC no Brasil. As correlações observadas apontam para sua utilidade na prática clínica, como avaliação mais abrangente da dispneia
Abstract: This study was aimed at evidencing the clinical applicability of the Brazilian version of the Modified Dyspnea Index (MDI), among Chronic Obstructive Pulmonary Disease (COPD) outpatients by the analyses of its correlations with data regarding pulmonary function; submaximal physical capacity, generic as well as specific measures of health-related quality of life (HRQoL) and another measure of dyspnea. Methods: In this cross-sectional study, data collection was gathred from August 2012 to October 2013, individually, in a private room. Patient records were reviewed and individual interviews were conducted with application of the MDI and then of the other questionnaires, in a random order. Subsequently, patients underwent the assessment of respiratory muscle strength, functional capacity and pulmonary function. Pulmonary function was assessed by spirometry obtaining the following data: forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC. All data were expressed as absolute (obtained) values and percentage of predicted. Respiratory muscle strength was assessed through the measures of maximal inspiratory and expiratory pressures (PIM and PEM). The submaximal physical capacity was objectively evaluated by the 6-minute walk test (6MWT) and by the self-reported measure, the Veterans Specific Activity Questionnaire (VSAQ). HRQoL was assessed by a generic measure ¿ the Medical Outcomes Study Short Form-36 (SF-36), and another specific for lung diseases ¿ the Modified Saint George's Respiratory Questionnaire- SGRQm. The Modified Borg Scale was used as another measure of dyspnea. Data Analysis: Data were initially submitted to the descriptive analysis. The partial correlation, adjusted by age, gender and BMI, was used to verify the correlation of the Brazilian version of the MDI with data concerning pulmonary function, submaximal exercise capacity, quality of life and other as dyspnea. Outlier¿s analysis (single or multivariate) discarded the presence of extreme values of the interest variables. The Bonferrroni correction was adopted to control type I errors. Results: Modest to moderate positive correlations were observed between the MDI and respiratory capacity (%): VEF1 (r = .25, p<.01); PIM (r = .36, p<.01). Moderate to strong positive correlations were observed with functional capacity: 6MWT-distance (%) r = .34, p<.01); VSAQ (r = .63, p<.01) and negative correlations with Borg scale (dyspnea) (r = -.46, p<.01). Moreover, strong positive correlations were found between total score of the MDI and HRQoL measures, specifically with the domains concerned to physical capacity: SF-36 (r =.72, p<.01) and SGRQm (r =.63, p<.01). Conclusion: Our data demonstrated evidence of convergent validity of the MDI among Brazilian COPD outpatients. The correlations observed point to the usefulness of the MDI in the clinical practice, as more comprehensive assessment of dyspnea
Doutorado
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Mendonca, Cassandra. "Physiological mechanisms of dyspnea during exercise in the presence of external thoracic restriction: role of increased neural respiratory motor drive". Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=121504.
Pełny tekst źródłaContexte et raisonnement. La «dyspnée» désigne une prise de conscience de gêne respiratoire se manifestant généralement à l'effort autant chez ceux en santé que ceux atteints de diverses maladies. Sans doute, il est symptôme le plus lourdement ressenti par patients atteints de maladies pulmonaires chroniques (MPC) pour son effet limitant sur l'activité physique et effet nocif sur la santé, y compris l'hospitalisation et la mort. Néanmoins, les mécanismes de la dyspnée d'effort en temps de santé et maladie restent que partiellement comprises. Des étudies ultérieurs suggèrent le découplage neuromécanique du système respiratoire comme mécanisme de dyspnée d'effort, en particulier chez patients atteints de MPC. Selon cette hypothèse, l'intensité sensorielle et le sentiment de malaise augmentent en fonction d'une disparité croissante entre pulsion respiratoire neuronale et réaction simultanée du système respiratoire, concernant notamment le volume courant (VT) d'extension. Une hypothèse alternative et largement non vérifiée suggère qu'une perception de la dyspnée élevée durant exercice reflète une prise de conscience d'une pulsion respiratoire neuronale nécessaire pour atteindre une ventilation (V· E) donnée lors de contraintes "anormales" sur l'expansion VT. À ce jour, la contribution des anomalies physiopathologiques sur la pulsion respiratoire neural, mécanique respiratoire dynamique et symptôme de la dyspnée au cours de l'exercice chez patients atteints de MPC s'est révélée difficile à étudier (au-delà de corrélation) en raison de présence de multiples comorbidités contribuant indépendamment à la perception de la dyspnée. Objectif. En guise de l'information présentée précédemment, nous tentons de mieux comprendre les mécanismes physiologiques de dyspnée d'effort. Méthode. Cette étude randomisée, contrôlée et croisée a permis d'examiner les effets aigus de la restriction thoracique externe par le cerclage de paroi thoracique (chest wall strapping, CWS),- un modèle accepté qui assimile les contraintes restrictives "anormales" sur l'expansion du VT de patients avec troubles pulmonaires chroniques - sur la V· E, mode de respiration, mécanique respiratoire dynamique, pulsion respiratoire neural (évaluée par changements dans l'électromyogramme du diaphragme; EMGdi), cotes d'intensité sensorielle et malaise accompagnant la dyspnée au cours d'épreuve incrémental d'effort limitée par symptômes, dans 20 jeunes hommes en santé et à fonctions pulmonaire et cardiorespiratoire normaux. Résultats. Les résultats principaux furent : [1] Les contraintes mécaniques dynamiques sur l'expansion du VT étaient relativement plus grandes durant effort avec CWS que sans; [2] L'EMGdi était systématiquement plus élevé lors de l'effort avec CWS que sans; [3] Le CWS n'avait aucun effet sur le découplage neuromécanique du système respiratoire, comme la relation entre EMGdi et expansion du VT (normalisée selon la réduction de la capacité vitale causée par le CWS) durant effort a été maintenue. [4] L'intensité sensorielle et le sentiment de malaise accompagnant la dyspnée étaient sensiblement plus élevés durant effort avec CWS que sans; et [5] Le CWS n'a eut aucun effet sur la relation entre une l'EMGdi augmentée, et l'intensité sensorielle et malaise ressentie, pris séparément durant l'effort progressif. Conclusions. Nous concluons que la perception accrue de la dyspnée durant effort avec CWS n'est pas aisément expliquée par découplage neuromécanique du système respiratoire élevé, mais qu'elle reflète plutôt la prise de conscience de la pulsion respiratoire neural supplémentaire nécessaire pour surmonter les contraintes restrictives « anormales » sur l'expansion du VT. Nos résultants permettent d'approfondir notre compréhension des mécanismes physiopathologiques causant la dyspnée d'effort chez patients à troubles pulmonaires chroniques, et s'avère important pour le développement de modalités soulageant la dyspnée chez ces patients dans le futur.
Ferreira, José Filipe Miranda. "Dispneia: vivências do cuidador informal". Bachelor's thesis, [s.n.], 2018. http://hdl.handle.net/10284/7081.
Pełny tekst źródłaA presente investigação é do tipo descritivo-exploratório, de cariz fenomenológico inserido no paradigma qualitativo e realizado em meio natural, onde se incluíram 14 cuidadores informais de pessoas com dispneia, realizando-se a colheita de dados individualmente, através de um questionário presencial, na visita do doente numa instituição de saúde do Porto. Assim, importa conhecer quais as vivências do cuidador informal de pessoas com dispneia, em contexto domiciliário, visto ser um tema ainda pouco estudado em Portugal, considerando-o primordial para o instruir a cuidar de um doente com dispneia. Dos resultados obtidos o cuidar regista 57,14% na figura do feminino, 42,85% da população da amostra têm mais de 63 anos de idade e 28,56% com idade inferior a 39 anos, sendo 78,57% casados, tendo 28,57% completado o 1º ensino básico e 21,43% completou o 2º ensino básico. A respeito da situação profissional a taxa de 42,86% iguala a situação quer de empregado quer de reformado. No prestar cuidados à pessoa com dispneia os CI´s adjetivam-no, em reconfortante (n=5) e em tristeza (n=4). Assumir o papel de CI teve implicações na vida social (n=9). A família é o apoio no cuidar (n=9), sendo que para os CI´s (n=14) não têm qualquer apoio para além das instituições de saúde. Os CI´s (n=10) não tiveram qualquer ensino formal. Num episódio agudo e súbito de dispneia os CI’s caracterizam a reação, como não tendo reação (n=6), com desespero (n=3) sendo que (n=2) ainda não vivenciaram tal episódio. Como estratégias de coping no alívio da dispneia num episódio agudo a maioria dos CI´s assumem “sentar” (n=7). Nas AVD a gestão de esforço e tempo (n=6) é a estratégia assumida pelos CI´s, para diminuir e/ou evitar períodos agudos de dispneia, sendo que (n=5) assumem “nada” fazerem. Relativamente ao controlo sintomático da dispneia através de medidas não farmacológicas a maioria dos CI´s (n=10) dizem desconhecer.
The present descriptive-exploratory research, with a phenomenological nature inserted in the qualitative paradigm and carried out in the natural environment, where 14 informal caregivers of people with dyspnea were included, and individual data were collected through a face-to-face questionnaire at the visit of the patient in a Porto health institution. Thus, it is important to know the experiences of the informal caregiver of people with dyspnea, in a home context, since it is a subject that has not yet been studied in Portugal, considering it to be the primary instruction for caring for a patient with dyspnea. Of the results obtained, caregiving registered 57,14% in the female figure, 42,85% of the population of the sample were over 63 years of age and 28,57% under the age 39, 78,57% being married, with 28,57% having completed elementary education and 21,43% completed 2nd grade. Regarding the professional situation, the rate of 42,86% equals the situation of both employed and retired. In caring for the person with dyspnea, the ICs adjectival, comforting (n=5) and sadness (n=4). Assuming the role of IC had implications in social life (n=9). The family is caring support (n=9), and for ICs (n=14) they have no support beyond health institutions. The ICs (n=10) did not have any formal education. In an acute and sudden episode of dyspnea, ICs characterize the reaction, not having a reaction (n=6), with despair (n=3) and (n=2) not yet experienced this episode. How coping strategies in relieving dyspnea in an acute episode most ICs assume "sit" (n=7). In ADL, effort and time management (n=6) is the strategy adopted by ICs to decrease and/or avoid acute periods of dyspnea, and (n=5) assume "nothing" to do. Regarding the symptomatic control of dyspnea through non-pharmacological measures most ICs (n=10) say they do not know.
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Hedin, Kajsa. "Samband mellan gångsträcka, dyspné och desaturation i 6 minuters gångtest hos en grupp individer med pulmonell arteriell hypertension (PAH) - en registerbaserad pilotstudie". Thesis, Uppsala universitet, Åsenlöf: Fysioterapi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-407329.
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