Dyspnea and its correlates in taiwanese patients with terminal cancer.
This study prospectively assessed dyspnea and related bio-psycho-social-spiritual factors--including severity, cause, psychological distress, and fear of death--that were possibly related to dyspnea in 125 terminal cancer patients at admission and two days before their death. At admission, 74 patients had dyspnea, which improved but later worsened. Causes included cachexia, anemia, pleural effusion, and lymphangitis. Quality of life, anxiety, depression, and fear of death improved after admission; anxiety was correlated with dyspnea before death (r = 0.211, P < 0.05, univariate analysis). Lung infection (odds ratio = 2.29, 95% confidence interval = 0.68-3.90; multiple regression), airway obstruction (2.27, 1.41-3.13), acidemia (1.82, 0.72-2.98), and pericardial effusion (1.38, 0.44-2.32) were independent correlates of dyspnea severity at admission (42.8% of explained variance). Before death, airway obstruction, esophageal cancer, pericardial effusion, lung infection, and mediastinal mass were independent correlates of severity (42.7% of explained variance). Comprehensive care, including improved psychospiritual status, can help in controlling dyspnea and enhancing patients' quality of life.
Hospice and Palliative Care Unit, Departments of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.
Tai-Yuan
TY
Chiu
Wen-Yu
WY
Hu
Bee-Horng
BH
Lue
Chien-An
CA
Yao
Ching-Yu
CY
Chen
Susumu
S
Wakai
D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D004417:Dyspnea / Q000401:mortality* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000523:psychology; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D013624:Taiwan / Q000453:epidemiology; D019452:Terminally Ill / Q000706:statistics & numerical data*