title: Does the use of a handheld fan improve chronic dyspnea? A randomized, controlled, crossover trial.
abstract: BACKGROUND
  Dyspnea is a disabling distressing symptom that is common in advanced disease affecting millions of people worldwide. Current palliative strategies are partially effective in managing this symptom; facial cooling has been shown to reduce the sensation of breathlessness when induced in volunteers but has not been formally investigated in dyspnea associated with disease.
  
  
  OBJECTIVE
  The objective of this study was to investigate whether a handheld fan reduces the sensation of breathlessness in such patients, enhancing palliative approaches.
  
  
  METHODS
  The effectiveness of a handheld fan (blowing air across the nose and mouth) in reducing the sensation of breathlessness was assessed in patients with advanced disease. Fifty participants were randomized to use a handheld fan for five minutes directed to their face or leg first and then crossed over to the other treatment. The primary outcome measure was a decrease of greater than 1cm in breathlessness recorded on a 10 cm visual analog scale (VAS).
  
  
  RESULTS
  There was a significant difference in the VAS scores between the two treatments, with a reduction in breathlessness when the fan was directed to the face (P=0.003).
  
  
  CONCLUSIONS
  This study supports the hypothesis that a handheld fan directed to the face reduces the sensation of breathlessness. The fan was acceptable to participants: it is inexpensive, portable, enhances self-efficacy, and available internationally. It should be recommended as part of a palliative management strategy for reducing breathlessness associated with advanced disease.
authors.affiliation: Palliative Care Service, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom. sarah.galbraith@addenbrookes.nhs.uk
authors.forename: Sarah
authors.initials: S
authors.lastname: Galbraith
authors.forename: Petrea
authors.initials: P
authors.lastname: Fagan
authors.forename: Paul
authors.initials: P
authors.lastname: Perkins
authors.forename: Andrew
authors.initials: A
authors.lastname: Lynch
authors.forename: Sara
authors.initials: S
authors.lastname: Booth
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D004417:Dyspnea / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D018579:Patient Selection; D012648:Self Care / Q000295:instrumentation*; D016896:Treatment Outcome