title: Hospitalist attitudes toward the assessment and management of dyspnea in patients with acute cardiopulmonary diseases.
abstract: BACKGROUND
  Dyspnea is a common symptom in patients hospitalized with acute cardiopulmonary diseases. Routine assessment of dyspnea severity is recommended by clinical guidelines based on the evidence that patients are not treated consistently for dyspnea relief.
  
  
  OBJECTIVE
  To evaluate attitudes and beliefs of hospitalists regarding the assessment and management of dyspnea.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Nine hospitals in the United States.
  
  
  METHODS
  Survey questions assessed the following domains regarding dyspnea: importance in clinical care, potential benefits and challenges of implementing a standardized assessment, current approaches to assessment, and how awareness of severity affects management. A 5-point Likert scale was used to assess the respondent's level of agreement; strongly agree and agree were combined into a single category.
  
  
  RESULTS
  Of the 255 hospitalists invited to participate, 69.8% completed the survey; 77.0% agreed that dyspnea relief is an important goal when treating patients with cardiopulmonary conditions. Approximately 90% of respondents stated that awareness of dyspnea severity influences their decision to intensify treatment, to pursue additional diagnostic testing, and the timing of discharge. Of the respondents, 61.0% agreed that standardized assessment of dyspnea should be part of the vital signs, and 64.6% agreed that awareness of dyspnea severity influences their decision to prescribe opioids. Hospitalists who appreciated the importance of dyspnea in clinical practice were more likely to support the implementation of a standardized scale.
  
  
  CONCLUSIONS
  Most hospitalists believe that routine assessment of dyspnea severity would enhance their clinical decision making and patient care. Measurement and documentation of dyspnea severity may represent an opportunity to improve dyspnea management.
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts.|Division of General Internal Medicine, Baystate Medical Center, Springfield, Massachusetts.|Tufts Clinical and Translational Science Institute and Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Mihaela S
authors.initials: MS
authors.lastname: Stefan
authors.affiliation: Pulmonary Division, Harborview Medical Center, University of Washington Medicine, Seattle, Washington.
authors.forename: David H
authors.initials: DH
authors.lastname: Au
authors.affiliation: Center for Health Research & Department of Pulmonary and Critical Care Medicine, Kaiser Permanente Northwest, Portland, Oregon.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Mularski
authors.affiliation: University of Illinois-Jesse Brown VAMC, Chicago, Illinois.
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Krishnan
authors.affiliation: Division of Pulmonary and Critical Care, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Eduard T
authors.initials: ET
authors.lastname: Naureckas
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
authors.forename: Shannon S
authors.initials: SS
authors.lastname: Carson
authors.affiliation: University of Illinois-Jesse Brown VAMC, Chicago, Illinois.
authors.forename: Patrick
authors.initials: P
authors.lastname: Godwin
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts.
authors.forename: Aruna
authors.initials: A
authors.lastname: Priya
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts.|University of Massachusetts Amherst, School of Public Health Sciences, Amherst, Massachusetts.
authors.forename: Penelope S
authors.initials: PS
authors.lastname: Pekow
authors.affiliation: Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts.|Division of General Internal Medicine, Baystate Medical Center, Springfield, Massachusetts.|Tufts Clinical and Translational Science Institute and Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Peter K
authors.initials: PK
authors.lastname: Lindenauer
mesh_terms: D000208:Acute Disease; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D019468:Disease Management; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006331:Heart Diseases / Q000150:complications*; D020445:Hospitalists; D006761:Hospitals; D006801:Humans; D008171:Lung Diseases / Q000150:complications; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States