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Communicating breathlessness: Outcome study of patients with COPD and asthma
Introduction: Currently little data exists on the effectiveness of using the Modified Borg Scale (MBS) in the initial assessment, triage and treatment of patients with chronic obstructive pulmonary disease (COPD) and asthma exacerbation.
The specific aim of this study was the following: (1) can asthma and COPD patients in acute bronchospasm communicate their level of dyspnea using the MBS.
(2) does subjective improvement in the patient's breathlessness correlate with improvement in pulmonary state as measured by peak expiratory flow rate (PEFR) and pulse oximetry.
Sample: Of the 400 male veterans who presented to the Emergency Department (ED) with a chief complaint of dyspnea, 102 male veterans were in acute bronchospasm. Forty-two (42) males diagnosed with asthma and 60 males were diagnosed with COPD. All subjects had been previously diagnosed by their primary care provider as either having COPD or asthma. Subjects in this study were between the ages of 24 and 87 mean age 59.
Method: Retrospective chart review comparing MBS with two objective measures of the intensity of dyspnea: the peak expiratory flow rate (PEFR) and pulse oximetry in patients with asthma and COPD. The MBS was used to rate perceived breathlessness sensation intensity.
Results/Conclusion: Data were analyzed used the Pearson's correlation coefficient to describe the pre-and post scores. Our study showed that patients with asthma or COPD when presented in acute bronchospasm with a chief complaint of shortness of breath are able to use the MBS to give a subjective indication of the severity of breathlessness. Also our study shows that as patient's respiratory function improved after using beta,-agonist and anticholinergics as measured by PEFR and pulse oximetry the number on the MBS also improved.
Implications for Nursing: Health care providers are establishing models for outcome based care. Tools that measure and or evaluate outcomes of care play an important role in the model towards maximizing positive outcomes from therapy. A self rating tool such as the MBS could be a contributory link in the patients perception of his physical condition. Information from this study could generate outcome changes in documenting and quantifying the sensation of dyspnea. In addition, the practice of developing a common language to bridge and measure the most common sensory description of being |
Research Data
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| Ending
Year:
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1998 |
| Design:
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Descriptive: Correlational, Methodological, Evaluation Research |
| Study
Type:
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| Theoretical
Framework:
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Investigator Developed |
| Description
of Sample:
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Veterans with COPD or Asthma |
| Sample
Size:
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102 |
| Number
of Groups:
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| Sampling
Plan:
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| Gender:
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Male |
| Minimum
Age:
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24 |
| Maximum
Age:
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87 |
| Data
Collection Settings(s):
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Question:
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No longer required |
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Primary Investigator
Karla R. Kendrick, MSN
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P.I. Institution Name
VA San Diego Healthcare System
Title
Education Facilitator of ER
Contact Address
3350 La Jolla Village Dr.
San Diego, CA, 92161-4189
USA
Contact E-mail
karlak@ix.netcom.com
Contact Telephone
858.552.8585
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Secondary Investigators
Sunita C. Baxi
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