Respiratory Distress: A model of subcortical responses to an asphyxial threat in persons with cognitive impairment

2.50
Hdl Handle:
http://hdl.handle.net/10755/161423
Type:
Presentation
Title:
Respiratory Distress: A model of subcortical responses to an asphyxial threat in persons with cognitive impairment
Abstract:
Respiratory Distress: A model of subcortical responses to an asphyxial threat in persons with cognitive impairment
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2003
Author:Campbell , Margaret
Contact Address:Nursing Administration, 4201 St. Antoine, Detroit, MI, 48201, USA
Co-Authors:Barbara Therrien
Patients with cognitive impairment are limited in their ability to report their symptoms and any associated distress. Respiratory distress, an observed corollary to dyspnea, is a nociceptive response to abnormalities in respiratory function. This model of respiratory distress is the physical and/or emotional suffering that is characterized by behaviors that can be observed and measured in response to an asphyxial threat in a population of patients with impaired cognition. Standard measures of distress are grounded on the patient’s ability to provide a self-report that relies on intact cognition. However, many patients who experience respiratory distress are unable to self-report because of impaired and/or declining cognitive function making them vulnerable to under-recognition and under-treatment of respiratory distress that is still being experienced. Thus, there is a need to understand and measure responses to respiratory distress in a population of patients who, for a number of reasons, are unable to use a self-report instrument or tool. This model of respiratory distress in persons with impaired cognition relies on subcortical neurological systems in the emotional and autonomic domains that are rapidly triggered in response to a threat of asphyxia. Consequently, evolutionarily ancient reactions produce compensatory responses oriented to survival. Fear is a strongly correlated emotional response to the threat of suffocation but the nature and trajectory of this complex primal response in people with cognitive impairment is not known. Subcortical elicitation of fear involves the amygdala, hypothalamus and autonomic nervous system; we propose that this produces an organized array of specific facial, vocal, motor and physiological responses that can be observed as measurable behaviors. A respiratory distress observation scale has been developed from this model and is being subjected to psychometric testing for reliability and validity in patients who are at risk for respiratory distress. The model and preliminary results will be presented. AN: MN030313
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleRespiratory Distress: A model of subcortical responses to an asphyxial threat in persons with cognitive impairmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/161423-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Respiratory Distress: A model of subcortical responses to an asphyxial threat in persons with cognitive impairment</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Campbell , Margaret</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Nursing Administration, 4201 St. Antoine, Detroit, MI, 48201, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Barbara Therrien </td></tr><tr><td colspan="2" class="item-abstract">Patients with cognitive impairment are limited in their ability to report their symptoms and any associated distress. Respiratory distress, an observed corollary to dyspnea, is a nociceptive response to abnormalities in respiratory function. This model of respiratory distress is the physical and/or emotional suffering that is characterized by behaviors that can be observed and measured in response to an asphyxial threat in a population of patients with impaired cognition. Standard measures of distress are grounded on the patient&rsquo;s ability to provide a self-report that relies on intact cognition. However, many patients who experience respiratory distress are unable to self-report because of impaired and/or declining cognitive function making them vulnerable to under-recognition and under-treatment of respiratory distress that is still being experienced. Thus, there is a need to understand and measure responses to respiratory distress in a population of patients who, for a number of reasons, are unable to use a self-report instrument or tool. This model of respiratory distress in persons with impaired cognition relies on subcortical neurological systems in the emotional and autonomic domains that are rapidly triggered in response to a threat of asphyxia. Consequently, evolutionarily ancient reactions produce compensatory responses oriented to survival. Fear is a strongly correlated emotional response to the threat of suffocation but the nature and trajectory of this complex primal response in people with cognitive impairment is not known. Subcortical elicitation of fear involves the amygdala, hypothalamus and autonomic nervous system; we propose that this produces an organized array of specific facial, vocal, motor and physiological responses that can be observed as measurable behaviors. A respiratory distress observation scale has been developed from this model and is being subjected to psychometric testing for reliability and validity in patients who are at risk for respiratory distress. The model and preliminary results will be presented. AN: MN030313 </td></tr></table>en_GB
dc.date.available2011-10-26T23:21:06Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:21:06Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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