2.50
Hdl Handle:
http://hdl.handle.net/10755/162787
Type:
Presentation
Title:
Dyspnea in Emergency Department Visits for Heart Failure
Abstract:
Dyspnea in Emergency Department Visits for Heart Failure
Conference Sponsor:Emergency Nurses Association
Conference Year:1998
Author:Parshall, Mark B., RN, MSN, PhD(c), CEN
P.I. Institution Name:University of Kentucky
Contact Address:, Lexington, KY, USA
Co-Authors:J. Darlene Welsh, RN, MSN; Karma B. Cassidy, RN, BSN; Regina M. Heiser, RN, MSN, CEN; Mary P. Schooler, RN, MSN, CCRN; and Dorothy Y. Brockopp, RN, PhD
Purpose: Dyspnea is the most common symptom in emergency department (ED) visits for heart failure (HF). The purpose of this study was to explore dimensions of dyspnea (intensity, distress, duration, and sensory quality) that may contribute to HF patients' decisions to present to an ED.

Methods: In a retrospective descriptive study of ED visits for preexisting HF (n=60), structured interviews about symptoms at the time subjects decided to come to the ED (DECISION) were conducted at least one day after a visit. A subset (n=42) also used a checklist of 13 dyspnea sensory quality descriptors to identify and rate the intensity (1 very mild, 10-very severe) of those they recalled having felt at DECISION and a week before the visit (WEEK BEFORE).

Results: More than 80% of the visits resulted in admission. For 65%, dyspnea was the most distressing symptom at DECISION. Exacerbation duration was bimodal (51% equal to or less than 1 day; 36% equal to or greater than 7 days) and unrelated to admission. Open-ended questions about how breathing felt at DECISION generally elicited only one or two qualitative descriptors per subject, most commonly: ôcouldnÆt breathe, get breath, or get any air (40%); short or out of breath (35%); heaviness, hard to breathe, labor, or effort (15%); not deep enough (11%); wheezing or tightness (10%); or smothering or suffocating (8%). In contrast, at least 65% chose out of breath, short of breath, heavy, effort, tight, needed to breathe more, hunger for more air, could not get enough air, suffocating, gasping, and wheezy from the DECISION checklist (median number of descriptors chosen = 11). The overall mean paired increase in intensity from WEEK BEFORE to DECISION was only 1.7 (95%CI: 0.4 to 3.1).

Conclusions: HF patients' decisions to seek ED care reflected severity of condition appropriately. Visits were associated with relatively small increases in dyspnea intensity from WEEK BEFORE to DECISION despite most exacerbations having lasted less than one week. It is not clear if changes in sensory quality contribute to decisions to present to an ED, but open-ended questions about breathing symptoms may not elicit the range of dyspneic sensations experienced by HF patients. [Research Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDyspnea in Emergency Department Visits for Heart Failureen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162787-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Dyspnea in Emergency Department Visits for Heart Failure</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1998</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Parshall, Mark B., RN, MSN, PhD(c), CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Kentucky</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">, Lexington, KY, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">J. Darlene Welsh, RN, MSN; Karma B. Cassidy, RN, BSN; Regina M. Heiser, RN, MSN, CEN; Mary P. Schooler, RN, MSN, CCRN; and Dorothy Y. Brockopp, RN, PhD</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Dyspnea is the most common symptom in emergency department (ED) visits for heart failure (HF). The purpose of this study was to explore dimensions of dyspnea (intensity, distress, duration, and sensory quality) that may contribute to HF patients' decisions to present to an ED.<br/><br/>Methods: In a retrospective descriptive study of ED visits for preexisting HF (n=60), structured interviews about symptoms at the time subjects decided to come to the ED (DECISION) were conducted at least one day after a visit. A subset (n=42) also used a checklist of 13 dyspnea sensory quality descriptors to identify and rate the intensity (1 very mild, 10-very severe) of those they recalled having felt at DECISION and a week before the visit (WEEK BEFORE).<br/><br/>Results: More than 80% of the visits resulted in admission. For 65%, dyspnea was the most distressing symptom at DECISION. Exacerbation duration was bimodal (51% equal to or less than 1 day; 36% equal to or greater than 7 days) and unrelated to admission. Open-ended questions about how breathing felt at DECISION generally elicited only one or two qualitative descriptors per subject, most commonly: &ocirc;couldn&AElig;t breathe, get breath, or get any air (40%); short or out of breath (35%); heaviness, hard to breathe, labor, or effort (15%); not deep enough (11%); wheezing or tightness (10%); or smothering or suffocating (8%). In contrast, at least 65% chose out of breath, short of breath, heavy, effort, tight, needed to breathe more, hunger for more air, could not get enough air, suffocating, gasping, and wheezy from the DECISION checklist (median number of descriptors chosen = 11). The overall mean paired increase in intensity from WEEK BEFORE to DECISION was only 1.7 (95%CI: 0.4 to 3.1).<br/><br/>Conclusions: HF patients' decisions to seek ED care reflected severity of condition appropriately. Visits were associated with relatively small increases in dyspnea intensity from WEEK BEFORE to DECISION despite most exacerbations having lasted less than one week. It is not clear if changes in sensory quality contribute to decisions to present to an ED, but open-ended questions about breathing symptoms may not elicit the range of dyspneic sensations experienced by HF patients. [Research Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:34:09Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:34:09Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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