Chronic breathlessness, breathlessness persisting despite optimal treatment, is a central symptom in many conditions, notably respiratory and cardiac diseases, and advanced cancer. Breathlessness is strongly associated with decreased activity and poorer clinical outcomes, including worse quality of life and increased rates of anxiety and depression. In patients with COPD breathlessness has been shown to be a stronger predictor of mortality than lung function tests and in heart disease it is a better predictor of mortality than angina. However, for some patients, the experience of breathlessness is poorly explained by the findings of medical tests. That is, quantitative markers for disease severity do not always align with a patient's report of subjective symptoms, such as breathlessness. These discrepancies, alongside the multifaceted and subjective nature of breathlessness, make its assessment and treatment challenging.
Recent literature describes breathlessness as a multidimensional subjective symptom. Many breathlessness researchers use the model of pain multidimensionality as a helpful analogy to study breathlessness; both incorporate sensory-qualities, and are unpleasant and evoke emotions that motivate behaviour. This approach has provided a foundation to develop multidimensional scales to assess breathlessness. While a variety of instruments are available for assessing breathlessness, the majority assess the impact of breathlessness, rather than its sensory and affective dimensions. The Dyspnoea-12 was published in 2010 and was developed for assessment of the multiple dimensions of breathlessness; physical (sensory) and affective. It has been translated into more than 20 languages.
This presentation will describe chronic breathlessness and its multi-dimensional experience. It will summarise the application of the Dyspnoea-12 to assess breathlessness.
