Explain Breathlessness: Could ‘Usual’ Explanations Contribute to Maladaptive Beliefs of People Living with Breathlessness?
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. If You Were Asked “Why Am I Breathless?” By a Person with a Long-Standing Medical Condition Where Breathlessness Was a Daily Feature, What Would You Normally Say?
3.2. Would You Change Anything in Your Explanation If the Person Had a Specific Chronic Condition Such as Chronic Obstructive Pulmonary Disease, Heart Failure, Idiopathic Pulmonary Fibrosis, Cystic Fibrosis, Neuromuscular Disease, etc.?
3.3. What Do You Think Are the Most Important Points to Convey When Explaining Chronic Breathlessness to a Person with This Symptom?
3.4. Is There Any Information That You Avoid or Try Not to Say When Explaining Chronic Breathlessness to a Person with This Symptom?
3.5. When Explaining Chronic Breathlessness to People Living with This Symptom, Are There Particular Ideas or Concepts That You Think People Find Difficult to Understand or Follow?
4. Discussion
4.1. Why Do Explanations for Chronic Breathlessness Matter?
4.2. What Constitutes a ‘Good’ Explanation for Chronic Breathlessness?
4.3. How Might Explanation Content Encourage Maladaptive Breathlessness Beliefs in People Living with Chronic Breathlessness?
- (1)
- Normal function of lungs and heart is oxygen transportation;
- (2)
- Diseases of lungs/heart impair normal function;
- (3)
- Chronic breathlessness results from impairment of oxygen transportation.
4.4. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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N = 61 | ||
---|---|---|
Professional discipline | Physiotherapy | 33 |
Nursing | 17 | |
Medicine | 10 | |
Respiratory scientist | 1 | |
Role in the past 6 months 1 | Mainly clinical | 47 |
Clinical + nonclinical | 10 | |
Nonclinical | 4 | |
Frequency of conversations about chronic breathlessness with a patient in the past 6 months | At least once a day | 21 |
At least once a week | 28 | |
At least once a month | 10 | |
No direct clinical contact | 2 | |
“Usual explanation” | Provided text response | 61 |
Usual explanation provided | 57 | |
Usual explanation not provided 2 | 4 | |
Change usual explanation if person had a specific chronic condition? | Would change | 53 |
Would not change | 8 |
Responder Identifier | Usual Explanations (Complete Unedited Verbatim Explanation) |
---|---|
ID 3 | “You need to work harder with your breathing to make sure your body gets enough oxygen to fuel your muscles” |
ID 30 | “You have a chronic lung disease which cause air to be trapped. When you feel like you can’t get enough air in, you actually already have too much ‘stale’ air trapped in your lungs, which is why you feel breathless. In order to breath better, you need to focus on lean forward positions to utilise your arm muscles in helping you breathe, pursed lip breath and breath out as much air as possible to get rid of as much of the trapped stale air as possible so that you can get more fresh (oxygenated) air into your lungs.” |
ID 37 | “Unfortunately, because your lungs are damaged they struggle to produce enough oxygen. Oxygen is like a fuel for the body. Being breathless is your bodies way of saying help, I haven’t got enough fuel for you. Your body thinks that if you breath more you will get more air into your lungs and if not the shortness of breath will slow you down so that the need goes away. |
ID 42 | “The emphysema has led to a dramatic decrease in the amount of air sacks/alveolus that are able to ‘pick up’ oxygen and get rid of carbon dioxide in the lungs. The air sacks that are remaining are ‘floppy’ and don’t work properly.” |
ID 52 | “The damage to your airways means that your lungs are not getting air out effectively. This in means that you have less space to get new air in and therefore less oxygenated air getting to your blood. You will therefore be breathing more shallowly and at faster rate.” |
ID 54 | “Your heart/lungs muscles are a little weaker, so to ensure your body gets the circulation and oxygen it needs, you breathe a little quicker to make sure it gets it.” |
ID 88 | “Your body is trying to get enough oxygen for all the organs to function as best as possible—by breathing faster this is one ‘shortcut’ to get enough, but it may not the most efficient.” |
ID 44 | “There are many reasons why people are breathless. Commonly your lungs aren’t able to get in enough oxygen or your muscles are weak, and this makes it harder for your heart and lungs.“ |
ID 32 | “Your lungs aren’t working that well anymore and the tubes that carry the oxygen in your lungs are sometimes tired or not as elastic as they used to be.” |
ID 71 | “I would explain the need for oxygen when muscles are used to complete daily activities. I would describe changes that have happened to their lungs because of their lung condition (if relevant) and would explain the role of fitness on breathlessness.” |
ID 82 | “Breathlessness is usually multi-factorial and is most likely related to the way your heart and lungs get oxygen around your body as well as how hard your breathing muscles are working to keep up with the demand for oxygen.” |
ID 56 | “Breathlessness can be caused from many things and may also be a combination of reasons. It is important to be aware of some of the causes which may be relevant to you. As well, it is helpful to be aware of the things you can do to relieve breathlessness. For example breathing techniques and doing activity in intervals of rest can help manage your breathlessness where possible. Breathlessness is often caused by the inability of the body i.e., the heart and lungs to either use your oxygen properly or pump the blood with oxygen around your body. While breathlessness can be caused from low oxygen levels in the blood this is not necessarily true for some lung diseases. The damage of your lungs or heart may be making it challenging to keep up with the way you breathe during activity. “ |
ID 10 | “Breathlessness is a complex symptom which is the mix of a number of things: your oxygen levels, how good your muscles are at using oxygen, how fit your heart is, and your lung condition.” |
ID 35 | “There are many reasons you may be breathless; it is not likely to be a single thing that causes it. It may because of the difficulty you have moving air in/out of your lungs, it may be driven be abnormal oxygen or CO2 levels, because of loss of fitness and feelings of worry or panic can make the sensation worse” |
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Williams, M.T.; Lewthwaite, H.; Brooks, D.; Johnston, K.N. Explain Breathlessness: Could ‘Usual’ Explanations Contribute to Maladaptive Beliefs of People Living with Breathlessness? Healthcare 2024, 12, 1813. https://doi.org/10.3390/healthcare12181813
Williams MT, Lewthwaite H, Brooks D, Johnston KN. Explain Breathlessness: Could ‘Usual’ Explanations Contribute to Maladaptive Beliefs of People Living with Breathlessness? Healthcare. 2024; 12(18):1813. https://doi.org/10.3390/healthcare12181813
Chicago/Turabian StyleWilliams, Marie T., Hayley Lewthwaite, Dina Brooks, and Kylie N. Johnston. 2024. "Explain Breathlessness: Could ‘Usual’ Explanations Contribute to Maladaptive Beliefs of People Living with Breathlessness?" Healthcare 12, no. 18: 1813. https://doi.org/10.3390/healthcare12181813