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Hospitalist attitudes toward the assessment and management of dyspnea in patients with acute cardiopulmonary diseases
Author(s) -
Stefan Mihaela S.,
Au David H.,
Mularski Richard A.,
Krishnan Jerry A.,
Naureckas Eduard T.,
Carson Shan S.,
Godwin Patrick,
Priya Aruna,
Pekow Penelope S.,
Lindenauer Peter K.
Publication year - 2015
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.2422
Subject(s) - medicine , respondent , medline , hospital medicine , acute care , intensive care medicine , likert scale , severity of illness , emergency medicine , physical therapy , family medicine , health care , political science , law , statistics , mathematics , economics , economic growth
BACKGROUND Dyspnea is a common symptom in patients hospitalized with acute cardiopulmonary diseases. Routine assessment of dyspnea severity is recommended by clinical guidelines based on the evidence that patients are not treated consistently for dyspnea relief. OBJECTIVE To evaluate attitudes and beliefs of hospitalists regarding the assessment and management of dyspnea. DESIGN Cross‐sectional survey. SETTINGS Nine hospitals in the United States. MEASUREMENTS Survey questions assessed the following domains regarding dyspnea: importance in clinical care, potential benefits and challenges of implementing a standardized assessment, current approaches to assessment, and how awareness of severity affects management. A 5‐point Likert scale was used to assess the respondent's level of agreement; strongly agree and agree were combined into a single category. RESULTS Of the 255 hospitalists invited to participate, 69.8% completed the survey; 77.0% agreed that dyspnea relief is an important goal when treating patients with cardiopulmonary conditions. Approximately 90% of respondents stated that awareness of dyspnea severity influences their decision to intensify treatment, to pursue additional diagnostic testing, and the timing of discharge. Of the respondents, 61.0% agreed that standardized assessment of dyspnea should be part of the vital signs, and 64.6% agreed that awareness of dyspnea severity influences their decision to prescribe opioids. Hospitalists who appreciated the importance of dyspnea in clinical practice were more likely to support the implementation of a standardized scale. CONCLUSIONS Most hospitalists believe that routine assessment of dyspnea severity would enhance their clinical decision making and patient care. Measurement and documentation of dyspnea severity may represent an opportunity to improve dyspnea management. Journal of Hospital Medicine 2015;10:724–730. © 2015 Society of Hospital Medicine