Review
Year 2021,
Volume: 12 Issue: 2, 537 - 544, 01.04.2021
Abstract
Dispnenin yönetiminde farmakolojik yaklaşımların yanı sıra farklı non farmakolojik yaklaşımlar da kullanılmaktadır. Yüze soğuk hava uygulamasının 2. ve 3. trigeminal sinirlere soğutma ve hava akışı sağlayarak nefes darlığını azaltıp, egzersiz toleransını arttırdığı belirtilmiştir. Bu mekanizmanın nazal ya da hava yolu mukozasının soğutulması ya da yüz derisinin serinletilmesi ile ortaya çıktığı düşünülmektedir. Farklı bir bakış açısı ise el fanının solunum afferent sinirlerinden gelen sinyallerin beyin tarafından algılanmasını değiştirerek psikolojik ve duygusal yönetimi sağladığıdır. Yapılan çalışmalarda orta ve şiddetli dispneli hastalara beş dakika boyunca, 15 cm uzaktan, burnun iki yanı ve üst dudağın üst kısımlarına fan uygulanmasının etkili bir yaklaşım olabileceği bildirilmiştir. Bazı çalışmalarda el fanı uygulamasının dispne ile birlikte solunum sayısı ve oksijen saturasyonunu da etkilediği görülmüştür. Pil ile çalışan el fanları hem ucuz hem de taşıması kolay olması ile hastaların tercih edeceği bir araçtır. El fanı uygulamasının yan etkilerinin olmaması ve uygulanabilirliğinin kolay olması hastanın yaşam kalitesini arttırabilir. Bu derlemenin amacı dispnenin yöentiminde el fanının etkisini tartışmaktır.
Keywords
References
- 1. Tanaka K, Akechi T, Okuyama T, Nishiwaki Y, Uchitomi Y. Factors correlated with dyspnea in advanced lung cancer patients: organic causes and what else? J Pain Symptom Manage. 2002;23(6):490-500. http://dx.doi.org/10.1016/s0885-3924(02)00400-1
- 2. Shin JA, Kosiba JD, Traeger L, Greer JA, Temel JS, Pirl WF. Dyspnea and panic among patients with newly diagnosed non-small cell lung cancer. J Pain Symptom Manage. 2014;48(3):465-70. http://dx.doi.org/10.1016/j.jpainsymman.2013.10.021
- 3. Bruera E, Schmitz B, Pither J, Neumann CM, Hanson J. The frequency and correlates of dyspnea in patients with advanced cancer. J Pain Symptom Manage. 2000;19(5):357-62. http://dx.doi.org/10.1016/S0885-3924(00)00126-3
- 4. Guirimand F, Sahut d'izarn M, Laporte L, Francillard M, Richard JF, Aegerter P. Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer. Cancer Med. 2015;4(4):532-9. http://dx.doi.org/10.1002/cam4.419
- 5. Currow DC, Smith J, Davidson PM, Newton PJ, Agar MR, Abernethy AP. Do the trajectories of dyspnea differ in prevalence and intensity by diagnosis at the end of life? A consecutive cohort study. J Pain Symptom Manage. 2010;39(4):680-90. http://dx.doi.org/10.1016/j.jpainsymman.2009.09.017
- 6. Thomas S, Bausewein C, Higginson I, Booth S. Breathlessness in cancer patients–implications, management and challenges. Eur J Oncol Nurs. 2011;15(5):459-69. http://dx.doi.org/10.1016/j.ejon.2010.11.013
- 7. Weingaertner V, Scheve C, Gerdes V, Schwarz-Eywill M, Prenzel R, Bausewein C, et al. Breathlessness, functional status, distress, and palliative care needs over time in patients with advanced chronic obstructive pulmonary disease or lung cancer: a cohort study. J Pain Symptom Manage. 2014;48(4):569-81. http://dx.doi.org/10.1016/j.jpainsymman.2013.11.011
- 8. Bausewein C, Booth S, Gysels M, Higginson IJ. Non‐pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases. Cochrane Database Syst Rev. 2008. 16;(2): CD005623. http://dx.doi.org/10.1002/14651858.CD005623.pub2
- 9. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012;185(4):435-52. http://dx.doi.org/10.1164/rccm.201111-2042ST
- 10. Booth S. Science supporting the art of medicine: improving the management of breathlessness. Palliat Med. 2013;27(6):483-5. http://dx.doi.org/10.1177/0269216313488490
- 11. Thomas LA. Effective dyspnea management strategies identified by elders with end-stage chronic obstructive pulmonary disease. Appl Nurs Res. 2009;22(2):79-85. http://dx.doi.org/10.1016/j.apnr.2007.04.010
- 12. Schwartzstein RM, Lahive K, Pope A, Weinberger SE, Weiss JW. Cold facial stimulation reduces breathlessness induced in normal subjects. Am Rev Respir Dis. 1987;136(1):58-61. http://dx.doi.org/10.1164/ajrccm/136.1.58
- 13. Philip J, Gold M, Milner A, Di Iulio J, Miller B, Spruyt O. A randomized, double-blind, crossover trial of the effect of oxygen on dyspnea in patients with advanced cancer. J Pain Symptom Manage. 2006;32(6):541-50. http://dx.doi.org/10.1016/j.jpainsymman.2006.06.009
- 14. Swan F, English A, Allgar V, Hart SP, Johnson M. The hand-held fan and the Calming Hand for people with chronic breathlessness: a feasibility trial. J Pain Symptom Manage. 2019; 57(6):1051-1061.e1. http://dx.doi.org/10.1016/j.jpainsymman.2019.02.017
- 15. Puspawati NLPD, Sitorus R, Herawati T. Hand-held fan airflow stimulation relieves dyspnea in lung cancer patients. Asia Pac J Oncol Nurs. 2017;4(2):162. http://dx.doi.org/10.4103/apjon.apjon_14_17
- 16. Galbraith S, Fagan P, Perkins P, Lynch A, Booth S. Does the use of a handheld fan improve chronic dyspnea? A randomized, controlled, crossover trial. J Pain Symptom Manage. 2010;39(5):831-8. http://dx.doi.org/10.1016/j.jpainsymman.2009.09.024
- 17. Bausewein C, Booth S, Gysels M, Kühnbach R, Higginson IJ. Effectiveness of a hand-held fan for breathlessness: a randomised phase II trial. BMC palliative care. 2010;9(1):22. http://dx.doi.org/10.1186/1472-684X-9-22
- 18. Kako J, Morita T, Yamaguchi T, Sekimoto A, Kobayashi M, Kinoshita H, et al. Evaluation of the appropriate washout period following fan therapy for dyspnea in patients with advanced cancer: a pilot study. Am J Hosp and Palliat Care. 2018;35(2):293-6. http://dx.doi.org/10.1177/1049909117707905
- 19. Kako J, Morita T, Yamaguchi T, Kobayashi M, Sekimoto A, Kinoshita H, et al. Fan therapy is effective in relieving dyspnea in patients with terminally ill cancer: A parallel-arm, randomized controlled trial. J Pain Symptom Manage. 2018;56(4):493-500. http://dx.doi.org/10.1016/j.jpainsymman.2018.07.001
- 20. Wong SL, Leong SM, Chan CM, Kan SP, Cheng HWB. The effect of using an electric fan on dyspnea in Chinese patients with terminal cancer: a randomized controlled trial. Am J Hosp and Palliat Care. 2017;34(1):42-6. http://dx.doi.org/10.1177/1049909115615127
- 21. O'Driscoll BR, Neill J, Pulakal S, Turkington PM. A crossover study of short burst oxygen therapy (SBOT) for the relief of exercise-induced breathlessness in severe COPD. BMC Pulmonary Medicine. 2011;11(1):23. http://dx.doi.org/10.1186/1471-2466-11-23
- 22. Barnes-Harris M, Allgar V, Booth S, Currow D, Hart S, Phillips J, et al. Battery operated fan and chronic breathlessness: does it help? BMJ Support Palliat Care. 2019;9(4): 478-81. http://dx.doi.org/10.1136/bmjspcare-2018-001749
- 23. Johnson MJ, Booth S, Currow DC, Lam LT, Phillips JL. A mixed-methods, randomized, controlled feasibility trial to inform the design of a phase III trial to test the effect of the handheld fan on physical activity and carer anxiety in patients with refractory breathlessness. J Pain Symptom Manage. 2016;51(5):807-15. http://dx.doi.org/10.1016/j.jpainsymman.2015.11.026
- 24. Luckett T, Phillips J, Johnson MJ, Farquhar M, Swan F, Assen T, et al. Contributions of a hand-held fan to self-management of chronic breathlessness. Eur Respir J. 2017;50(2):1700262. http://dx.doi.org/10.1183/13993003.00262-2017
- 25. Marchetti N, Lammi MR, Travaline JM, Ciccolella D, Civic B, Criner GJ. Air current applied to the face improves exercise performance in patients with COPD. Lung. 2015;193(5):725-31. http://dx.doi.org/10.1007/s00408-015-9780-0
- 26. Liss HP, Grant BJ. The Effect of Nasal Flow on Breathlessness in Patients with Chronic Obstructive Pulmonary Disease. Am Rev Respir Dis. 1988;137(6):1285-8.http://dx.doi.org/10.1164/ajrccm/137.6.1285
- 27. Morélot-Panzini C. Fooling the brain to alleviate dyspnoea. Fooling the brain to alleviate dyspnoea. Eur Respir J. 2017;50(2):1701383. http://dx.doi.org/10.1183/13993003.01383-2017
- 28. Mularski RA, Reinke LF, Carrieri-Kohlman V, Fischer MD, Campbell ML, Rocker G, et al. An official American Thoracic Society workshop report: assessment and palliative management of dyspnea crisis. Ann Am Thorac Soc. 2013;10(5):98-S106. http://dx.doi.org/10.1513/AnnalsATS.201306-169ST
- 29. Smith T, Cho J-G, Robert M, Wheatlry J. Hand held fans for dyspnoea relief in COPD: Physical properties and patient perceptions. Eur Respir J. 2016;48:719; http://dx.doi.org/10.1183/13993003.congress-2016.PA719
- 30. Swan F, Booth S. The role of airflow for the relief of chronic refractory breathlessness. Curr Opin Support Palliat Care. 2015;9(3):206-11. http://dx.doi.org/10.1097/SPC.0000000000000160
- 31. Qian Y, Wu Y, de Moraes AR, Yi X, Geng Y, Dibaj S, et al. Fan Therapy for the Treatment of Dyspnea in Adults: a Systematic Review. J Pain Symptom Manage. 2019;58(3): 481-6. http://dx.doi.org/10.1016/j.jpainsymman.2019.04.011
- 32. Swan F, Newey A, Bland M, Allgar V, Booth S, Bausewein C, et al. Airflow relieves chronic breathlessness in people with advanced disease: an exploratory systematic review and meta-analyses. Palliat Med. 2019;33(6):618-33. http://dx.doi.org/10.1177/0269216319835393
- 33. Yu S, Sun K, Xing X, Zhong Y, Yan X, Qiu W, et al. Fan Therapy for the Relief of Dyspnea in Adults with Advanced Disease and Terminal Illness: A Meta-Analysis of Randomized Controlled Trials. J Palliat Med. 2019;22(12):1603-9. http://dx.doi.org/10.1089/jpm.2019.0140
Year 2021,
Volume: 12 Issue: 2, 537 - 544, 01.04.2021
Abstract
In dyspnea management, different non-pharmacological approaches are used along with pharmacological approaches. It is stated that apply cool to the face reduces dyspnea and increases exercise tolerance by allowing coolness and air flow into the second and third trigeminal nerves. This mechanism is thought to arise from cooling the nasal or airway mucosa or cooling the facial skin. According to a different viewpoint, hand held fan provides psychological and emotional management by altering the sensing of signals, coming from respiratory afferent nerves, by the brain. The studies have reported that applying a fan on both sides of the nose and upper parts of the upper lip from a distance of 15 cm for five minutes in patients with moderate and severe dyspnea may be effective. In some studies, it has also been observed that hand held fan application is effective on not only dyspnea, but also respiratory rate and oxygen saturation. Hand held fans, which operate with batteries, are a tool to be preferred by patients because they are cheap and portable. Additionally, hand fan can enhance the quality of life of patients since it has no side effect and is easily applicable. The purpose of this review is to discuss the effect of the hand held fan in management of the dyspnea.
References
- 1. Tanaka K, Akechi T, Okuyama T, Nishiwaki Y, Uchitomi Y. Factors correlated with dyspnea in advanced lung cancer patients: organic causes and what else? J Pain Symptom Manage. 2002;23(6):490-500. http://dx.doi.org/10.1016/s0885-3924(02)00400-1
- 2. Shin JA, Kosiba JD, Traeger L, Greer JA, Temel JS, Pirl WF. Dyspnea and panic among patients with newly diagnosed non-small cell lung cancer. J Pain Symptom Manage. 2014;48(3):465-70. http://dx.doi.org/10.1016/j.jpainsymman.2013.10.021
- 3. Bruera E, Schmitz B, Pither J, Neumann CM, Hanson J. The frequency and correlates of dyspnea in patients with advanced cancer. J Pain Symptom Manage. 2000;19(5):357-62. http://dx.doi.org/10.1016/S0885-3924(00)00126-3
- 4. Guirimand F, Sahut d'izarn M, Laporte L, Francillard M, Richard JF, Aegerter P. Sequential occurrence of dyspnea at the end of life in palliative care, according to the underlying cancer. Cancer Med. 2015;4(4):532-9. http://dx.doi.org/10.1002/cam4.419
- 5. Currow DC, Smith J, Davidson PM, Newton PJ, Agar MR, Abernethy AP. Do the trajectories of dyspnea differ in prevalence and intensity by diagnosis at the end of life? A consecutive cohort study. J Pain Symptom Manage. 2010;39(4):680-90. http://dx.doi.org/10.1016/j.jpainsymman.2009.09.017
- 6. Thomas S, Bausewein C, Higginson I, Booth S. Breathlessness in cancer patients–implications, management and challenges. Eur J Oncol Nurs. 2011;15(5):459-69. http://dx.doi.org/10.1016/j.ejon.2010.11.013
- 7. Weingaertner V, Scheve C, Gerdes V, Schwarz-Eywill M, Prenzel R, Bausewein C, et al. Breathlessness, functional status, distress, and palliative care needs over time in patients with advanced chronic obstructive pulmonary disease or lung cancer: a cohort study. J Pain Symptom Manage. 2014;48(4):569-81. http://dx.doi.org/10.1016/j.jpainsymman.2013.11.011
- 8. Bausewein C, Booth S, Gysels M, Higginson IJ. Non‐pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases. Cochrane Database Syst Rev. 2008. 16;(2): CD005623. http://dx.doi.org/10.1002/14651858.CD005623.pub2
- 9. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012;185(4):435-52. http://dx.doi.org/10.1164/rccm.201111-2042ST
- 10. Booth S. Science supporting the art of medicine: improving the management of breathlessness. Palliat Med. 2013;27(6):483-5. http://dx.doi.org/10.1177/0269216313488490
- 11. Thomas LA. Effective dyspnea management strategies identified by elders with end-stage chronic obstructive pulmonary disease. Appl Nurs Res. 2009;22(2):79-85. http://dx.doi.org/10.1016/j.apnr.2007.04.010
- 12. Schwartzstein RM, Lahive K, Pope A, Weinberger SE, Weiss JW. Cold facial stimulation reduces breathlessness induced in normal subjects. Am Rev Respir Dis. 1987;136(1):58-61. http://dx.doi.org/10.1164/ajrccm/136.1.58
- 13. Philip J, Gold M, Milner A, Di Iulio J, Miller B, Spruyt O. A randomized, double-blind, crossover trial of the effect of oxygen on dyspnea in patients with advanced cancer. J Pain Symptom Manage. 2006;32(6):541-50. http://dx.doi.org/10.1016/j.jpainsymman.2006.06.009
- 14. Swan F, English A, Allgar V, Hart SP, Johnson M. The hand-held fan and the Calming Hand for people with chronic breathlessness: a feasibility trial. J Pain Symptom Manage. 2019; 57(6):1051-1061.e1. http://dx.doi.org/10.1016/j.jpainsymman.2019.02.017
- 15. Puspawati NLPD, Sitorus R, Herawati T. Hand-held fan airflow stimulation relieves dyspnea in lung cancer patients. Asia Pac J Oncol Nurs. 2017;4(2):162. http://dx.doi.org/10.4103/apjon.apjon_14_17
- 16. Galbraith S, Fagan P, Perkins P, Lynch A, Booth S. Does the use of a handheld fan improve chronic dyspnea? A randomized, controlled, crossover trial. J Pain Symptom Manage. 2010;39(5):831-8. http://dx.doi.org/10.1016/j.jpainsymman.2009.09.024
- 17. Bausewein C, Booth S, Gysels M, Kühnbach R, Higginson IJ. Effectiveness of a hand-held fan for breathlessness: a randomised phase II trial. BMC palliative care. 2010;9(1):22. http://dx.doi.org/10.1186/1472-684X-9-22
- 18. Kako J, Morita T, Yamaguchi T, Sekimoto A, Kobayashi M, Kinoshita H, et al. Evaluation of the appropriate washout period following fan therapy for dyspnea in patients with advanced cancer: a pilot study. Am J Hosp and Palliat Care. 2018;35(2):293-6. http://dx.doi.org/10.1177/1049909117707905
- 19. Kako J, Morita T, Yamaguchi T, Kobayashi M, Sekimoto A, Kinoshita H, et al. Fan therapy is effective in relieving dyspnea in patients with terminally ill cancer: A parallel-arm, randomized controlled trial. J Pain Symptom Manage. 2018;56(4):493-500. http://dx.doi.org/10.1016/j.jpainsymman.2018.07.001
- 20. Wong SL, Leong SM, Chan CM, Kan SP, Cheng HWB. The effect of using an electric fan on dyspnea in Chinese patients with terminal cancer: a randomized controlled trial. Am J Hosp and Palliat Care. 2017;34(1):42-6. http://dx.doi.org/10.1177/1049909115615127
- 21. O'Driscoll BR, Neill J, Pulakal S, Turkington PM. A crossover study of short burst oxygen therapy (SBOT) for the relief of exercise-induced breathlessness in severe COPD. BMC Pulmonary Medicine. 2011;11(1):23. http://dx.doi.org/10.1186/1471-2466-11-23
- 22. Barnes-Harris M, Allgar V, Booth S, Currow D, Hart S, Phillips J, et al. Battery operated fan and chronic breathlessness: does it help? BMJ Support Palliat Care. 2019;9(4): 478-81. http://dx.doi.org/10.1136/bmjspcare-2018-001749
- 23. Johnson MJ, Booth S, Currow DC, Lam LT, Phillips JL. A mixed-methods, randomized, controlled feasibility trial to inform the design of a phase III trial to test the effect of the handheld fan on physical activity and carer anxiety in patients with refractory breathlessness. J Pain Symptom Manage. 2016;51(5):807-15. http://dx.doi.org/10.1016/j.jpainsymman.2015.11.026
- 24. Luckett T, Phillips J, Johnson MJ, Farquhar M, Swan F, Assen T, et al. Contributions of a hand-held fan to self-management of chronic breathlessness. Eur Respir J. 2017;50(2):1700262. http://dx.doi.org/10.1183/13993003.00262-2017
- 25. Marchetti N, Lammi MR, Travaline JM, Ciccolella D, Civic B, Criner GJ. Air current applied to the face improves exercise performance in patients with COPD. Lung. 2015;193(5):725-31. http://dx.doi.org/10.1007/s00408-015-9780-0
- 26. Liss HP, Grant BJ. The Effect of Nasal Flow on Breathlessness in Patients with Chronic Obstructive Pulmonary Disease. Am Rev Respir Dis. 1988;137(6):1285-8.http://dx.doi.org/10.1164/ajrccm/137.6.1285
- 27. Morélot-Panzini C. Fooling the brain to alleviate dyspnoea. Fooling the brain to alleviate dyspnoea. Eur Respir J. 2017;50(2):1701383. http://dx.doi.org/10.1183/13993003.01383-2017
- 28. Mularski RA, Reinke LF, Carrieri-Kohlman V, Fischer MD, Campbell ML, Rocker G, et al. An official American Thoracic Society workshop report: assessment and palliative management of dyspnea crisis. Ann Am Thorac Soc. 2013;10(5):98-S106. http://dx.doi.org/10.1513/AnnalsATS.201306-169ST
- 29. Smith T, Cho J-G, Robert M, Wheatlry J. Hand held fans for dyspnoea relief in COPD: Physical properties and patient perceptions. Eur Respir J. 2016;48:719; http://dx.doi.org/10.1183/13993003.congress-2016.PA719
- 30. Swan F, Booth S. The role of airflow for the relief of chronic refractory breathlessness. Curr Opin Support Palliat Care. 2015;9(3):206-11. http://dx.doi.org/10.1097/SPC.0000000000000160
- 31. Qian Y, Wu Y, de Moraes AR, Yi X, Geng Y, Dibaj S, et al. Fan Therapy for the Treatment of Dyspnea in Adults: a Systematic Review. J Pain Symptom Manage. 2019;58(3): 481-6. http://dx.doi.org/10.1016/j.jpainsymman.2019.04.011
- 32. Swan F, Newey A, Bland M, Allgar V, Booth S, Bausewein C, et al. Airflow relieves chronic breathlessness in people with advanced disease: an exploratory systematic review and meta-analyses. Palliat Med. 2019;33(6):618-33. http://dx.doi.org/10.1177/0269216319835393
- 33. Yu S, Sun K, Xing X, Zhong Y, Yan X, Qiu W, et al. Fan Therapy for the Relief of Dyspnea in Adults with Advanced Disease and Terminal Illness: A Meta-Analysis of Randomized Controlled Trials. J Palliat Med. 2019;22(12):1603-9. http://dx.doi.org/10.1089/jpm.2019.0140
There are 33 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Nursing |
| Journal Section | Review |
| Authors | |
| Publication Date | April 1, 2021 |
| Submission Date | April 13, 2020 |
| Published in Issue | Year 2021Volume: 12 Issue: 2 |
