Authors (including presenting author) :
Leung Carmen (1), Wong KH (1), Chan WC (2), Leung WM (2), Sally Wan (3), Yeung PS (4), Tiffany Tse (4),Lau Adelina (5) Harry Wong (6), Joe Huang (6)
Affiliation :
Palliative care team of Clinical Oncology Department, Queen Elizabeth Hospital ( 1: Doctor; 2: Nurse; 3: Physiotherapist; 4: Occupational therapist; 5: Clinical psychologist; 6: Social worker)
Introduction :
Breathlessness is a common and distressing symptom. This is frightening for patients and families, and accompanied by feelings of loss of mastery over breathing and panic.
Objectives :
To improve patients’ symptom of breathlessness and their quality of life and to relieve the distress and anxiety of patients and their families.
Methodology :
The first PROACTIVE EDUCATION group targets the newly registered lung cancer patients to the KCC Hospice Centre at QEH. All patients with their families will attend a Multidisciplinary Orientation Talk on self-management of breathlessness and complete an Individual Comprehensive Breathlessness Assessment (ICBA). Those patients with significant breathlessness will then be referred to the Therapeutic group. The second THERAPEUTIC group recruits those patients with significant breathlessness. The patient will first have ICBA done by therapists and then interview jointly by our multidisciplinary team. Personalized Interventions including both pharmacological and non-pharmacological approaches will be offered with drug education by pamphlets and nurse counselling and various non- pharmacological interventions provided by therapists. Patient’s symptom control, stress and confident scores were regularly monitored on every visit. The team will also empower patient’s care-givers by providing relevant information and training up of their caring skills.
Result & Outcome :
A total number of 344 patients have been recruited (Proactive 279; Therapeutic 65). Analysis was performed on the Therapeutic group. Significant number of patients (72%) had moderate to high level exertional dyspnea score at presentation. This greatly affects their quality of life as evidenced by their high level of emotion stress (34%) and unconfident feeling (50%). Majority of patients had only received short period of service (78% patients had 3 or less attendances) due to their rapid clinical deterioration. The Breathlessness Service Program is effective in improving both breathless patient’s physical (47%) and psychological status (33%).
Proactive approach to focus on Education of Prophylactic Measures for high risk group is useful. Only six patients (2%) after the proactive class referred back to the Therapeutic group in the due course. Conclusion: This Integrated Breathlessness Service Program is effective in improving both breathless patient’s physical and psychological status. Adopting a proactive approach can equip the high-risk patients or their care-givers with knowledge and skills for handling breathlessness symptom.
Co-location with:
