Dyspnea Among Patients With Advanced Lung Cancer: A Concept Analysis

Background: Dyspnea is a subjective, multidimensional experience of breathing discomfort, influenced by physiological, psychological, social, and environmental factors, which includes secondary psychological and behavioral responses and cannot be defined only by physical objective abnormalities. It has been found to create barriers in daily life among patients with advanced lung cancer which interferes with physical activities such as walking, work, and psychological activities such as disposition, taking pleasure in life, relationship with others, and sleep. To the lung cancer population, dyspnea is a constant reminder of how serious the consequences are of being stricken by a life threatening disease

Objective: First, to identify current theoretical and operational definitions of dyspnea and second, to identify and describe defining attributes of dyspnea

Methods: The method of inquiry was guided byWalker and Avant’s (2011) approach to concept analysis.

Findings: From this analysis, a conceptual model of dyspnea experience within the core of patients with advanced lung cancer may include attributes of dyspnea occurrence and distress as not only the physiological, psychological, and environmental, but also the situational existential meaning or perception of individual suffering from dyspnea.

Discussion: Dyspnea is a symptom that is usually under-diagnosed and inadequately managed due to lack of recognition or availability of interventions. Dyspneic patients are unable to perform activities of daily living because of fatigue, discomfort and anxiety associated with the inability to breath normally. The impact of dyspnea management on the quality of life in advanced lung cancer patients requires more recognition and better quality of care.

Conclusions: Patients with advanced lung cancer experience dyspnea in ways that changes lives with restriction, loss of autonomy, and with subsequent dependence on others by threatening the joy in their existence. Despite the frequency and complexity of this symptom, little research has been conducted to specifically identify effective treatment in patients with advanced lung cancer. Further investigations are needed in this area to assert the total dyspnea experience that could be influential in regards to the impact of dyspnea management on the quality of life in patients with advanced lung cancer.