TREATMENTS FOR DYSPNEA--EDUCATION, EXPOSURE OR TRAINING

描述：（改编自申请人摘要）呼吸困难或气短 呼吸困难，是患者最常见和最严重的投诉， 肺部疾病 它会扰乱日常生活活动， 生活质量 研究人员已经表明，感官和 呼吸困难的情感维度可以显著降低， 慢性阻塞性肺疾病（COPD）患者的自我起搏 提供护士呼吸困难暴露的运动训练计划- 监控环境。 12次治疗后呼吸困难的减轻 锻炼计划的发生是因为更好的锻炼表现 （提高效率和调节）， 通气和脱敏（症状相对于 通风）。 本研究的总体目标是确定 步行回家是否能减少呼吸困难， 在监测环境中短时间暴露于症状或典型的 高强度肺康复运动训练。 主 目的是测试三种治疗方法的有效性差异， 呼吸困难：关于呼吸困难的教育和居家步行处方; 护士指导的呼吸困难暴露与教育和回家散步 处方;和肺康复模型与高- 高强度运动、教育和居家步行处方。 次要目的是确定呼吸困难是否在最少 一次递增的跑步机试验， 取决于疾病的严重程度、性别、种族或对家庭的依从性 步行处方。 该研究还试图确定 反应的持续时间取决于治疗。 的 设计是一项为期一年的实验性纵向研究。 将分配90例COPD患者，受限于呼吸困难 随机分为三个治疗组。 所有团体将收到 关于处理呼吸困难的策略和家庭锻炼的教育 处方. 此外，曝光组还将完成四个自我- 在跑步机上进行有节奏的训练， 呼吸困难，高强度训练组将完成24 高强度的跑步机训练。眼前与长远 结果包括：a）呼吸困难的感觉和情感维度， 运动; B）日常生活活动中的呼吸困难; c）运动 能力; d）健康状况; e）与健康有关的生活质量，包括 功能状态、社会地位和健康感知; f）自我 功效; g）呼吸困难的感知控制;和h）情绪状态。 以较短者为准 而对呼吸困难的不太密集的治疗被证明是有效的， 高强度运动训练计划在减轻 呼吸困难和改善生活质量，对护理的影响 慢性阻塞性肺疾病患者将是巨大的。

DESCRIPTION: (adapted from applicant's abstract) Dyspnea, or shortness of breath, is the most frequent and severe complaint of patients with pulmonary disease. It disrupts activities of daily living and decreases quality of life. The investigators have shown that the sensory and affective dimensions of dyspnea can be significantly decreased in chronic obstructive pulmonary disease (COPD) patients by a self-paced exercise training program that provides exposure to dyspnea in a nurse- monitored environment. This reduction in dyspnea after a 12-session exercise program occurred because of both better exercise performance (increased efficiency and conditioning), which requires less ventilation, and desensitization (a decrease in the symptom relative to ventilation). The overall objective of this study is to determine whether dyspnea decreases as much with home walking as it does with short exposure to the symptom in a monitored environment or with typical high-intensity pulmonary rehabilitation exercise training. The primary aim is to test differences in the effectiveness of three treatments for dyspnea: education about dyspnea and a home walking prescription; nurse-coached exposure to dyspnea with education and a home walking prescription; and a model of pulmonary rehabilitation with high- intensity exercise, education, and a home walking prescription. Secondary aims are to determine if dyspnea decreases after as little as one incremental treadmill test and whether the treatment response depends on disease severity, gender, ethnicity, or adherence to a home walking prescription. The study also seeks to determine whether the duration of the response differs depending upon the treatment. The design is an experimental longitudinal study extending over one year. Ninety patients with COPD and limited by dyspnea will be assigned randomly to one of three treatment groups. All groups will receive education about strategies for dealing with dyspnea and a home exercise prescription. In addition, the exposure group will complete four self- paced sessions on a treadmill designed to allow nurse-coached exposure to dyspnea, and the high intensity training group will complete 24 sessions of high intensity treadmill training. Immediate and long-term outcomes include: a) sensory and affective dimensions of dyspnea with exercise; b) dyspnea with activities of daily living; c) exercise capacity; d) health status; e) health-related quality of life, including functional status, social status, and health perception; f) self- efficacy; g) perceived control of dyspnea; and h) mood state. If shorter and less intensive treatments for dyspnea prove to be as effective as a high-intensity exercise training program in decreasing the symptom of dyspnea and improving the quality of life, the impact on the care of patients with COPD will be substantial.