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The hand-held fan and the Calming Hand for people with chronic breathlessness: a feasibility trial

Swan, Flavia; English, Anne; Allgar, Victoria; Hart, Simon P.; Johnson, Miriam


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Dr Flavia Swan
Research fellow in cancer rehabilitation

Anne English

Victoria Allgar


The battery operated hand-held fan (“fan”) and the Calming Hand (CH), a cognitive strategy, are interventions used in clinical practice to relieve chronic breathlessness.

To test the feasibility of a phase III randomised controlled trial (RCT) evaluating the impact of the fan and/or CH compared with exercise advice alone for the relief of chronic breathlessness due to respiratory conditions.

Single site, feasibility “2x2” factorial, non-blinded, mixed-methods RCT. Participants randomly allocated to four groups: fan + exercise advice vs CH + exercise advice vs fan + CH + exercise advice vs exercise advice alone. Measures included: recruitment, acceptability; data quality and study outcomes (baseline, day 28); modified incremental shuttle walk test (mISWT), recovery time from exertion-induced breathlessness, Life-space, General Self-Efficacy Scale and breathlessness numerical rating scales. Willing participants and carers were interviewed at study end.

Recruitment/acceptability/data completion: 53 people were screened, 40 randomised and completed; (mean age 72 years (SD 9.8), 70% male). There were few missing data (2 mISWT). Recovery time [seconds] from exertion-induced breathlessness showed most improvement for the fan; mean reduction from baseline -33.5 vs CH mean increase from baseline 5.7. This represents a recovery speed at day 28 -20.4% faster for the fan vs 4.1% slower for the CH.

Qualitative data indicated participants valued the faster recovery and identified the fan as a useful “medical” device, but found the CH unhelpful.

A phase III RCT is feasible. Mixed-method data synthesis supports recovery time as a novel, meaningful outcome measure.


Swan, F., English, A., Allgar, V., Hart, S. P., & Johnson, M. (2019). The hand-held fan and the Calming Hand for people with chronic breathlessness: a feasibility trial. Journal of pain and symptom management, 57(6), 1051-1061.e1.

Journal Article Type Article
Acceptance Date Feb 18, 2019
Online Publication Date Feb 23, 2019
Publication Date 2019-06
Deposit Date Mar 26, 2019
Publicly Available Date Mar 26, 2019
Journal Journal of Pain and Symptom Management
Print ISSN 0885-3924
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 57
Issue 6
Pages 1051-1061.e1
Keywords Anesthesiology and Pain Medicine; General Nursing; Clinical Neurology
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Copyright Statement
© 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license

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