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How physicians in South India recognise, assess and manage people with chronic breathlessness syndrome: a thematic analysis

Barnes-Harris, Matilda; Daniel, Sunitha; Venkateswaran, Chitra; Hutchinson, Ann; Johnson, Miriam

Authors

Matilda Barnes-Harris

Sunitha Daniel

Chitra Venkateswaran



Abstract

Objectives: Chronic breathlessness syndrome has been defined to help clinicians actively seek, and patients legitimately present with, persistent breathlessness, and to drive services and research. However, views from low- to middle-income countries were not included. We aimed to explore the views of hospital physicians regarding chronic breathlessness syndrome, its recognition and management. Methods: This was a secondary analysis of qualitative data collected during a service development project. Three focus groups of physicians caring for patients with chronic breathlessness in a single tertiary hospital in South India were conducted in English, audio-recorded, transcribed, and subjected to thematic analysis. Results: Fifteen physicians from oncology, palliative care, cardiology, and respiratory specialties participated. Three major themes (impact, invisibility, and purpose) were generated. Findings mirrored those in high-income countries. Chronic breathlessness, as defined, was seen as prevalent, with a major impact on patients, families, and physicians. Nonpalliative care physicians described therapeutic helplessness with poor awareness and/or ability to manage breathlessness accompanied by active avoidance. This helplessness, a perceived lack of assessment tools and lack of access to palliative care contributed to the “invisibility” of chronic breathlessness. Most participants agreed with the name of chronic breathlessness syndrome. All agreed that systematic identification would foster education regarding assessment and management and support service development and research. Conclusions: Chronic breathlessness syndrome is recognized in South India but, as in higher-income countries, risks being invisible due to the lack of awareness of therapeutic interventions. A named and defined syndrome was seen as a way to improve identification and management.

Citation

Barnes-Harris, M., Daniel, S., Venkateswaran, C., Hutchinson, A., & Johnson, M. (in press). How physicians in South India recognise, assess and manage people with chronic breathlessness syndrome: a thematic analysis. Indian Journal of Palliative Care, 27(1), 54-61. https://doi.org/10.4103/IJPC.IJPC_139_20

Journal Article Type Article
Acceptance Date Jul 1, 2020
Online Publication Date Feb 17, 2021
Deposit Date Jul 28, 2020
Journal Indian Journal of Palliative Care
Print ISSN 0973-1075
Peer Reviewed Peer Reviewed
Volume 27
Issue 1
Pages 54-61
DOI https://doi.org/10.4103/IJPC.IJPC_139_20
Keywords Chronic breathlessness; Dyspnea; India; Qualitative; Syndrome
Public URL https://hull-repository.worktribe.com/output/3548617