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Dyspnoea at the end of life: instrument development and validation—the CONFORTO Strategy
  1. Isadora Crosara Alves Teixeira1,
  2. Ana Maria Porto Carvas2,
  3. Ricardo Borges da Silva1,
  4. Eliza Borges2,
  5. Patrícia Corrêa-Faria3 and
  6. Marcelo Fouad Rabahi1
  1. 1Internal Medicine Department, School of Medicine, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
  2. 2Hospital Estadual Dr. Alberto Rassi, Goiânia, Brazil
  3. 3Dentistry Graduate Program, School of Dentistry, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
  1. Correspondence to Dr Isadora Crosara Alves Teixeira, Universidade Federal de Goiás, Goiania, GO 74690-900, Brazil; isadoracrosara{at}gmail.com

Abstract

Objective To describe the construction and validation of the algorithm for Criteria for inclusion; Objective of dyspnoea; Notification of patient/family/health professionals; Facial air flow; Oxygen; Relaxion and breathing; Treating causes of dyspnoea and Opioid (CONFORTO), an instrument to guide health professionals in managing dyspnoea in patients with an advance stage of the disease at the end-of-life.

Methods The study was carried out in three stages: (1) literature review and construction of CONFORTO; (2) semantic validation; (3) application of the CONFORTO Strategy to health professionals as a test (before video lessons) and post-test (20 days after watching video lessons) methodology. The scores obtained in the pretest and post-test were compared using the Wilcoxon test.

Results Seventy-four professionals from different internal medicine and intensive care units participated in the study. The CONFORTO Strategy involved eight acronym-forming items: Criteria for inclusion; Objective of dyspnoea; Notification of patient/family/health professionals; Facial air flow; Oxygen; Relaxion and breathing; Treating causes of dyspnoea and Opioid. The post-test indicated a significant increase in the score for the following items: facial air flow (p=0.016); oxygen (p=0.002); relaxation and breathing (p=0.002) and treating the causes of dyspnoea (p=0.011). The increase in score occurred after the training sessions with video lessons.

Conclusion The CONFORTO Strategy proved valid and reliable for managing dyspnoea in patients with an advanced stage of the disease at the end-of-life. Because the instrument is easy-to-use, it can be used by the entire health team at any assistance-providing location, and can, thus, contribute to improving dyspnoea management for these patients.

  • Clinical decisions
  • Dyspnoea
  • Terminal care

Data availability statement

All data relevant to the study are included in the article.

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Data availability statement

All data relevant to the study are included in the article.

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Footnotes

  • Contributors IT—the author made substantial contributions to the conception of the work, acquisition, data collection, analysis, interpretation of data, drafting the article, approved the final version to be published and is responsible for the overall content as guarantor. AMC—the author made substantial contributions to the conception of the work, data collection, drafting the article and approved the final version to be published. RS—the author made substantial contributions to the conception of the work, data collection, drafting the article and approved the final version to be published. EB—the author made substantial contributions to the conception of the work, data collection, drafting the article and approved the final version to be published. PC-F—the author made substantial contributions to the analysis, interpretation of data, drafting the article and approved the final version to be published. MR—the author made substantial contributions to the conception of the work, acquisition, interpretation of data, drafting the article and approved the final version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.