RDOS-family: A guided learning tool for layperson assessment of respiratory distress

摘要

The authors have developed and completed pilot testing of a tool for family assessment of respiratory distress. The Respiratory Distress Observation Scale?(RDOS) was developed to guide clinician assessment when a patient's dyspnea self-report could not be elicited. Acceptable reliability and validity psychometrics are reported elsewhere. RDOS-Family was developed for use in the home palliative care/ hospice setting to guide family caregiving. Family-caregivers (FC) receive variable amounts of training from hospice personnel regarding symptom management, yet they have the around-the-clock responsibility of ensuring patient comfort at the end of life. Patient and family outcomes are dependent on the quality of FC ability to accurately assess the patient and provide the relevant interventions. Increased feelings of guilt, despair, and anger over the suffering and symptoms of their loved ones because the FC felt responsible for the worsening symptoms have been identified. Negative caregiver outcomes have been reported such as depression, fatigue, and mood disturbance. In addition, hospice diagnoses of heart and lung disease, with dyspnea as the most prevalent, distressing symptom, are associated with acute hospital admissions and a nonpreferred site of death.