Differences between experienced and recalled breathlessness: a review

Abstract

Purpose of reviewExperienced breathlessness and recalled breathlessness are two different entities, which may be associated with different factors and might have different impacts on function for the individual. The aim was to review the knowledge from the last 2 years concerning experienced breathlessness and recalled breathlessness and related factors. Recent findingsExperienced breathlessness was most often induced or measured during exercise testing in a lab environment using a modified Borg scale. It was associated with both psychological factors, such as social rejection, presence of others, psychosocial stress and prenatal exposure to stress, as well as physical factors, such as hypoxia and frequent exacerbations. Recalled breathlessness was most often measured in epidemiological studies, most commonly using the modified Medical Research Council scale. It was associated with lung volumes, overweight, exercise training, frailty, smoking, personality traits, behavior and marital and occupational status. SummaryNo studies during the review period had directly compared experienced breathlessness and recalled breathlessness. Several factors were related to either experienced breathlessness or recalled breathlessness but no clear differences between factors were found in this review. There is a need for comparative studies using the same measurement methods and in the same settings in order to examine their relation.

How to Assess Breathlessness in Chronic Obstructive Pulmonary Disease

“…Importantly, recall (involving cognition and memory) might not reflect the symptom that was actually experienced during the time period or activity. 100,101 While symptom recall forms the basis for most medical assessment and management, it is influenced by a number of factors including the person's mood and symptom severity at the time of assessment, as well as the peak (worst) symptom level during the recall period, ie, the peak-end-rule. 101,102 Another important limitation to daily life assessment is the lack of standardization of assessment conditions including of the person's level of physical activity.…”

Effect of the trajectory of exertional breathlessness on symptom recall and anticipation: A randomized controlled trial

“…The intervention group lacked one value regarding recalled performance and one value regarding physical capacity. Abbreviations: Borg CR10 = Borg Category-ratio scale (0-10); Borg RPE = Borg rating of perceived exertion scale (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

“…Recalled symptoms can differ substantially from the actually experienced symptoms [5][6][7]. The recall of symptom intensity is affected by several factors including the experienced peak intensity and the intensity at the end of the episode [5][6][7]. This 'Peak-end rule' has been reported in studies of pain [5,7], anxiety [8] and in breathlessness in daily life [9] and during exercise [10].…”

“…Patients' recall of breathlessness during recent activities and daily life is the basis for clinical evaluation and management. Recalled symptoms can differ substantially from the actually experienced symptoms [5][6][7]. The recall of symptom intensity is affected by several factors including the experienced peak intensity and the intensity at the end of the episode [5][6][7].…”

Prevalence and correlates of somatization in anxious individuals in a Chinese online crisis intervention during COVID-19 epidemic

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