Dyspnoea or shortness of breath is a common symptom experienced by many patients with life-limiting illness. Although dyspnoea can be measured in several ways, the impact and significance of symptoms for patients is often best described directly by patients through regular assessment. The patient’s symptoms of dyspnoea can exert a strong influence on patient, family and carer experience throughout the trajectory of serious illness. The Symptom Assessment Scale includes a domain around breathing problems. Assessment of dyspnoea should include collecting information about the onset of shortness of breath (gradual or acute), the relationship to activity, and relieving factors (rest, positioning-forward lean, etc.). Additional investigations may be appropriate to guide management these could include oxygen saturations, bloods, medical imaging, electrocardiogram, etc.
Dyspnoea Visual Analogue Scale (VAS)
This unidimensional single-item scale, usually on a scale of 0-10, provides an estimate of a patient’s shortness of breath.
Modified Borg Dyspnoea Scale (181kb pdf)
This instrument is used to measure the self-reported intensity of the sensation of breathlessness. The Modified Borg Dyspnoea Scale rates dyspnoea on a scale of 0-10 to quantify the intensity of dyspnoea during activity.
| Modified Borg Dyspnoea Scale |
| 0 |
Nothing at all |
| 0.5 |
Very, Very slight (just noticeable) |
| 1 |
Very slight |
| 2 |
Slight |
| 3 |
Moderate |
| 4 |
Somewhat severe |
| 5 |
Severe |
| 6 |
|
| 7 |
Very, severe |
| 8 |
|
| 9 |
Very, very severe (almost maximal) |
| 10 |
Maximal |
Patient Instructions for the Modified Borg Dyspnoea Scale: “This is a scale that asks you to rate the difficulty of your breathing. It starts at number 0 where your breathing is causing you no difficulty at all and progresses through to number 10 where your breathing difficulty is maximal. How much difficulty is your breathing causing you right now?”