Persistant Dyspnea discovery through experiential teaching in Palliative Care Training

Dyspnea is one of the symptoms most frequently encountered in the advanced stages of many pathologies (cancerous or otherwise), which means that the principles of the palliative approach must be integrated into thinking on this subject.

Dyspnea, defined as a "subjective experience of respiratory discomfort consisting of qualitatively distinct sensations that vary in intensity, unpleasantness and emotional and behavioral significance", is a frequent symptom common to many pathologies. It is often compared to pain, which is defined as an "unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage."

These two symptoms are frequent, ubiquitous, multidimensional and can evolve into a true disease "in itself", becoming real sources of suffering with a major impact on patients' quality of life. However, analysis of the literature shows that dyspnea is less often sought out and identified by carers than pain. Its intensity and impact are often underestimated, and symptomatic treatment is less frequently implemented.

Correcting this invisibility is a major challenge for improving patient care. One explanation for the invisibility of dyspnea is that, unlike pain, it is not a universal experience. It is therefore difficult, even for caregivers, to imagine what patients who suffer from it are going through.

Discovering the experience of dyspnoea in people who don't usually suffer from it has already proved effective in reducing the invisibility of dyspnoea.

The aim of this work is to explore with continuing education students enrolled in Sorbonne University's palliative care university diploma this question of the invisibility of dyspnea.

Objective N°1: To compare the attitudes of students (otherwise experienced caregivers) to dyspnea or pain.

Objective N°2: Evaluate the impact of experiential dyspnea teaching on attitudes to dyspnea.

This is a prospective study akin to pedagogical research.

The aim is to see whether in this particular audience (experienced caregivers practicing in palliative care) there is a difference between pain and dyspnea.

If there isn't: by what mechanisms has the invisibility of dyspnea been lifted? Is there an influence of profession? seniority? Role of palliative care practice?

If it exists: what factors explain why dyspnea remains invisible to these experienced caregivers accustomed to assessing and taking into account the suffering of others? What is the impact of experiential learning? Is it of the same nature as what has been described in the literature in less experienced students?