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We need more research to manage dyspnoea

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My invitation to write this editorial came as I was attending the American Thoracic Society’s (ATS) International Conference in Toronto, Canada (16–21 May).

The ATS Nursing Assembly is leading a project to revise the 1999 ATS statement on dyspnoea, which states that: ‘Breathlessness comprises qualitatively distinct sensations and arises from multiple factors including environmental, psychological and physiological.’ This definition highlights the complexity of the sensation of breathlessness, which is addressed in the article on p36. It will be interesting to see how far our understanding of this troublesome symptom has come since 1999.

An issue highlighted at the Assembly meeting was the challenge of managing dyspnoea in patients near the end of life. There is little evidence available as to the optimal management in such situations and, as such, this is a priority for future investigation.

Given the size of the ATS conference, one can imagine the huge volume of presentations and posters available. One poster that caught my attention was a study (Apps et al, 2008) that explored patients’ beliefs and expectations of pulmonary rehabilitation before they attended the programme. The authors concluded that, although patients were eager to take part in the programme, they had little idea about what pulmonary rehabilitation meant or consisted of. The study highlights the need for information that includes explaining to patients the content of pulmonary rehabilitation as this may be important for programme uptake and completion.

This is a very exciting time for respiratory care. There are many advances and opportunities for respiratory nurses and our patients, not least the long-awaited National Service Framework for COPD. Nursing Times has relaunched a respiratory section on nursingtimes.net and I will be doing frequent blogs to keep respiratory nurses up to date with the many innovative activities taking place. I look forward to communicating with you all via this mechanism.

Janelle Yorke, lecturer, School of Nursing, Faculty of Health and Social Care, University of Salford.

Apps, L.D. et al (2008) Beliefs and expectations of pulmonary rehabilitation: a qualitative study.

American Journal of Respiratory and Critical Care Medicine; Abstract issue: 177.

American Thoracic Society (1999) Statement on dyspnoea.

American Journal of Respiratory and Critical Care Medicine; 159: 321–340.

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