References
A Survey of Community Nurses' Knowledge and Strategies Used to Relieve Breathlessness in People with Chronic Obstructive Pulmonary Disease

Abstract
Background:
Little is known about community nurses’ knowledge of breathlessness and its management in chronic obstructive pulmonary disease (COPD).
Aim:
To explore the community registered nurses’ knowledge of COPD and the strategies that they use to manage breathlessness in people with COPD.
Methods:
A cross-sectional survey study of community registered nurses was conducted using the 65-item Bristol COPD Knowledge Questionnaire and an open-ended item to outline breathlessness strategies.
Findings:
A total of 59 nurses participated. The total mean Bristol COPD Knowledge Questionnaire Score was 43. The breathlessness category was the lowest scoring category. There were three themes that synthesised: the community nurse’s role in monitoring self-management of medications to relieve breathlessness; the use of non-pharmacological strategies to relieve breathlessness; the nursing skills used to monitor breathlessness in people with COPD.
Chronic obstructive pulmonary disease (COPD) is the third leading cause of global deaths (WHO, 2017). The WHO estimates that there are 251 million people diagnosed globally with moderate to severe COPD (WHO, 2017). In Australia, approximately 4.8% of people aged over 45 years have COPD, costing the Australian health system over AUD 970 million, or 24% of the chronic respiratory disease expenditure (Australian Institute of Health and Welfare, 2020). People with COPD incur frequent clinical exacerbations; in later stages, there is a progressive deterioration in physical status, a high symptom burden, increased social restrictions and psychological stressors that impact on quality of life (Global Initiative for Chronic Obstructive Lung Disease (GOLD), 2020).
In Australia, community nursing services are an integral part of primary healthcare and are often provided in the home for people with chronic diseases, as they are ideally placed to provide symptom management (Wagner, 2000). Community nurses in Australia and the UK share many similiar tasks and activities including: health promotion; disease prevention; chronic disease management; rehabilitation and palliation (WHO, 2017). In both countries, these skills are supported by self-management models that have focused on improving motivation, resilience and confidence of people with chronic diseases to manage their condition (Wagner, 2000).
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