Australian Institute of Health and Welfare. Chronic obstructive pulmonary disease (COPD). 2020.

Blackstock FC, Lareau SC, Nici L Chronic obstructive pulmonary disease education in pulmonary rehabilitation. An Official American Thoracic Society/Thoracic Society of Australia and New Zealand/Canadian Thoracic Society/British Thoracic Society Workshop Report. Ann Am Thorac Soc. 2018; 15:(7)769-784

Bolton CE, Bevan-Smith EF, Blakey JD British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax. 2013; 68:(Suppl 2)ii1-30

Edwards K, Singh S P235 The Bristol COPD knowledge questionnaire (bckq): assessing the knowledge of healthcare professionals involved in the delivery of COPD services. Thorax.. 2012; 67:(Suppl 2)A167.2-A167

Gibbs GR, 2nd edn. London: SAGE Publications; 2018

Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2020.

Griffiths R, Johnson M, Piper M, Langdon R A nursing intervention for the quality use of medicines by elderly community clients. International Journal of Nursing Practice.. 2004; 10:(4)166-176

Guo SE, Shen HC, Okoli C Generalist versus specialist nurses’ knowledge, attitudes, and behavioral intentions toward promoting pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: a cross-sectional correlational study. Medicine (Baltimore).. 2018; 97:(43)

Howcroft M, Walters EH, Wood-Baker R, Walters JA Action plans with brief patient education for exacerbations in chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2016; 12

Hutchinson A, Pickering A, Williams P, Bland JM, Johnson MJ Breathlessness and presentation to the emergency department: a survey and clinical record review. BMC Pulm Med.. 2017; 17:(1)

Johnston KN, Young M, Kay D, Booth S, Spathis A, Williams MT Attitude change and increased confidence with management of chronic breathlessness following a health professional training workshop: a survey evaluation. BMC Med Educ.. 2020; 20:(1)

Kirkpatrick P, Wilson E, Wimpenny P Support for older people with copd in community settings: a systematic review of qualitative research. systematic reviews.. 2012; 10:(57)3649-3763

Lung Foundation Australia. The COPD-X Plan: Australian and New Zealand Guidelines for the management of chronic obstructive pulmonary disease. 2020.

Ma Y, Peng Y, Chen P, Nie N, Chen Y Assessment of COPD-related knowledge among internal medicine nurses: a cross-sectional study. Int J Chron Obstruct Pulmon Dis.. 2019; 14:2917-2925

McHugh GA, Horne M, Chalmers KI, Luker KA Specialist community nurses: a critical analysis of their role in the management of long-term conditions. Int J Environ Res Public Health.. 2009; 6:(10)2550-2567

Parshall MB, Schwartzstein RM, Adams L An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med.. 2012; 185:(4)435-452

Prekker ME, Feemster LC, Hough CL The epidemiology and outcome of prehospital respiratory distress. Acad Emerg Med.. 2014; 21:(5)543-550

Schutz S Reflection and reflective practice. Community Pract. Sep. 2007; 80:(9)26-29

Sharma A, Minh Duc NT, Luu Lam Thang T A consensus-based checklist for reporting of survey studies (CROSS). J Gen Intern Med.. 2021; 36:(10)3179-3187

Spathis A, Booth S, Moffat C The Breathing, Thinking, Functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease. NPJ Prim Care Respir Med.. 2017; 27:(1)

Spruit MA, Singh SJ, Garvey C An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med.. 2013; 188:(8)e13-64

Stedman TLPhiladelphia: Lippincott Williams & Wilkins; 2016

Wagner EH The role of patient care teams in chronic disease management. Education and debate. BMJ.. 2000; 320:569-572

White R, Walker P, Roberts S, Kalisky S, White P Bristol COPD Knowledge Questionnaire (BCKQ): testing what we teach patients about COPD. Chronic Respiratory Disease.. 2006; 3:123-131

Wong CX, Carson KV, Smith BJ Home care by outreach nursing for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012; (4)

World Health Organization. Enhancing the role of community health nursing for universal health coverage. 2017.;jsessionid=07400E8537C72BA5772085C36576825B?sequence=1

Zwerink M, Brusse-Keizer M, van der Valk PD Self management for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2014; (3)

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

02 August 2023
Volume 28 · Issue 8



Little is known about community nurses’ knowledge of breathlessness and its management in chronic obstructive pulmonary disease (COPD).


To explore the community registered nurses’ knowledge of COPD and the strategies that they use to manage breathlessness in people with COPD.


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.


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).

Register now to continue reading

Thank you for visiting Community Nursing and reading some of our peer-reviewed resources for district and community nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • New content and clinical newsletter updates each month