Non-pharmacological management of breathlessness: a collaborative nurse--physiotherapist approach

Breathlessness is a common and challenging symptom in palliative care. A simple audit of 470 patients under the St Christopher's Hospice Homecare team found that 43% complained of breathlessness. Research has indicated that non-pharmacological management can be of benefit to terminally ill patients with breathlessness. Knowing that both nurses and physiotherapists each have core skills to offer these patients, the authors aimed to integrate and consolidate their approach to enhance best practice. The supportive care and advice of the clinical nurse specialist was combined with physiotherapy sessions. The aim of this collaborative approach was to reduce patient anxiety, maximize respiratory function and provide information to help patients understand, adapt and regain some control of their breathing. A leaflet containing simple written information for patients was developed and found to be useful. It was found that supportive professional relationships strengthened links between the multiprofessional team. Positive feedback has been received from patients and health-care professionals about the sessions and breathlessness leaflet. By establishing this combined approach the authors have contributed to significant practice development at St Christopher's Hospice.