The subjective and psychosocial nature of breathlessness

Dyspnoea, also referred to as breathlessness, is a concern of nurses in most clinical settings. Nursing interventions are directed toward preventing or treating dyspnoea in a timely manner. Even though dyspnoea is a common phenomenon found in clinical settings and discussed in the literature, it has not been added formally to the list of diagnoses developed by the North American Nursing Diagnosis Association, most likely because it is an isolated, observable sign. However, breathlessness, the related construct, is a distinctly different phenomenon from dyspnoea. The terms dyspnoea and breathlessness are used interchangeably in the literature. Traditionally, dyspnoea is defined as difficult or laboured breathing observable to another person. Breathlessness is the subjective feeling of laboured breathing with and without dyspnoea and/or abnormal pulmonary functions. These authors submit that the nursing diagnosis of breathlessness consists of two essential defining criteria, the subjective feeling of difficulty in breathing and anxiety, in the presence or absence of dyspnoea and/or abnormal pulmonary functions. A biopsychosocial model is presented to guide research and nursing care for individuals who experience breathlessness.