Table 3 Classification of breathlessness self-management interventions using evidence-based recommendations
Types of breathlessness self-management programmes shown to be effective by research 11 | ATS guidance on support for dyspnoea crisis 27 | |
|---|---|---|
Structured education | Information about breathlessness and its management including the actions patients can take: breathing and coughing techniques; energy conservation; health lifestyle behaviour change to increase activity/exercise; smoking cessation; management of roles and relationships; strategies for coping. | Â |
Breathing techniques skill training | Inclusion of specific breathing techniques and opportunities for skill feedback and monitoring. | Breathing retraining including pursed lip breathing, slowed pattern of breathing, prolonged exhalation and posture modification. |
Cognitive symptom management skill training | Coping training for symptoms, emotions and stress: therapeutic support; relaxation therapy. | Relaxation techniques, mindfulness meditation, guided imagery and distraction strategies (e.g., music, TV, reading by self or caregiver) |
Goal setting and action planning | Using a short-term plan of action for exacerbations or panic breathing episodes and to reach goals. | Use of a written action plan that includes appropriate administration and dosing of medications and stepwise titration regimens |
Problem-solving skills | Solution implementation and evaluation/monitoring of results; key messages and support for decision-making; skills of self-tailoring to facilitate adapting lifestyle to accommodate symptoms and to adopt health lifestyle change such as exercise: with or without surveillance; adherence measure. | Â |
Coaching in use of support services | Awareness of resources and navigating skills to gain access. | Â |
Partnership with healthcare providers | Ways to communicate effectively with providers. | Â |
Enhancement of self-efficacy | Teaching for performance mastery, modelling, re-interpretation of symptoms and social persuasion (peer support/modelling). | Â |
Other |  | • Basic facts about causes and triggers of dyspnoea crises. • How to identify signs and symptoms that are an indication of a dyspnoea crisis. • How to recognise and measure changes from baseline for both intensity of dyspnoea and an affective component (anxiety or distress). • Appropriate and individualised use of oxygen, ventilation and/or fans. |
