It is suggested by Henderson (1998) that breathlessness in the UK today is a common and complex subjective set of symptoms. A vast range of medical and lifestyle choices cause and exacerbate breathlessness, which can be a frightening and sometimes a painful experience for the patient. A nurses interaction with a patient can help alleviate and reduce these episodes and make a substantial difference to patients both in the community and hospital setting.
For many people, becoming breathless after normal exertion is nothing to be concerned about as commented on by Madge and Esmond (2001) and is the expected physiological response to increased activity. However for those who become ...view middle of the document...
The biggest shift is the use of the model rather than its development, as the model was created for the education purpose of nursing students rather than nurses in practice.
The Activities of Daily Living have been refined for over 30 by the authors and were first published as part of the publication “The Elements of Nursing” in 1980. Today the model is widely used by students and healthcare professionals from different backgrounds including Occupational Therapists, Physiotherapists, Nurses and others. It is useful for health care professions and others when using parts of the model in direct relation to a person’s healthcare needs in an individual area such as breathlessness, and as mentioned previously allows for the start of an evidence based approach to the patients difficulty.
As part of the model of living, the activities that make up the model are referred to collectively as the Activities of Living, and describe what everyday activities take place in human life regardless of age, wealth or circumstance. By modelling these activities it is possible to compare different groups and/or individuals and to measure their relative quality of life, well-being and health status.
The Activity of living - breathing is possibly one of the most important of the 12 AL’s, yet is one where most people would take for granted or neglect to identify it’s importance in the first place. “Taking the first breath is of crucial importance at the birth of every baby and determines whether or not the infant will have a viable existence as a human being” Roper, Logan and Tierney (2003 p22).
A competent assessment of breathlessness (also referred to as dyspnoea) would require a nurse to ask a patient to briefly describe how various daily activities affect their breathing. Documenting the patient’s responses on a scale such as provided by the Medical Research Councils Dyspnoea Scale (NICE 2007) is an effective way of understanding the patient’s physical limitations and the impact that breathlessness has.
The activity of maintaining a safe environment as described by Roper, Logan and Tierney (2003 p17) with regards to stress (excessive) as an environmental hazard is key, and it may not always be within the ability of the patient to remain calm at such a distressing time. Good communication, reassurance and an understanding of the patients experience are key factors in order to limit the episode, as well as obtaining relevant information related to the onset of breathlessness as well as correct medical intervention.
Roberts and Powell (1998 p119) clearly define this by saying “The ability to build good rapport and demonstrate empathy will greatly enhance the therapeutic relationship between the nurse and patient and the quality of the information gathered”. Maintaining eye contact, matching the pace and pitch of the patients language and taking time to understand and confirm back to the patient that the information they are sharing has been understood...