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dyspnea, hospice, nonpharmacological



  1. Smothers, Angel DNP, FNP-BC
  2. Buck, Joy PhD, RN


Patients with advanced illness who experience dyspnea struggle for comfort. Nurses and advanced practice providers use strategies involving pharmacological interventions to improve the comfort level for these patients. Despite empirical support for nonpharmacological interventions, their use has decreased as pharmacological interventions have proven effective. However, pharmacological interventions alone often do not relieve dyspnea. We evaluated an educational intervention to increase the use of nonpharmacological interventions as an adjunct to standard treatment among hospice patients with dyspnea. Fourteen nurses at a single hospice agency participated in an hour-long in-service and were given a toolkit of evidence-based nonpharmacological interventions. Pretest and posttest questionnaires were used to elicit prior knowledge and use of nonpharmacological interventions and posteducation intervention knowledge and intent to educate patients and caregivers about these techniques. Follow-up calls to patients (n = 30) and caregivers (n = 23) were conducted approximately 2 weeks after the educational session. The calls revealed that 67% of patients and 57% of caregivers were taught the interventions, 90% of patients and 92% of caregivers remembered the interventions, 70% of patients and 58% of caregivers used at least one of the techniques, and 93% of patients and 86% of caregivers found them useful. The implementation of a nonpharmacological treatment plan into the care provided in a hospice setting can improve dyspnea management.