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BackgroundBreathlessness is a debilitating and distressing symptom in a wide variety of diseases and still a difficult symptom to manage. An integrative review of systematic reviews of non-pharmacological and pharmacological interventions for breathlessness in non-malignant disease was undertaken to identify the current state of clinical understanding of the management of breathlessness and highlight promising interventions that merit further investigation.MethodsSystematic reviews were identified via electronic databases between July 2007 and September 2009. Reviews were included within the study if they reported research on adult participants using either a measure of breathlessness or some other measure of respiratory symptoms.ResultsIn total 219 systematic reviews were identified and 153 included within the final review, of these 59 addressed non-pharmacological interventions and 94 addressed pharmacological interventions. The reviews covered in excess of 2000 trials. The majority of systematic reviews were conducted on interventions for asthma and COPD, and mainly focussed upon a small number of pharmacological interventions such as corticosteroids and bronchodilators, including beta-agonists. In contrast, other conditions involving breathlessness have received little or no attention and studies continue to focus upon pharmacological approaches. Moreover, although there are a number of non-pharmacological studies that have shown some promise, particularly for COPD, their conclusions are limited by a lack of good quality evidence from RCTs, small sample sizes and limited replication.ConclusionsMore research should focus in the future on the management of breathlessness in respiratory diseases other than asthma and COPD. In addition, pharmacological treatments do not completely manage breathlessness and have an added burden of side effects. It is therefore important to focus more research on promising non-pharmacological interventions.

The aim of this study was to assess the cancer nursing research papers published in the past decade; identify their characteristics in terms of country of origin, participants, settings, diagnostic foci, and methodologic choices; and evaluate their quality. A systematic review was carried out of all published papers in the Cumulative Index of Nursing and Allied Health Literature between the years 1994 and 2003, using the keywords ''cancer,'' ''nursing,'' and ''research.'' A total of 619 papers met inclusion criteria and were evaluated by 5 researchers. Almost half the papers were derived from the United States (49.1%), followed by the UK, Sweden, Canada, and Australia. In more than half of the published papers (52.2%), health professionals (mostly nurses) were the studies' participants. Also, much of the published research used patients with mixed diagnosis, or patients with breast or hematologic cancers. Two-thirds of the studies were quantitative, whereas most studies were descriptive in nature. The quality of both quantitative and qualitative studies was low, with only a small percentage meeting the highest quality criteria.Studies reporting funding and those published in journals with an impact factor showed a higher quality score than those not reporting funding or not published in journals with an impact factor. Cancer nursing research is still in a developmental stage, although it has made a considerable contribution to the evidence base of the discipline. A number of issues need to be tackled before we improve our output, such as organizational or workforce issues, infrastructure support, funding, and methodologic challenges.

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