Living with breathlessness: a systematic literature review and thematic synthesis

Abstract

Question: What is the experience of people living with breathlessness due to medical conditions, those caring for and those treating them, with regard to quality of life and the nature of clinical interactions? Methods: Electronic databases (Ovid MEDLINE, Embase, CINAHL Plus, PsycINFO) were searched (1987 to October 2017; English language), for qualitative studies exploring the experience of chronic breathlessness (patients, carers, clinicians).Two independent reviewers screened titles, abstracts and papers retrieved against inclusion criteria. Disagreements were resolved with a third reviewer. Primary qualitative data were extracted and synthesised using thematic synthesis.Results: Inclusion and synthesis of 101/2,303 international papers produced four descriptive themes: 1) widespread effects of breathlessness, 2) coping, 3) helpseeking behaviour, and 4) clinicians' responsiveness to the symptom of breathlessness. The themes were combined to form the concept of "Breathing Space", to show how engaged coping and appropriate help-seeking (patient) and attention to symptom (clinician) helps maximise the patient's quality of living with breathlessness.Answers: Breathlessness has widespread impact on patient and carer and affects Breathing Space. The degree of Breathing Space is influenced by interaction between the patient's coping style, their help-seeking behaviour and their clinician's responsiveness to breathlessness itself in addition to managing the underlying disease. 10 family nurse units Narrative Analysis Pinnock (94) UK COPD Patients (14m, 7f) Carers (13 informal, professional) Unspecified Roberts 1993 (95) Canada Cancer patients (4m, 6f), Clinicians (12 -all nurses, gender unspecified) Cancers -Lung (4), Breast (2), Throat (1), Stomach (1), Prostate (1) Kidney (1) Unspecified Robinson 2005