The overall objective of this study is to design and implement a nursing intervention strategy which will decrease the distress of the symptom of dyspnea and increase patients' capability for coping with this frightening and disabling sensation. This purpose will be accomplished by studying how repeated practice with the experience of dyspnea with nurse coaching in a controlled situation affects the intensity of dyspnea and the distress of the symptom for the patient, related anxiety, dyspnea with selected activities, perceived self efficacy for completing activities and distance walked. A secondary aim will be to determine if there is a pattern of change over time in anxiety, dyspnea intensity and dyspnea distress during the actual practice of exercising with dyspnea with nurse coaching. Theories of coping, control, desensitization, and self efficacy provide the framework. The design is an experimental longitudinal design over 3 months, with random assignment to a control group which receives the usual information about pulmonary disease and an experimental group which receives information plus repeated practice with the experience of dyspnea with nurse coaching. A 3 day a week for 3 weeks intensive graduated exercise with coaching through dyspnea will be followed by at home exercise with dyspnea. One home visit will be made at 2 months for reinforcement of the experimental intervention. The sample will be 62 chronic lung disease patients who are limited by dyspnea. Pre and post treatment measures of dyspnea intensity, anxiety, dyspnea with activities, perceived self-efficacy and distance walked between the 2 groups will be compared followed by a secondary analysis of the trends in anxiety, dyspnea intensity and dyspnea distress during actual graduated levels of dyspnea with nurse coaching. This study will systematically examine a """"""""desensitization"""""""" treatment of dyspnea proposed by several authors. The study findings will add to knowledge related to the treatment of dyspnea, a common human response to illness, and contribute to the development of nursing science in the care of pulmonary patients.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR002131-02
Application #
3392094
Study Section
Nursing Research Study Section (NURS)
Project Start
1989-06-01
Project End
1992-05-31
Budget Start
1990-06-01
Budget End
1991-05-31
Support Year
2
Fiscal Year
1990
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Type
Schools of Nursing
DUNS #
073133571
City
San Francisco
State
CA
Country
United States
Zip Code
94143
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Donesky, DorAnne; Janson, Susan L; Nguyen, Huong Q et al. (2011) Determinants of frequency, duration, and continuity of home walking in patients with COPD. Geriatr Nurs 32:178-87
Carrieri-Kohlman, Virginia; Donesky-Cuenco, DorAnne; Park, Soo Kyung et al. (2010) Additional evidence for the affective dimension of dyspnea in patients with COPD. Res Nurs Health 33:4-19
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Carrieri-Kohlman, Virginia; Nguyen, Huong Q; Donesky-Cuenco, DorAnne et al. (2005) Impact of brief or extended exercise training on the benefit of a dyspnea self-management program in COPD. J Cardiopulm Rehabil 25:275-84
Nguyen, Huong Q; Carrieri-Kohlman, Virginia (2005) Dyspnea self-management in patients with chronic obstructive pulmonary disease: moderating effects of depressed mood. Psychosomatics 46:402-10
Nguyen, Huong Q; Carrieri-Kohlman, Virginia; Rankin, Sally H et al. (2005) Is Internet-based support for dyspnea self-management in patients with chronic obstructive pulmonary disease possible? Results of a pilot study. Heart Lung 34:51-62
Nguyen, Huong Q; Altinger, Julie; Carrieri-Kohlman, Virginia et al. (2003) Factor analysis of laboratory and clinical measurements of dyspnea in patients with chronic obstructive pulmonary disease. J Pain Symptom Manage 25:118-27
Carrieri-Kohlman, V; Gormley, J M; Eiser, S et al. (2001) Dyspnea and the affective response during exercise training in obstructive pulmonary disease. Nurs Res 50:136-46
Carrieri-Kohlman, V; Gormley, J M; Douglas, M K et al. (1996) Differentiation between dyspnea and its affective components. West J Nurs Res 18:626-42

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