S E Roberts1, F M Schreuder2, T Watson2, M Stern3. 1. Whittington Hospital Physiotherapy, Whittington Health, London, UK. Electronic address: Suzanne.roberts4@nhs.net. 2. Department of Allied Health Professions and Midwifery, School of Health and Social Work University of Hertfordshire, UK. 3. Department of Respiratory Medicine, Whittington Health, London, UK.
Abstract
OBJECTIVE: To investigate whether COPD patients taught pursed lips breathing (PLB) for dyspnoea management continue to use the technique long-term and, if so, their experience of this. DESIGN: A mixed methodological approach using semi-structured telephone interviews, a focus group and observation of current PLB technique was used. Qualitative analysis was based on grounded theory. SETTING: Participants were recruited from the two inner city London (UK) boroughs. PARTICIPANTS: A purposive sample of 13 patients with COPD taught PLB 6 to 24 months previously. 11 participants took part in the telephone interviews; focus group participation and observed PLB was 5/11 and 6/11 respectively. MAIN OUTCOME MEASURES: A thematic analysis of interviews and focus group; observation of PLB technique. RESULTS: Nine reported on-going use of PLB with 8 reporting definite benefit. Observed technique showed ongoing ability for PLB to reduce RR and increase SpO2. Four distinct themes emerged from the data: use of PLB when short of breath due to physical activity (8/9), increased confidence and reduced panic (4/9), use as an exercise (3/9), use at night (3/9). Those that had discontinued PLB had done so because it didn't help (2) and they had forgotten/were too busy to continue. CONCLUSION: This study found 9 of 13 of patients taught PLB continued with long-term use and 8 of 13 reporting definite benefit from PLB. The role of PLB in increasing patients' confidence in their ability to manage their breathlessness and, use at night, were novel findings.
OBJECTIVE: To investigate whether COPDpatients taught pursed lips breathing (PLB) for dyspnoea management continue to use the technique long-term and, if so, their experience of this. DESIGN: A mixed methodological approach using semi-structured telephone interviews, a focus group and observation of current PLB technique was used. Qualitative analysis was based on grounded theory. SETTING:Participants were recruited from the two inner city London (UK) boroughs. PARTICIPANTS: A purposive sample of 13 patients with COPD taught PLB 6 to 24 months previously. 11 participants took part in the telephone interviews; focus group participation and observed PLB was 5/11 and 6/11 respectively. MAIN OUTCOME MEASURES: A thematic analysis of interviews and focus group; observation of PLB technique. RESULTS: Nine reported on-going use of PLB with 8 reporting definite benefit. Observed technique showed ongoing ability for PLB to reduce RR and increase SpO2. Four distinct themes emerged from the data: use of PLB when short of breath due to physical activity (8/9), increased confidence and reduced panic (4/9), use as an exercise (3/9), use at night (3/9). Those that had discontinued PLB had done so because it didn't help (2) and they had forgotten/were too busy to continue. CONCLUSION: This study found 9 of 13 of patients taught PLB continued with long-term use and 8 of 13 reporting definite benefit from PLB. The role of PLB in increasing patients' confidence in their ability to manage their breathlessness and, use at night, were novel findings.