NURSE COACHED PRACTICE FOR RELIEF OF DYSPNEA

本研究的总体目标是设计和实现一个 减少患者痛苦的护理干预策略 呼吸困难症状与提高患者应对能力 带着这种可怕和令人不知所措的感觉。这一目的将是 是通过研究如何反复练习 受控情况下护士指导下呼吸困难的护理体会 影响呼吸困难的强度和症状的苦恼 对于患者，相关的焦虑，有选择的活动的呼吸困难， 完成活动的自我效能感与距离 走着去。次要目标将是确定是否存在某种模式 焦虑、呼吸困难强度和呼吸困难随时间的变化 在实际练习中出现呼吸困难时的苦恼 护士指导。应对、控制、脱敏和 自我效能感提供了框架。 该设计是一个为期3个月的试验性纵向设计， 随机分配给对照组，对照组接受通常的 关于肺部疾病的信息和一个试验组 获得信息，并通过以下经验反复练习 带护士指导的呼吸困难。每周3天，为期3周的强化训练 将遵循分级练习，并通过呼吸困难进行指导 通过在家中锻炼呼吸困难。一次家访将在 2个月为强化实验干预。这个 样本将是62名慢性肺部疾病患者，他们受到 呼吸困难。治疗前后呼吸困难强度的治疗措施， 焦虑、活动呼吸困难、自我效能感和 将比较两组之间的步行距离，然后是 焦虑、呼吸困难强度变化趋势的再分析 和呼吸困难期间的实际程度的呼吸困难 护士指导。 这项研究将系统地研究一种“脱敏”。 几位作者提出的治疗呼吸困难的方法。这项研究 这些发现将增加与呼吸困难治疗相关的知识， 人类对疾病的共同反应，并有助于 护理科学在肺部疾病护理中的发展。

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.