Term Paper: Family Copes With COPD Nursing

Pages: 6 (2221 words)  ·  Bibliography Sources: 8  ·  Level: College Senior  ·  Topic: Disease  ·  Buy This Paper


[. . .] " (Blumenthal, et al., 2009, p. 1) Kelly and Lymes (2008) report psychological interventions exist for managing dysponoea including techniques such as: (1) distraction therapy and (2) relaxation. (2008, p. 1) As well good communication and patient and family involvement in decision making serve to reduce fears and assist the patient in feeling more in control. Pharmacological approaches are stated to be valuable in depression, panic, and insomnia treatment and include use of anxiolytics and opiods as well as oxygen treatment for relieving dysponoea. (Kelly and Lymes, 2008, paraphrased) Blumenthal, et al. (2009) report study findings that state as follows:

"Given the significant symptom burden associated with COPD, and the impact of resulting psychological distress on physical functioning and exercise capacity, there is a great need for treatments that reduce the psychological symptoms of patients. The INSPIRE-II study is designed to reduce distress among COPD patients and to evaluate the impact of reduced distress on quality of life and medical endpoints. Inclusion of caregivers in this treatment is designed to allow for ongoing coaching support for patients, while also reducing caregiver strain, a common problem among caregivers of chronically ill patients. (Blumenthal, et al., 2009, p. 1)

Analysis of the Nursing Literature

As noted in the work of Kelly and Lymes (2008) there has been a tendency to ignore the psychosocial burden associated with COPD. Contributing to depression in patients with COPD as well as in their caregivers and families is the "degenerative trajectory of the disease" as well as the loss of the quality of life for the patient. Stress and anxiety as well as depression, fear of dying, panic, an altered body image and altered role in the family along with the loss of control and independence all exacerbated by lifestyle changes and changes in relationships work toward the patient developing low self-esteem and oftentimes denial, anger, loss of dignity and frustration accompanied by frustration, guilt and a loss of intimacy resulting in the patient feeling irritable and impatient. Patients with COPD have been shown to often have a tougher time coping than do patients with cancer.

Evidence-based Recommendations, Gaps in Treatment and Implications for Nursing Practice

Evidence-based recommendations for the nursing practice in patients with COPD include those as stated in the Registered Nurses Association of Ontario, Nursing Best Practice Guidelines: Recommendations which are attached to this work and labeled Appendix 'A. Evidence-based recommendations for the nursing practice in patients with COPD include recommendations for ongoing coaching and support provided by the professional nurse to patients with COPD and their families. Assessment tools are available for assessing patient depression and include those of: (1) the Chronic Respiratory Disease Questionnaire; or (2) the St. George's Respiratory Questionnaire. (Kelly and Lymes, 2008, p. 1) There are therapies that can be used to treat depression, anxiety, and insomnia as well as pharmacological therapies that are effective and that include the use of anxiolytics and opiods as well as oxygen treatment therapy. It is critical that the nurse recognize the family role as one that is essential and that the nurse makes a determination of the family involvement in caregiving for the patient with COPD. Assessment should focus on the perception of the family as well as the family structure, environmental conditions and strengths of the family. There are gaps existing in the research including how to make the determination of the degree of involvement of the family in care of the patient as well as in the strategies that nursing professionals can use effectively in informing the patient and their family of the disease progression and the treatment care needed for each stage of the disease.


Arne, M. et al. (2007) COPD patients' perspectives at the time of diagnosis. Primary Care Respiratory Journal; 16: 4, 215 -- 221 in: Kelly, Carol and Lymes, D. (2008) Psychological effects of chronic lung disease. Nursing Times; 104: 47, 82 -- 85.

Blumenthal, James A., et al. (2009) Caregiver-Associated Coping Skills Training for Patients with COPD; background, design, and methodological issues for the INSPIRE-II Study. Clinical Trails 2009 April 6(2). Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690229/

Kelly, Carol and Lynmes, D. (2008) Psychological effects of chronic lung disease. Nursing Times; 104: 47, 82 -- 85.

MacNaughton, Kathi (2009) COPD Caregiver Perspectives -- Dealing with Depression.… [END OF PREVIEW]

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