• Simen A Steindal, Henny Torheim, Trine Oksholm, Vivi L Christensen, Kathryn Lee, Anners Lerdal, Heidi Øksnes Markussen, Gerd Gran, Marit Leine, and Christine Råheim Borge.
• Lovisenberg Diaconal University College, Oslo, Norway.
• J Adv Nurs. 2019 May 1; 75 (5): 927-945.

AimTo critically review and synthesize the findings of studies that evaluated the effectiveness of nursing interventions for improving breathlessness in adults with chronic obstructive pulmonary disease.BackgroundSystematic reviews of nursing interventions for breathlessness in people with chronic obstructive pulmonary disease have not been specifically addressed.DesignSystematic review with meta-analysis.Data SourcesA systematic search of Medline, CINAHL, PsycINFO and Embase was performed for studies published between January 2000 and June 2017.Review MethodsRisk of bias, data extraction and meta-analysis were conducted using Cochrane methodology. The quality of evidence was assessed using the GRADE approach.ResultsTwenty papers were included. A meta-analysis of interventions performed at home, including two trials, showed a significant effect in favour of experimental groups for the symptom score of the St. George Respiratory Questionnaire compared with controls. A meta-analysis of interventions performed in clinics with home follow-up showed a significant effect in favour of experimental groups for the mastery and fatigue scores of the Chronic Respiratory Questionnaire compared with controls. In this category of intervention, an additional meta-analysis showed a significant effect in favour of experimental groups for the symptom, activity and total scores of the St. George Respiratory Questionnaire compared with controls. The quality of evidence was assessed to be very low to moderate.ConclusionThe results are equivocal as to whether nursing interventions performed at home and nursing interventions performed in hospital with follow-up improve breathlessness in people with chronic obstructive pulmonary disease.© 2018 John Wiley & Sons Ltd.

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