Emma McGleenan and Dr Helen Noble, Queens University Belfast
“Chronic obstructive pulmonary disease (COPD) is an umbrella term for chronic lung conditions characterised by airflow obstruction that cannot be fully reversed, such as emphysema and chronic bronchitis” (Osadnik et al, 2012). COPD is the third leading cause of death in the world. Over 29,776 deaths occurred due to COPD in 2012 within the UK (British Lung Foundation, 2012). The disease needs to be fully understood by health professionals in order to provide the best care possible and reduce the global impact of the disease. There is no cure for COPD. Management of COPD involves the use of bronchodilators, corticosteroids and oxygen therapy. Inhaled corticosteroid therapy reduces frequency of exacerbations when given in combination with an inhaled long-acting beta2 agonist and improves quality of life. As the main symptom of COPD is dyspnoea, The Medical Research Council dyspnoea scale is used to assess the severity of the shortness of breath and whether it is in the presence of exertion or not. It is graded from grade one to five and it allows the progression of the disease to be monitored. Pulmonary rehabilitation should be considered in the management of COPD. This involves exercise training, education and psychosocial support. Pulmonary rehabilitation involves aerobic exercise to rebuild skeletal muscle e.g. cycling and walking. Healthcare professionals can educate patients on airway clearance techniques which have shown some benefits to COPD patients. NICE (2015) recommend that every patient with COPD undertakes a comprehensive reassessment including a psychosocial assessment, important because patients with COPD have an increased associated risk of suffering from depression and anxiety.
There is little research available on interventions for sexual dysfunction for people with COPD specifically. However, erectile dysfunction is estimated to be between 72 and 87% in men with moderate to severe COPD. Current and up to date advice should be given to patients about this area and nurses should encourage patients to express any concerns they have. People with COPD also have an overwhelming fear of dying due to suffocation and health care professionals can help alleviate this by maintaining good communication, in particular, in relation to end of life care.
COPD is a debilitating, progressive disease of the airways which leads to individuals feeling fatigued and as a result socially isolated. Healthcare professionals play a very important role in supporting patients to invest in their health, to stay positive, address all concerns, and to manage their condition effectively. Government initiatives also help to manage and prevent COPD. Tele-monitoring has become popular with an emphasis on people managing their own conditions at home. There are some cases where COPD is not preventable but in a large number of cases it is and smoking cessation is the best way to prevent someone developing COPD. It is the role of healthcare professionals to attempt to persuade people to quit smoking using methods such as brief intervention training.
British Lung Foundation (2012) Chronic obstructive pulmonary disease (COPD) statistics Available at: http://statistics.blf.org.uk/copd (Accessed: 28/12/2015)
Osadnik C R, McDonald C F, Jones A P, Holland A E. (2012) ‘Airway clearance techniques for chronic obstructive pulmonary disease’ The Cochrane Collaboration