"The breath of life: the whole shebang!": a quality improvement project to develop a self-management programme for breathlessness

Background
Breathlessness is a distressing and complex symptom that can profoundly affect a person’s life, leading to loss of independence, increased distress and reduced quality of life. Evidence suggests that in conjunction with optimised medications, teaching people self-management techniques and offering psychological support can improve physical well-being, personal coping strategies and quality of life.
Project Aim
To develop a sustainable 12 week self-management programme for people living with end stage breathlessness. 
Methods
Utilising the model for improvement, the multidisciplinary team set an aim, identified outcome measures, and planned the content of the programme using current evidence as guidance. Continuous Plan, Do, Study, Act (PDSA) test cycles were used to improve the programme. Four participants were invited to participate and completed the programme.
Results
Improvements were identified in participant’s social capital, long-term coping strategies and self-management of their breathlessness. However, the patient-reported outcome measures demonstrated few sustained improvements in symptom burden.
Conclusion
This project highlighted the challenge and complexity of living with a life limiting illness and its symptoms. Reflecting the national strategy for self-management; using a person-centred approach, offering enablement and expressing empathy were found to be key components which support participants to improve their self-management skills.