The pilot study explored the effects of a mindfulness based stress reduction (MBSR) intervention on nurses' perceived stress (PS) and compassion. A quasi experimental pre-test-post-test design was used. Nurses (n=90) working at three university teaching hospitals completed the Perceived Stress Scale (PSS) and Compassion Scale (CS) at the beginning of the MSBR intervention and 64 completed the scales at the end of the intervention. The 64 matched data sets were analysed using the ttest, Chi Square test and ANOVA. The findings indicated that the nurses' perceived stress was significantly reduced after the intervention. Notably, compassion scores were increased after the intervention, and this finding was significant for nurses working at one of the hospitals. There were no significant differences between results from a six week or eight week MBSR intervention. The results suggest that a MBSR can impact positively on nurses' perceived stress and also enhance nurses' compassion. MBSR may well be a suitable self-care, stress management intervention that can effectively teach nurses coping skills to assist them manage daily stressors inherent in their home and work life.

Understanding the experience of living with COPD and the balances involved in 'co-existing with COPD' can help health professionals provide more focused and empowered client care. Enabling people to achieve 'controlled co-existence' with COPD challenges health professionals to educate people with COPD on how to effectively manage their disease.

ObjectiveTo evaluate the effectiveness of a structured education pulmonary rehabilitation programme on the health status of people with chronic obstructive pulmonary disease (COPD).DesignTwo-arm, cluster randomised controlled trial.Setting32 general practices in the Republic of Ireland.Participants350 participants with a diagnosis of moderate or severe COPD.InterventionExperimental group received a structured education pulmonary rehabilitation programme, delivered by the practice nurse and physiotherapist. Control group received usual care.Main outcome measureHealth status as measured by the Chronic Respiratory Questionnaire (CRQ) at baseline and at 12–14 weeks postcompletion of the programme.ResultsParticipants allocated to the intervention group had statistically significant higher mean change total CRQ scores (adjusted mean difference (MD) 1.11, 95% CI 0.35 to 1.87). However, the CI does not exclude a smaller difference than the one that was prespecified as clinically important. Participants allocated to the intervention group also had statistically significant higher mean CRQ Dyspnoea scores after intervention (adjusted MD 0.49, 95% CI 0.20 to 0.78) and CRQ Physical scores (adjusted MD 0.37, 95% CI 0.14 to 0.60). However, CIs for both the CRQ Dyspnoea and CRQ Physical subscales do not exclude smaller differences as prespecified as clinically important. No other statistically significant differences between groups were seen.ConclusionsA primary care based structured education pulmonary rehabilitation programme is feasible and may increase local accessibility to people with moderate and severe COPD.Trial registrationISRCTN52403063.

This article describes the development of a Structured Education Pulmonary Rehabilitation Programme (SEPRP), for the PRINCE (Pulmonary Rehabilitation In Nurse-led Community Environments) study. This process involved a literature review of existing PR programmes, a content analysis of national and international PR programmes and a concept analysis of empowerment. Secondly, two small descriptive qualitative studies were undertaken to further inform programme content exploring the views of health professionals and clients on programme content, as well as their perceptions of living with COPD. The findings of these two stages led to the development of the eight-week PRINCE SEPRP, based on a philosophy of empowerment and the SEPRP was underpinned by the Transtheoretical model (TTM) of behaviour change. Programme content included managing medications and managing breathlessness, knowing and managing symptoms, recognizing and managing acute exacerbations as well as an individualized exercise programme. Participants' experiences of self management following participation in the SEPRP were also examined. The findings indicate that nurses working in primary care have an important role in informing the development of SEPRP as well as having a key role in their delivery. They have the potential to work in empowering ways with COPD clients and the PRINCE SEPRP is just one example of how this can be put into practice.

The strongest common theme emerged through descriptions of the patient's 'Sense of Self', within which emerged sub-themes; The Future Self, The Living Self, The Mortal/Fragile Self and The Growing/Learning Self. These were further explored and related back to importance of awareness of such findings within the renal haemodialysis practice setting.