This paper describes how difficult it can be to discuss the experience of breathlessness with patients, as identified by respiratory trainees in a psychology-led workshop. The reasons why it is considered an essential role for clinicians to facilitate conversations about patients' breathlessness are outlined within the context of the challenges of respiratory care. The benefits for both patient and clinician are described including rapport building, more focused and targeted consultations, and increasing a patient's receptivity to interventions. The value of preparing a patient to actively engage with their breathlessness management is highlighted. As a way to support clinicians to initiate talk about breathlessness, a 'five-step guide to talking' is presented.
key determinants of smoking, gender, DM, HTN, hypercholesterolaemia and BMI. On univariate analysis, BMI was significantly higher in the NSIP subgroup (p¼0.025 vs UIP or INDET). Rates of STEMI and strokes were highest in UIP cases (n/s) whereas that of CABG was highest in the INDET subgroup. These observations were corrected for IPF severity in so far as FVC and DL CO were decreased comparably across all three radiological subgroups. Evaluation of co-existing COPD was not undertaken; however, mean FEV 1 did not differ between groups. Conclusions Amongst patients with clinical IPF, UIP morphology correlates with the highest risk of cardiovascular morbidity compared to NSIP. A tendency for ischaemic heart disease to precede IPF in the majority of cases suggests the possibility that broader systemic or cardiac-specific factors may influence the pathogenesis of these pulmonary disorders. Introduction Allogeneic haematopoietic stem cell transplantation (HSCT) is often complicated by serious pulmonary complications including severe infections, drug toxicity and graft vs host disease. However, there is limited data on the prevalence of significant lung function defects in long-term survivors.Method We undertook a UK wide, multi-centre, retrospective study of the effects on pulmonary function in adult patients undergoing HSCT over a 4-year period. Pulmonary function tests (PFT) were evaluated at baseline (pre-transplant) and 12 months post-transplant. Impaired pulmonary function was defined as FEV 1 or FVC less than 80% predicted.Results 532 allogeneic HSCTs were registered in the BSBMT database, having been performed at 6 centres over the 4-year study period. 157 patients underwent PFT pre-HSCT and at least 6 months post-BMT, with 12-month data available for 90 patients (Abstract S135
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