Paper
Thursday, 20 July 2006
This presentation is part of : Caring for the Chronically Ill
The Effect of Inspiratory Muscle Training on Dyspnea and HRQOL in Clients with Heart Failure
Evelyn Yeaw, PhD, RN and Cynthia Padula, PhD, RN, CS. College of Nursing, University of Rhode Island, Kingston, RI, USA
Learning Objective #1: To identify the positive outcomes of an inspiratory muscle training program
Learning Objective #2: To recognize the effective strategies in employing Self-efficacy theory underlying an inspiratory muscle training program
 
 
            Heart failure (HF) is considered to be the final pathway of all cardiac disorders and one of the most devastating of all chronic illnesses.  People with HF are living longer, but with disabling symptoms, in particular dyspnea, that erode health-related quality of life (HRQOL).   Decreased strength of the inspiratory muscles (IM) may contribute to and worsen  dyspnea in HF.  Interventions that can reduce adverse outcomes and /or improve respiratory muscle strength, specifically inspiratory muscles, are needed.  Inspiratory muscle training (IMT) is a safe, cost-effective, low technology, noninvasive intervention that can be implemented easily in the home.  The purpose of this study was to determine the effects of a three-month, home-based, nurse-coached inspiratory muscle training (IMT) program employing a Threshold Device (Healthscan).  Therefore the goals of this study were twofold, to determine the effects of: (1) a nurse-coached IMT intervention in relation to inspiratory muscle strength and dyspnea, and (2)  IMT with respect to self-efficacy and physical/functional, psychosocial dimensions of HRQOL.  The framework for this study is based on Bandura’s Self –Efficacy Theory.
            This research is a two-group, randomized study with repeated measures.  Subjects were randomized into either an experimental group  (IMT) (n=15) or a control group (n=16), which received a standard educational protocol.  Data were collected during six home visits over twelve weeks with follow-up telephone calls.  Selection criteria included:  adults who were community dwelling; stable Class II or Class III HF with an ejection fraction of <45%; and without co-existing pulmonary disease.   Outcome measures included:  maximal inspiratory pressure (PI  max), Perceived Exertion Scale (Borg), Chronic Respiratory Questionnaire Dyspnea Scale {CDRQ} (Guyatt), COPD Self-Efficacy Scale (Wigal), and the MOS SF 36 (Ware & Sherbourne).    Statistical analysis (SPSS 13) and post hoc analysis revealed significant differences in PImax, shortness of breath as measured by the CDRQ, and respiratory rate.
           
 
 
 
 
 
 
 
 
 

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