Clinicians and people living with chronic breathlessness have expressed a need to better understand and manage this symptom. The aim of this study was to evaluate a 3-day health professional training workshop on the practical management of chronic breathlessness. Workshop design and delivery were based on current understandings and clinical models of chronic breathlessness management, principles of transformative learning, and included sessions co-designed with people living with breathlessness. Registrants were invited to complete pre and post-workshop surveys. Pre and 1-week post-workshop online questionnaires assessed familiarity and confidence about workshop objectives (0[lowest]-10[highest] visual analogue scale), attitudes and practices regarding chronic breathlessness (agreement with statements on 5-point Likert scales). Post-workshop, participants were asked to describe implementation plans and anticipated barriers. Baseline familiarity and confidence were reported as mean (SD) and change examined with paired t-tests. Pre-post attitudes and practices were summarised by frequency/percentages and change examined non-parametrically (5-point Likert scale responses) or using a McNemar test of change (binary responses). Forty-seven of 55 registrants joined the study; 39 completed both pre and post-workshop questionnaires (35 female; 87% clinicians; median 8 years working with people with chronic breathlessness). Post-workshop, greatest gains in confidence were demonstrated for describing biopsychosocial concepts unpinning chronic breathlessness (mean change confidence = 3.2 points; 95% CI 2.7 to 4.0, p < 0.001). Respondents significantly changed their belief toward agreement that people are able to rate their breathlessness intensity on a scale (60 to 81% agreement) although only a minority strongly agreed with this statement at both time points (pre 11%, post 22%). The largest shift in attitude was toward agreement (z statistic 3.74, p < 0.001, effect size r = 0.6) that a person’s experience of breathlessness should be used to guide treatment decisions (from 43 to 73% strong agreement). Participants’ belief that cognitive behavioural strategies are effective for relief of breathlessness changed further toward agreement after the workshop (81 to 100%, McNemar test chi- square = 5.14, p = 0.02). The focus of this training on biopsychosocial understandings of chronic breathlessness and involvement of people living with this symptom were valued. These features were identified as facilitators of change in fundamental attitudes and preparedness for practice.

中文翻译：

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在专业卫生培训班之后，态度改变和对慢性呼吸困难的管理增加了信心：一项调查评估

临床医生和患有慢性呼吸困难的人表示需要更好地理解和处理这种症状。这项研究的目的是评估为期3天的慢性呼吸困难的实际管理健康专业培训班。讲习班的设计和交付基于对慢性呼吸困难管理的最新理解和临床模型，变革性学习的原则，并包括与呼吸困难者共同设计的会议。邀请注册人完成车间前后的调查。车间前和一周后的在线调查表评估了对讲习班目标（0 [最低] -10 [最高]视觉模拟量表），关于慢性呼吸困难的态度和习惯（同意5点Likert量表的陈述）的熟悉度和信心。后车间 要求参与者描述实施计划和预期的障碍。基线熟悉度和置信度报告为平均值（SD），并通过配对t检验检验其变化。职位前的态度和做法通过频率/百分比进行汇总，并以非参数方式检查变更（5点李克特量表反应）或使用McNemar变更检验（二进制反应）。55位注册者中有47位参加了研究；39份完成了车间前后的问卷调查（35名女性； 87％的临床医生；中位8年与慢性呼吸困难患者一起工作）。讲习班后，在描述有助于缓和慢性呼吸困难的生物心理概念时，信心得到了最大的提高（平均改变信心= 3.2分； 95％CI 2.7至4.0，p <0.001）。尽管只有少数人在两个时间点都强烈同意这一说法（前11％，后22％），但受访者极大地改变了对共识的看法，即人们能够在一定程度上评估他们的呼吸强度（同意率为60％至81％）。态度上最大的转变是朝着达成共识（z统计量3.74，p <0.001，影响大小r = 0.6）达成共识，即应该将一个人的呼吸困难经验用于指导治疗决策（从43％到73％的强烈共识）。参加者对认知行为策略对缓解呼吸困难有效的信念在研讨会结束后进一步趋于一致（81％至100％，McNemar测试卡方= 5.14，p = 0.02）。该培训的重点是对慢性呼吸困难的生物心理社会理解以及患有此症状的人的参与。