Background Anxiety and depression are common co-morbidities in COPD. We conducted a RCT comparing CBT delivered by respiratory nurses (RNs) and self-help leaflets in 279 patients with COPD and anxiety. The CBT intervention delivered by RNs achieved clinical and statistical improvements for anxiety, depression and improving quality of life.¹ RNs with dual physical and psychological skills are rare. However there is an appetite for RNs to be trained to identify and treat psychological difficulties experienced by respiratory patients using CBT.²

Aims To evaluate the effectiveness of The Lung Manual Intervention used in The Newcastle COPD CBT Care study¹ on patient outcomes when delivered by nurses who completed 3 day foundation training compared to advanced post-graduate education in CBT.

Methods Following an educational course, four respiratory nurses delivered The Lung Manual Intervention.¹ Four nurses were randomly allocated patients and delivered CBT. Nurses with Diploma training delivered CBT to 83 patients; foundation level delivered 32. CBT sessions were audio-recorded to explore delivery of the intervention in practice. The recordings were then assessed fidelity of intervention delivery by an independent CBT therapist. Unpaired t-tests were used to compare mean anxiety scores and at baseline and three months.

Results The nurses competency was rated highly by an independent CBT therapist. The mean number of CBT sessions was 4 and this was similar for all nurses. Table 1 summarises the outcome from nurses delivering The Lung Manual CBT intervention.

Conclusion Brief education in CBT was effective in improving patient symptoms of anxiety at three months. RNs with dual skills in physical and psychological well being may be an appropriate model to provide holistic care for patients with COPD.

References

1. Heslop-Marshall K, Stenton C, Newton J, Carrick-Sen D, Baker C, Burns G, De Soyza A. A RCT of CBT delivered by respiratory nurses to reduce anxiety in COPD`. ERJ 2016;48:OA289. doi:10.1183/13993003.congress-2016.OA289

2. Heslop-Marshall K, Knighting K, Pilkington M, Kelly C. A UK survey on the experiences and views of Respiratory Nurses (RNs) on their role in delivering Cognitive Behavioural Therapy (CBT) for patients with Chronic Obstructive Pulmonary Disease (COPD)2017. In press.