To explore the utility of the breathing, thinking, functioning (BTF) clinical model in managing breathlessness through a practical workshop aiming to equip professionals

Background
Breathlessness is a common and distressing symptom within progressive respiratory conditions. Emerging research advocates that irrespective of diagnosis, management is harmonised. Evidence identifies a more holistic, non-drug approach to effective management. This study aimed to embed the Breathing, Thinking, Functioning clinical model in managing breathlessness into clinical practice, equipping and enabling professionals to cascade the approaches to patients and carers.

Methods
Multi stage approach:
• A 2 hour practical workshop to understand the Breathing, Thinking, Functioning (BTF) conceptual model of breathlessness will be offered to all staff within the palliative care teams (community, inpatient and hospital) under MCH CIC management.
• Staff will complete pre and post questionnaires following this intervention, looking at experience, confidence and utility in managing breathlessness with questionnaires at 3 month follow—up.

Results
40 professionals attended the practical workshops (n=4) with participants initially rating their experience (‘quite a bit’ and ‘very well’) in managing breathlessness with 15% (6/40) compared to 77% (31/40) post- intervention, along with confidence increasing from 15% (6/40) to 72% (29/40) within the same group. Feedback was very positive with 88% (35/40) participants identifying the utility of this model in clinical practice. Follow-up at 3 months identified that confidence was still relatively high at 64% (14/22) despite lower response rate 55% (22/40).

Conclusions
This work identified the usefulness of the BTF model in the management of refractory breathlessness in progressive respiratory disease. Professionals initially rated themselves low in confidence managing breathlessness but after the workshop, identified confidence increasing by 57%. Despite the significantly reduced numbers at 3 month follow-up (22 vs. 40), this project still identified 64% of attendees identifying themselves as confident (‘quite a bit’ or ‘very well’) in managing breathlessness, compared with an initial 15% of participants. This practical workshop approach has the potential to equip professionals in the effective management of refractory breathlessness.