Respiratory nurse specialists prioritise experiences of living with COPD differently from patients with COPD and their carers

Introduction: Respiratory Nurse Specialists (RNS) can improve respiratory patients9 quality of life and their understanding of the condition, by providing education and support in managing symptoms and experiences. However, this presumes that nurses, patients and carers have a shared understanding of what the most important issues for people living with COPD and their carers are. Aims: To identify and prioritise the impact of living with COPD from the perspectives of patients, carers and RNS. Methods: A systematic literature search of the qualitative research was conducted to identify experiences of living with COPD as reported by people with COPD. The importance of each of these experiences to patients, carers and RNS were ranked during a series of consensus meetings, employing Nominal Group Technique; four meetings were held with patients with COPD and their carers, and one meeting with RNS. Results: The literature review identified 4 themes with 11 sub themes. 19 patients with COPD, 13 carers and 6 RNS participated in the consensus meetings. Patients and carers differed from RNS in how they prioritised experiences. Noteworthy, are differences between patients/carers and RNS in ranking of 9identifying the signs of an exacerbation9; 9feeling lonely or isolated9 and 9impact on carers9; RNS identified anxiety relating to symptoms, higher, and concerns regarding the future,lower than patients/carers. Conclusion: The results demonstrate that RNS and patients/carers prioritise experiences differently, which may have important implications for how nurses provide care and education to patients with COPD and their carers, potentially resulting in unmet needs.