The handheld fan for chronic breathlessness: Clinicians’ experiences and views of implementation in clinical practice

Swan, Flavia; Johnson, Miriam; Pearson, Mark; Luckett, Tim; Brown, Josh; Miller, Isobel

Abstract

Introduction

The handheld fan (‘fan’) is useful for chronic breathlessness management, however little is known about clinicians’ implementation of the fan in clinical practice.

Aim

To explore clinicians’ experiences and views of fan implementation.

Methods

A qualitative approach, using semi-structured interviews. Participants were purposively sampled from clinicians who had completed an on-line fan implementation survey and were willing to participate. A topic guide was developed using the Theoretical Domains Framework (TDF). Data were analysed using an inductive approach informed by the TDF.

Findings

Twelve clinicians participated (doctors n=4; nurses n=4; allied health professionals n=4) from respiratory and palliative care. Analysis generated three major themes: i) Clinician knowledge and skills in fan implementation, ii) environmental constraints on fan use and iii) clinician beliefs about the consequences of fan use.

Implementation by clinicians was positively influenced by having a scientific rationale for fan use presented (mechanism of action). Clinicians believed that the fan relieved breathlessness and did not carry a significant infection risk. Opportunity for fan use varied across healthcare settings; key environmental influences were COVID-19 restrictions, lack of access to resources and funding to provide fans, particularly in acute and respiratory services. Clinicians commonly encountered scepticism among patients and colleagues who felt the fan was an implausible intervention for breathlessness.

Conclusion

Implementation of the fan is motivated by clinician beliefs about patient-benefit, a scientific rationale to counter clinician and patient scepticism, and access to fans in clinic. Funding to allow patients to be supplied with and taught how to use a fan would support uptake. Research is needed to address concerns about infection risk.

Citation

Swan, F., Johnson, M., Pearson, M., Luckett, T., Brown, J., & Miller, I. The handheld fan for chronic breathlessness: Clinicians’ experiences and views of implementation in clinical practice. [Dataset]

• Deposit Date: Aug 3, 2023
• Public URL: https://hull-repository.worktribe.com/output/4348205
• Type of Data: Qualitative data: Clinician Interview transcriptions; Number of files: 11; Format: Word documents
• Collection Method: Telephone Interview recordings of clinicians.
• Additional Information: Access to the data will be provided in response to reasonable requests by bona fide researchers once a data sharing contract is in place. Data requests can be made to the authors, or [e-mail]