Karen Heslop-Marshall

• Doctor of Philosophy
• Consultant at The Newcastle upon Tyne Hospitals NHS Foundation Trust

Management of long-term conditions is a significant challenge in contemporary health care as people often require support for both physical and psychological symptoms. Assessing the competence of healthcare professionals delivering psychologically informed interventions informs decisions about future implementation. This is a comprehensive interven...

Background People with chronic obstructive pulmonary disease have high levels of anxiety and depression, which is associated with increased morbidity and poor uptake of effective treatments, such as pulmonary rehabilitation. Cognitive–behavioural therapy improves mental health of people with long-term conditions and could potentially increase uptak...

This multi-centre, pragmatic, randomised controlled trial evaluated whether a tailored psychological intervention based on a cognitive behavioural approach for people with COPD and symptoms of anxiety and/or depression improved anxiety or depression compared to usual care (UC). People with COPD and moderate to very severe airways obstruction and Ho...

Introduction Patients with COPD who exhibit elevated levels of anxiety and/or depression are typically less able to improve symptoms and physical activity (PA) levels following a programme of pulmonary rehabilitation (PR). Objective To provide proof of concept that offering an intervention comprising cognitive behavioural therapy (CBT) alongside P...

Introduction: The sizable population of people with respiratory conditions places a significant demand on healthcare services and a need for specialized nursing care. Aim: The ERS Nursing Group recognized the need for harmonized curricula for respiratory nurses. The following steps incorporate the knowledge and experience of academic and clinical...

Introduction: A coronavirus pandemic confirmed that respiratory nurses are critical healthcare providers. Knowledge about appropriate education for quality respiratory nursing care is limited. The ERS Nurses Chair formed the ICRN group to develop a core curriculum for respiratory nurses. Aims: The study surveyed the need for an international core...

Introduction Despite improvements in pulmonary function following lung transplantation (LTx), physical activity levels remain significantly lower than the general population. To date, there is little research investigating interventions to improve daily physical activity in LTx recipients. Objective To determine the potential efficacy of a novel,...

Background: Despite improvements in pulmonary function following lung transplantation (LTx), physical activity levels remain significantly lower than the general population. To date, there is little research investigating interventions to improve daily physical activity in LTx recipients. This study assessed the feasibility and acceptability of a...

Background The COVID-19 pandemic confirmed that respiratory nurses are critical healthcare providers. Limited knowledge is available about appropriate education to prepare nurses to deliver high-quality respiratory care. A survey was developed by the International Coalition for Respiratory Nursing (ICRN) group to identify the need for a respiratory...

Purpose The COVID-19 pandemic has increased the demand for tele-medicine, particularly for lung transplant (LTX) recipients who are immunosuppressed and often live far from transplant centres. We report the feasibility of a 3-month semi-automated tele-coaching intervention in this population. Methods The intervention consists of a pedometer and sm...

Self-management, as a strategy to support those living with chronic respiratory conditions such as asthma and COPD, has been widely advocated in guidelines and adopted in practice. However, there can be a disconnect between the goals of patients and healthcare professionals. Goals and barriers to self-management are often compounded by the complex...

Introduction In patients with COPD, pulmonary rehabilitation (PR) improves exercise capacity, but continues to report inconsistent improvements in physical activity, particularly in those with low baseline physical activity levels. In addition, patients with elevated levels of anxiety and/or depression are typically less able to manage symptoms and...

Introduction As the COVID-19 pandemic continues, the demand for tele-medicine remains high, particularly for lung transplant recipients who often live far from transplant centres. This interim analysis presents the early findings from our study investigating the feasibility of a 3-month semi-automated tele-coaching intervention (Demeyer et al., 201...

Background Guidelines now call for a thorough and comprehensive description of the development of healthcare interventions to aid evaluation and understanding of the processes of change. This was the primary aim of this study but we also recognised that effective interventions are commonly not implemented in clinical practice. It is suggested that...

Aims and objectives The Clinical PROactive Physical Activity in COPD (C-PPAC) instrument, combines a questionnaire assessing the domains of amount and difficulty of physical activity (PA) with activity monitor data (steps/day and vector magnitude units) to assess patients’ experiences of PA. The C-PPAC instrument is responsive to pharmacological an...

Anxiety and depression are common comorbidities of chronic obstructive pulmonary disease and have a negative impact on patients’ physical functioning, use of healthcare resources and mortality. Risk factors for and rates of psychological difficulties are currently higher due to the coronavirus pandemic. A recent trial demonstrated the clinical effe...

In response to #COVID19, healthcare professionals should scale up virtual consultations for assessing core patient-reported outcomes and providing home-based rehabilitation programmes #COPD https://bit.ly/30gQEpG.

Background Healthcare interventions shown to be effective, are commonly then found to be poorly implemented in clinical practice. It is suggested that insufficient attention is given to the implementation process at the developmental phase of intervention. This study outlines a 5 step process for considering both implementation and effectiveness is...

Background Guidelines now call for a thorough and comprehensive description of the development of healthcare interventions to aid evaluation and understanding of the processes of change. This was the primary aim of this study but we also recognized that effective interventions are commonly not implemented in clinical practice. It is suggested that...

Background Healthcare interventions shown to be effective, are commonly then found to be poorly implemented in clinical practice. It is suggested that insufficient attention is given to the implementation process at the developmental phase of intervention. This study outlines a 5 step process for considering both implementation and effectiveness is...

Background: People with chronic obstructive pulmonary disease (COPD) are at increased risk of depression and anxiety, which greatly reduces their quality of life and is associated with worse outcomes; but these psychological co-morbidities are under-recognised and undertreated in COPD patients. Pulmonary rehabilitation (PR) improves mood for up to...

Psychological ill health is very common in COPD; CBT may be a key step towards improving the care of COPD patients http://ow.ly/fb8j30onfPj.

Symptoms of COPD can be managed with cognitive behavioural therapy, says Karen Heslop-Marshall

It is estimated that by 2020 chronic obstructive pulmonary disease is likely to become the fourth leading cause of death. People living with this condition may experience symptoms that can be managed with cognitive behavioural therapy, says Karen Heslop-Marshall Chronic obstructive pulmonary disease (COPD) is a term oftened used to describe two lun...

Self-management interventions for chronic obstructive pulmonary disease (COPD) can improve quality of life, reduce hospital admissions, and improve symptoms. However, many factors impede engagement for patients and practitioners. Qualitative research, with its focus on subjective experience, can provide invaluable insights into such factors. Theref...

Anxiety is an important comorbidity in chronic obstructive pulmonary disease (COPD). We investigated if cognitive behavioural therapy (CBT), delivered by respiratory nurses, reduced symptoms of anxiety and was cost-effective. Patients with COPD and anxiety were randomised to CBT or self-help leaflets. Anxiety, depression and quality of life were me...

Self-management is recognised as an essential criteria for the provision of high quality care for chronic obstructive pulmonary disease (COPD). The management of COPD is usually delivered by a wide range of healthcare practitioners. This study aimed to understand the factors affecting self-management of COPD from the perspectives of the different m...

Background Self-management interventions (SMIs) are recommended for individuals with COPD to help monitor symptoms and optimize health-related quality of life (HRQOL). However, SMIs vary widely in content, delivery, and intensity, making it unclear which methods and techniques are associated with improved outcomes. This systematic review aimed to s...

Background: Chronic obstructive pulmonary disease (COPD) (commonly referred to as chronic bronchitis and emphysema) is a chronic lung condition characterised by the inflammation of airways and irreversible destruction of pulmonary tissue leading to progressively worsening dyspnoea. It is a leading international cause of disability and death in adu...

Chronic obstructive pulmonary disease (COPD) is common in the United Kingdom with approximately 835 000 people currently diagnosed. Symptoms of COPD lead to a gradual progression of disability over many years. It is argued that two of the most common and least-treated comorbidities of COPD are anxiety and depression. Guidelines for the management o...

Anxiety and depression are common co-morbidities in patients with chronic obstructive pulmonary disease (COPD). Serious implications can result from psychological difficulties in COPD including reduced survival, lower quality of life, and reduced physical and social functioning, increased use of health care resources and are associated with unhealt...

Background: Chronic obstructive pulmonary disease (COPD) (commonly referred to as chronic bronchitis and emphysema) is a chronic lung condition characterised by the inflammation of airways and irreversible destruction of pulmonary tissue leading to progressively worsening dyspnoea. It is a leading international cause of disability and death in adul...

This article describes the psychological impact of chronic obstructive pulmonary disease and outlines how cognitive behavioural therapy can be used to manage problems. It presents the results of research using CBT with this patientgroup.

COPD is a common progressive and debilitating medical condition. Mental health difficulties, such as anxiety and depression, have been reported in 25-50% of all patients with COPD. Interventions that reduce anxiety and depressive symptoms may affect COPD outcomes. Little data exists on the effect of managing these psychological difficulties in this...

The second article in a two-part series takes a detailed look at what issues healthcare professionals should consider when selecting an inhaler for a patient. It looks at the differences between the different types and explains how they should be used. Part one looked at the use of pressurised metered dose inhalers (Heslop, 2008).

Karen Heslop outlines the reasons for using inhaled medicines with patients who have respiratory disorders, and the technique required to use metered dose inhalers. Part 2 will provide an update on other inhaler devices.

Plans for a national service framework for chronic obstructive pulmonary disease (COPD) were announced recently. Care tailored to individual needs pays dividends.