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Ekdahl A, Söderberg S, Holmström Rising M. Being met as a person and not as a diagnosis - Meanings of healthcare encounters for women with chronic obstructive pulmonary disease stage III or IV. Health Care Women Int 2024:1-13. [PMID: 38334989 DOI: 10.1080/07399332.2024.2310068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 01/19/2024] [Indexed: 02/10/2024]
Abstract
Our study seeks to elucidate meanings of healthcare encounters for women with chronic obstructive pulmonary disease stage III or IV. We conducted 12 narrative interviews which were analyzed using phenomenological hermeneutic interpretation. Our analysis revealed one theme; being met as a person and not as a diagnosis with three subthemes: getting sufficient time and feeling involved in care; fulfillment of personal needs; and experiencing disrespect and injustice. We found that meanings of healthcare encounters center on the expectation of being seen as a person. Feeling disrespected and injust leaves women unsupported and could pose serious health risks.
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Affiliation(s)
- Ann Ekdahl
- Department of Health Sciences, Mid Sweden University, Sweden
| | - Siv Söderberg
- Department of Health Sciences, Mid Sweden University, Sweden
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Steindal SA, Hofsø K, Aagaard H, Mariussen KL, Andresen B, Christensen VL, Heggdal K, Wallander Karlsen MM, Kvande ME, Kynø NM, Langerud AK, Ohnstad MO, Sørensen K, Larsen MH. Non-invasive ventilation in the care of patients with chronic obstructive pulmonary disease with palliative care needs: a scoping review. BMC Palliat Care 2024; 23:27. [PMID: 38287312 PMCID: PMC10823671 DOI: 10.1186/s12904-024-01365-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 01/19/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Patients with severe chronic obstructive pulmonary disease (COPD) could have palliative care (PC) needs because of unmet needs such as dyspnoea. This may lead to anxiety and may have an impact on patients' ability to perform daily activities of living. PC can be started when patients with COPD have unmet needs and can be provided alongside disease-modifying therapies. Non-invasive ventilation (NIV) could be an important measure to manage dyspnoea in patients with COPD in need of PC. A scoping review was conducted to gain an overview of the existing research and to identify knowledge gaps. The aim of this scoping review was to systematically map published studies on the use of NIV in patients with COPD with PC needs, including the perspectives and experiences of patients, families, and healthcare professionals (HCPs). METHODS This review was conducted following the framework of Arksey and O'Malley. The reporting of the review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. The review protocol was published. AMED, CINAHL, Embase, MEDLINE, PEDro, and PsycInfo were searched from inception to November 14, 2022. The included studies had to report the perspectives and experiences of COPD patients, relatives, and HCPs regarding NIV in the care of patients with COPD with PC needs. In pairs, the authors independently assessed studies' eligibility and extracted data. The data were organised thematically. The results were discussed in a consultation exercise. RESULTS This review included 33 papers from 32 studies. Four thematic groupings were identified: preferences and attitudes towards the use of NIV; patient participation in the decision-making process of NIV treatment; conflicting results on the perceived benefits and burdens of treatment; and heterogenous clinical outcomes in experimental studies. Patients perceived NIV as a 'life buoy' to keep them alive. Many patients wanted to take part in the decision-making process regarding NIV treatment but expressed varying degrees of inclusion by HCPs in such decision-making. Conflicting findings were identified regarding the perceived benefits and burdens of NIV treatment. Diversity in heterogeneous clinical outcomes were reported in experimental studies. CONCLUSIONS There is a need for more studies designed to investigate the effectiveness of NIV as a palliative measure for patients with COPD with PC needs using comprehensive outcomes. It is especially important to gain more knowledge on the experiences of all stakeholders in the use of home-based NIV treatment to these patients.
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Affiliation(s)
- Simen A Steindal
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway.
- Faculty of Health Sciences, VID Specialized University, Mail Box 184 Vinderen, 0319, Oslo, Norway.
| | - Kristin Hofsø
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Hanne Aagaard
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
| | - Kari L Mariussen
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
| | - Brith Andresen
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
- The Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | | | - Kristin Heggdal
- Faculty of Health Sciences, VID Specialized University, Mail Box 184 Vinderen, 0319, Oslo, Norway
| | | | - Monica E Kvande
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
| | - Nina M Kynø
- Department of Nursing and Health Promotion, Acute and Critical Illness, Oslo Metropolitan University, Oslo, Norway
- Department of Pediatric and Adolescent Medicine, Division of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
| | - Anne Kathrine Langerud
- Department of Nursing and Health Promotion, Acute and Critical Illness, Oslo Metropolitan University, Oslo, Norway
- Department of Post-Operative and Critical Care, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Mari Oma Ohnstad
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
| | - Kari Sørensen
- Lovisenberg Diaconal University College, Lovisenberggt 15B, 0456, Oslo, Norway
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Ekdahl A, Söderberg S, Holmström Rising M. Striving for moments of easier breathing despite being trapped in breathlessness: meanings of feeling well for women with chronic obstructive pulmonary disease stage III or IV. Int J Qual Stud Health Well-being 2023; 18:2225937. [PMID: 37331013 DOI: 10.1080/17482631.2023.2225937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/12/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Living with chronic obstructive pulmonary disease stage III or IV means living an everyday life, severely restricted by breathlessness. AIM The aim of this study was to elucidate meanings of feeling well for women with chronic obstructive pulmonary disease stage III or IV. METHOD The study has used a phenomenological hermeneutical design. Individual narrative interviews were conducted with 14 women with chronic obstructive pulmonary disease at stages III or IV. RESULTS The results revealed one theme: striving for moments of easier breathing despite being trapped in breathlessness with four subthemes: acting in rhythm with breathing, taking care of oneself, taking advantage of better moments, and being in togetherness in everyday life. CONCLUSION This study shows that women with chronic obstructive pulmonary disease at stages III or IV strived for moments of feeling well despite living with a severe illness. Feeling well meant that when connected to nature, they felt alive, free, and less trapped in breathlessness, which provided a sense of being unconscious of their breathing rhythm. They could do what healthy people tend to take for granted during everyday life. To feel well, the women found it important to receive tailored support from their close relatives.
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Affiliation(s)
- Ann Ekdahl
- Department of Health Sciences Mid Sweden University, Sundsvall, Sweden
| | - Siv Söderberg
- Department of Health Sciences Mid Sweden University, Sundsvall, Sweden
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Bakthavatsalu B, Walshe C, Simpson J. The experience of hospitalization in people with advanced chronic obstructive pulmonary disease: A qualitative, phenomenological study. Chronic Illn 2023; 19:339-353. [PMID: 35118898 PMCID: PMC9999271 DOI: 10.1177/17423953211073580] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES People with advanced chronic obstructive pulmonary disease (COPD) are frequently hospitalized, reporting high physical, psychological and spiritual suffering. Existing research focused on discrete aspects of hospitalization, such as care or treatment, yet lacks a complete picture of the phenomenon. The aim of this study is to understand the lived experience of hospitalization in people with advanced COPD. METHODS A qualitative, descriptive phenomenological approach was employed to study the phenomenon of hospitalization for people with advanced COPD. Unstructured interviews were conducted during hospitalization at a tertiary care hospital in India, in 2017, audio-recorded, and then transcribed. Giorgi's descriptive phenomenological analysis method guided the analysis. RESULTS Fifteen people with advanced COPD participated. Emergency admissions were common because of acute breathlessness, leading to repeated hospitalizations. Hospitalization gave a sense of safety but, despite this, people preferred to avoid hospitalization. Care influenced trust in hospitalization and both shaped the experience of hospitalization. Multi-dimensional suffering was central to the experience and was described across physical, psychological and spiritual domains. DISCUSSION Hospitalization was identified largely as a negative experience due to the perception of continued suffering. Integrating palliative care into the routine care of people with advanced COPD may enable improvements in care.
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Affiliation(s)
- Barathi Bakthavatsalu
- Division of Health Research, 151268Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Catherine Walshe
- International Observatory for End-of-Life Care, Division of Health Research, 151268Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Jane Simpson
- Division of Health Research, 151268Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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Kauppi W, Axelsson C, Herlitz J, Jiménez-Herrera MF, Palmér L. Patients' lived experiences of breathlessness prior to prehospital care - A phenomenological study. Nurs Open 2022; 9:2179-2189. [PMID: 35606842 PMCID: PMC9190685 DOI: 10.1002/nop2.1247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/12/2021] [Accepted: 05/10/2022] [Indexed: 01/10/2023] Open
Abstract
Aims and objectives The study aimed to describe how breathlessness is experienced by patients prior to prehospital care. Design A qualitative phenomenological design. Methods Lifeworld interviews were conducted with 14 participants. The analysis was carried out within the descriptive phenomenological framework. Results The essential meaning of the breathlessness phenomenon is described as an existential fear in terms of losing control over one’s body and dying, which involves a battle to try to regain control. This is further described by four constituents: being in an unknown body, striving to handle the situation, the ambiguity of having loved ones close and reaching the utmost border. Conclusions Patients describe a battling for survival. It is at the extreme limit of endurance that patients finally choose to call the emergency number. It is a challenge for the ambulance clinician (AC) to support these patients in the most optimal fashion.
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Affiliation(s)
- Wivica Kauppi
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,PreHospen- Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Christer Axelsson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,PreHospen- Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Emergency Medical Service (EMS), Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Johan Herlitz
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,PreHospen- Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | | | - Lina Palmér
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Paul B, Isaac R, R. H, Jebaraj P, S. M, Das D, Norrie J, Grant L, Pinnock H, Nair H, Sheikh A, Weller D. Development of an educational intervention to reduce the burden of adult chronic lung disease in rural India: Inputs from a qualitative study. PLoS One 2021; 16:e0254534. [PMID: 34265001 PMCID: PMC8281992 DOI: 10.1371/journal.pone.0254534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Chronic respiratory diseases (CRDs) are major causes of mortality and morbidity worldwide with a substantial burden of the disease being borne by the low and middle income countries (LMICs). Interventions to change health behaviour which aim to improve the quality of life and reduce disease burden due to CRD require knowledge of the problem and factors influencing such behaviour. Our study sought to appreciate the lived experiences of people with CRD, their understanding of the disease and its risk factors, and usual practice of health behaviour in a rural low-literate community in southern India. METHODS Qualitative data were collected between September and December 2018 through eight focus group discussions (FGDs), five in-depth interviews and four key-informant interviews from patients and community members. Community engagement was undertaken prior to the study and all interviews and discussions were recorded with permission. Inductive coding was used to thematically analyse the results. RESULTS Major themes included understanding of chronic lung disease, health behaviours, lived experiences with the disease and social norms, attitudes and other factors influencing health behaviour. DISCUSSION Poor understanding of CRDs and their risk factors affect health seeking behaviour and/or health practices. Stigma associated with the disease and related health behaviours (e.g. inhaler use) creates emotional challenges and mental health problems, besides influencing health behaviour. However barriers can be circumvented by increasing community awareness; communication and connection with the community through community based health care providers can turn challenges into opportunities for better health care.
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Affiliation(s)
- Biswajit Paul
- RUHSA Department, Christian Medical College, Vellore, India
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Rita Isaac
- RUHSA Department, Christian Medical College, Vellore, India
| | - Hemalatha R.
- RUHSA Department, Christian Medical College, Vellore, India
| | - Paul Jebaraj
- RUHSA Department, Christian Medical College, Vellore, India
| | - Muthathal S.
- RUHSA Department, Christian Medical College, Vellore, India
| | - Deepa Das
- Pulmonology and Critical Care, Bangalore Baptist Hospital, Bengaluru, India
| | - John Norrie
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Liz Grant
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Hilary Pinnock
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Harish Nair
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - David Weller
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
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Ekdahl A, Söderberg S, Rising-Holmström M. Living with an ever-present breathlessness: Women's experiences of living with chronic obstructive pulmonary disease stage III or IV. Scand J Caring Sci 2021; 36:1064-1073. [PMID: 34008226 DOI: 10.1111/scs.12998] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/08/2021] [Accepted: 04/18/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Living with chronic obstructive pulmonary disease stage III or IV has a major impact on a person's everyday life. This qualitative study focuses on women with chronic obstructive pulmonary disease stage III or IV. AIM The aim of this study was to describe women's experiences of living with chronic obstructive pulmonary disease stage III or IV. METHOD A purposive sample of fifteen women with chronic obstructive pulmonary disease stage III or IV participated in the study. Data were collected through individual semi-structured interviews that were subjected to qualitative content analysis. FINDINGS One theme was identified, stabilizing an ever-present breathlessness by restoring strength, and three categories are as follows: managing a restricted everyday life as an expert of their illness, being afraid of contracting infections leading to suffocation and suffering and importance of continuous help and support from significant others and digital media. Breathlessness restricted women with chronic obstructive pulmonary disease, living with a body they have to wait for. Managing everyday life was adapted to their limited abilities and energy. This required detailed planning, good knowledge of their breathing and body. Women were afraid of contracting life-threatening infections that caused suffering, especially COVID-19. The fear leads to isolation and digital media was described as an important means of communication. Significant others gave support and help that was practical and emotional. Women with chronic obstructive pulmonary disease experienced lack of continuous help and support from healthcare professionals. CONCLUSION Stabilizing an ever-present breathlessness by restoring strength required women with chronic obstructive pulmonary disease stage III or IV to conduct detailed planning to manage everyday life. Being afraid of contracting infections and the consequences of suffocation had increased since the pandemic COVID-19 outbreak, which led to self-isolation and an inactive everyday life. To get help, support and socialize, women used digital media.
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Affiliation(s)
- Ann Ekdahl
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden
| | - Siv Söderberg
- Department of Nursing, Mid Sweden University, Sundsvall, Sweden
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Kalluri M, Younus S, Archibald N, Richman-Eisenstat J, Pooler C. Action plans in idiopathic pulmonary fibrosis: a qualitative study-'I do what I can do'. BMJ Support Palliat Care 2021:bmjspcare-2020-002831. [PMID: 33832967 DOI: 10.1136/bmjspcare-2020-002831] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a progressive, incurable fibrotic lung disease in which patients and caregivers report a high symptom burden. Symptoms are often poorly managed and patients and caregivers struggle to alleviate their distress in the absence of self-management support. AIM To explore perceptions of symptoms, symptom management strategies and self-efficacy for patients with IPF and caregivers who received self-management education and action plans created and provided in a Multidisciplinary Collaborative Interstitial Lung Disease (MDC-ILD) Clinic. DESIGN A qualitative study was conducted with participants recruited from the MDC-ILD Clinic. Participants received an early integrated palliative approach; most attended ILD pulmonary rehabilitation and some received home care support. Semistructured interviews were conducted. Patient participants completed Measure Yourself Medical Outcome Profile (MYMOP) for symptom assessment and Chronic Obstructive Pulmonary Disease Self-Efficacy Scale to assess self-management efficacy. RESULTS Thirteen patients and eight self-declared caregiver participants were interviewed. IPF severity ranged from mild to advanced disease. Participants integrated and personalised self-management strategies. They were intentional and confident, focused on living well and engaged in anticipatory planning. Twelve participants completed the MYMOP. Five reported dyspnoea. Four reported fatigue as an additional or only symptom. One reported cough. Five declared no dyspnoea, cough or fatigue. Participants reported 80% self-efficacy in symptom management. CONCLUSIONS The approach to symptom self-management and education was beneficial to patients with IPF and caregiver participants. Participants personalised the strategies, focusing on living, and planned both in the moment and for the future. They were confident and expressed dignity and meaning in their lives.
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Affiliation(s)
- Meena Kalluri
- Division of Pulmonary Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Multidisciplinary Collaborative ILD Clinic, Kaye Edmonton Clinic, Alberta Health Services, Edmonton, Alberta, Canada
| | - Sarah Younus
- Division of Pulmonary Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Nathan Archibald
- Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Janice Richman-Eisenstat
- Division of Pulmonary Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Multidisciplinary Collaborative ILD Clinic, Kaye Edmonton Clinic, Alberta Health Services, Edmonton, Alberta, Canada
| | - Charlotte Pooler
- Palliative/End of Life Care, Continuing Care, Alberta Health Services, Edmonton, Alberta, Canada
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Abrahamsen CS, Lang-Ree HM, Halvorsen K, Stenbakken CM. Patients with COPD: Exploring patients' coping ability during an interdisciplinary pulmonary rehabilitation programme: A qualitative focus group study. J Clin Nurs 2021; 30:1479-1488. [PMID: 33555629 DOI: 10.1111/jocn.15700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 02/03/2023]
Abstract
AIMS AND OBJECTIVES To investigate experiences that contribute to enhancing patients' ability to cope with COPD during interdisciplinary in-hospital pulmonary rehabilitation programmes. BACKGROUND Patients with COPD often experience difficulties accepting their life situation as well as reduced levels of activity and social interaction. Despite the large body of research conducted on interdisciplinary collaboration and coping, few studies have examined patient perspectives of why and how pulmonary rehabilitation actually contributes to helping patients with COPD to cope with their illness. DESIGN Qualitative design. METHODS The data consist of qualitative focus group interviews with 17 participants, divided into three focus groups. The data were analysed using a thematic analysis approach. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used. RESULTS The patients described a lack of knowledge and understanding of their illness. In addition, they felt that their illness imposed limitations on their lifestyle and social interaction. Support from healthcare professionals during pulmonary rehabilitation proved to be vital, yet the lectures and consultations they received were described as general and sometimes rushed. The patients reported a positive effect from undergoing pulmonary rehabilitation, but a loss of motivation after returning home. CONCLUSION The findings indicate that gaining better health competence during pulmonary rehabilitation contributes to enhancing patients' coping ability. Moreover, patients found it valuable to meet people in a comparable situation and to feel respected by healthcare professionals. Nevertheless, taking an individual empowerment-oriented approach and focusing on the return home seem to be significant aspects of the patients' improved and lasting ability to cope after pulmonary rehabilitation. RELEVANCE TO CLINICAL PRACTICE Patients with COPD should be offered pulmonary rehabilitation because it has proven to have a positive effect on coping ability. Different follow-up measures are vital after pulmonary rehabilitation to maintain motivation after returning home.
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Affiliation(s)
- Caroline Steen Abrahamsen
- Institute of Nursing and Health promotion, Oslo Metropolitan University, Oslo, Norway.,Regional Advisory Unit for Palliative Care, Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway
| | - Heidi Mandt Lang-Ree
- Institute of Nursing and Health promotion, Oslo Metropolitan University, Oslo, Norway
| | - Kristin Halvorsen
- Institute of Nursing and Health promotion, Oslo Metropolitan University, Oslo, Norway
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Pozzar M, Volpato E, Valota C, Pagnini F, Banfi PI. How people with chronic obstructive pulmonary disease perceive their illness: a qualitative study between mind and body. BMC Pulm Med 2020; 20:120. [PMID: 32366300 PMCID: PMC7199319 DOI: 10.1186/s12890-020-1157-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/20/2020] [Indexed: 12/12/2022] Open
Abstract
Background Although many studies on people with Chronic Obstructive Pulmonary Disease (COPD) have examined the mutual impact of physical status and emotional experience, there is limited knowledge about the way COPD people first-hand perceive their condition. This study was designed to investigate the illness perceptions of the patients and, secondarily, to explore their beliefs about the mind-body relationship. Methods This qualitative study has exploited an ad-hoc semi-structured interview to collect personal perspectives of participants on their illness. Twenty-seven patients (15 males and 12 females), with a mild to severe COPD, were recruited within the Respiratory Rehabilitation Unit of Don Carlo Gnocchi Foundation, in Milan. The thematic analysis of the interviews’ content was facilitated by NVivo (12th version, QSR International®). Results The thematic analysis of the corpus resulted in four master themes. Illness experience has been considered the primary one. Indeed, dealing with COPD every day allows these people to portray a specific representation of the mind-body relationship, to gain a certain degree of expertise and to develop a perspective on the future. Conclusions Individual perceptions of the illness vary among people with COPD, but some common experiences characterize them. Many patients share a profound belief that their mental state and their physical symptoms are highly interrelated.
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Affiliation(s)
- Marta Pozzar
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
| | - Eleonora Volpato
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Milan, 20148, Italy
| | - Chiara Valota
- IRCCS Fondazione Don Carlo Gnocchi, Milan, 20148, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Harvard University, Cambridge, MA, USA
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11
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Garcia MV, Luckett T, Johnson M, Hutchinson A, Lal S, Phillips JL. The roles of dispositional coping style and social support in helping people with respiratory disease cope with a breathlessness crisis. J Adv Nurs 2019; 75:1953-1965. [PMID: 31012133 DOI: 10.1111/jan.14039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/12/2019] [Accepted: 03/28/2019] [Indexed: 12/01/2022]
Abstract
AIM To explore the role of coping moderators in self-management of breathlessness crises by people with advanced respiratory disease. DESIGN A secondary analysis of semi-structured interview data. METHODS Interviews with patients who had advanced respiratory disease, chronic breathlessness and at least one experience where they considered presenting to Emergency but self-managed instead (a "near miss"). Participants were recruited from New South Wales, Queensland, Victoria, South Australia or Tasmania. Eligible caregivers were those who contributed to Emergency-related decision-making. Interviews were coded inductively and then deductively against the coping moderators social support and dispositional coping style, defined by the Transactional Model of Stress and Coping. RESULTS Interviews were conducted between October 2015 - April 2016 with 20 patients and three caregivers. Social networks offered emotional and practical support but also had potential for conflict with patients' 'hardy' coping style. Patient hardiness (characterized by a sense of 'commitment' and 'challenge') promoted a proactive approach to self-management but made some patients less willing to accept support. Information-seeking tendencies varied between patients and were sometimes shared with caregivers. An optimistic coping style appeared to be less equivocally beneficial. CONCLUSION This study shows that social support and coping style may influence how people self-manage through their breathlessness crises and identified ways coping moderators can facilitate or hinder effective self-management. IMPACT This study confers insights into how social-support and coping style can be supported and optimized to facilitate breathlessness self-management. Acknowledging coping moderator interactions is beneficial for developing resources and strategies that recognise patient mastery.
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Affiliation(s)
- Maja Villanueva Garcia
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Tim Luckett
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Miriam Johnson
- Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
| | - Ann Hutchinson
- Wolfson Palliative Care Research Centre, University of Hull, Hull, UK
| | - Sara Lal
- School of Life Sciences, University of Technology, Sydney, New South Wales, Australia
| | - Jane L Phillips
- IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Steindal SA, Österlind J, Halvorsen K, Schjelderup T, Kive E, Sørbye LW, Dihle A. A qualitative study of women's experiences of living with COPD. Nurs Open 2017; 4:200-208. [PMID: 29085646 PMCID: PMC5653384 DOI: 10.1002/nop2.86] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/18/2017] [Indexed: 01/05/2023] Open
Abstract
Aim To explore women's experiences of living with chronic obstructive pulmonary disease (COPD) at home. Design An explorative and descriptive qualitative design. Methods A consecutive sample of nine women with COPD living at home. Data were collected in 2014 using semi‐structured interviews and analysed using a qualitative content analysis. Results Three main themes were identified: having a good life with COPD despite limitations; predictability and confidence in getting help; and the struggle to achieve a balance between insight and compliance with management of COPD. These women experienced limitations related to the traditional female role and felt unable to fulfil their own expectations. They experienced a good life despite limitations arising from adaptation and coping strategies. To feel safe, they needed to feel confident that they would receive the necessary help in case of exacerbation of their disease. To enhance compliance with COPD management, the women wanted education that provided specific suggestions.
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Affiliation(s)
- Simen A Steindal
- Lovisenberg Diaconal University College Oslo Norway.,VID Specialized University Faculty of Health Studies Oslo Norway
| | | | - Kristin Halvorsen
- Oslo and Akershus University College of Applied Sciences Department of Nursing and Health Promotion Kjeller Norway
| | | | - Ellen Kive
- Diakonhjemmet Hospital Outpatient Clinic Oslo Norway
| | | | - Alfhild Dihle
- VID Specialized University Faculty of Health Studies Oslo Norway.,Oslo and Akershus University College of Applied Sciences Department of Nursing and Health Promotion Kjeller Norway
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