Living with COPD: a perspective on patients´concerns

Abstract

Background: The World Health Organization has emphasised the need for a patient-centred health care for the management of chronic conditions. COPD is a highly incapacitating chronic disease and its non-pharmacological management has been based on pulmonary rehabilitation programs. However, patients' perspectives regarding their own concerns have received little attention from these programs, which is crucial to design adequate patient-centred interventions. Aims and objectives: This study aimed to identify the concerns and fears of patients with moderate-to-very severe COPD, regarding their actual and future condition. Methods: A qualitative, cross-sectional study was carried out with 18 COPD outpatients. Data were collected using audiotaped semi-structured interviews to capture patients' detailed perceptions. A thematic analysis was performed by 2 independent judges. Results: Participants were mostly male (n=11; 61.1%), with a mean age of 58.4 (SD=8.3) years old and a mean FEV1 percentage predicted of 43.1 (SD=17.7)%. Patients were mainly concerned about the progression of their condition (n=10; 55.5%) associated with the deterioration of their physical capacities (n=5; 27.8%) and becoming older (n=3; 16.7%). Fears about being on their own (n=3; 16.7%) and dying due to their respiratory disease (n=9; 50%), particularly dying of asphyxiation (n= 6; 33.3%), were also reported by patients. Conclusions: The findings suggest that patients with COPD have significant concerns and fears about the irreversible process of their disease. Adequate knowledge about these aspects will allow health professionals to adjust pulmonary rehabilitation programs considering the patients' emotional needs.