Chronic obstructive pulmonary disease: a phenomenological study of patients' experiences.
OBJECTIVE
The purpose of this study is to explore the experience of living with chronic obstructive pulmonary disease by investigating the subjective phenomenon as described by the patient.


BACKGROUND
Chronic obstructive pulmonary disease is now recognized as one of the most common chronic respiratory diseases in the United Kingdom, with a high prevalence of morbidity and mortality. As the disease progresses, symptoms increase which gradually influence all aspects of the lives of those affected by it.


METHODS
A phenomenological approach was identified as the most appropriate method to gain an understanding of living with chronic obstructive pulmonary disease. The data were obtained from 10 participants using unstructured interviews to capture detailed experiences verbatim. Analysis, based on the framework of Diekelmann et al. (The NLN Criteria for Appraisal of Baccalaureate Programs: A Critical Hermeneutic Analysis, NLN Press, New York, 1989), was employed to interpret the data and determine shared themes that evolved during the course of the research.


RESULTS
The data revealed valuable insights, from a patient's perspective, into the impact chronic obstructive pulmonary disease had on their daily lives. The accounts obtained from participants, many of who had severe chronic obstructive pulmonary disease, illustrate the detrimental effects of this debilitating disease. Breathlessness was identified as the most troublesome symptom leading to anxiety, panic and fear. Participants also described feeling frustrated and tired because of their breathlessness, which led to loss of social activity. This also resulted in a loss of their role within the family including loss of intimacy in personal relationships. Despite this, half of the participants felt they had a fairly good quality of life.


CONCLUSIONS
The use of phenomenology as a research methodology fulfilled the aim of gaining a greater understanding of the experiences of living with chronic obstructive pulmonary disease. It provided valuable insights into how patients view the overall impact and their subsequent degree of coping with chronic obstructive pulmonary disease from day to day.


CONCLUSIONS
Whilst there is no cure for chronic obstructive pulmonary disease and medical interventions have limited effect, health professionals can do much to improve patient's symptoms and experiences of living with chronic obstructive pulmonary disease by listening to how their symptoms affect them and adapting coping strategies. It is hoped that the themes revealed in this study generate additional understanding and insight for future innovative practice.
Barnett
Margaret
M
COPD Nurse Specialist, Chest Clinic, Level 6, Derriford Hospital, Plymouth, Devon, UK. margaret.barnett@pcs-tr.swest.nhs.uk
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D001294:Attitude to Health; D002908:Chronic Disease; D004644:Emotions; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D036301:Qualitative Research; D011788:Quality of Life; D012106:Research; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires