COPD stories of complex causal 'truths' 'Sure I've smoked all my life/but I also put in 37 years at the mine'.
OBJECTIVE
Secondary analysis was conducted to interpret the causes of illness stories told by patients living with chronic obstructive pulmonary disease.


BACKGROUND
Despite the abundance of quantitative evidence regarding the causal relationship between smoking and chronic obstructive pulmonary disease, there is limited research that provides a contextual emic understanding of chronic obstructive pulmonary disease aetiology.


METHODS
Interview data from two earlier focused ethnography studies were examined by retrospective interpretation, a type of secondary qualitative research. Chronic obstructive pulmonary disease causation stories were identified in both primary study data bases, but were not previously systematically examined.


METHODS
The analysis was completed using an eclectic, explicit narrative approach that involved the examination of causation story elements.


RESULTS
Participants told 104 causal stories about the development of their lung disease. They situated the aetiology of their chronic illness within a psychosocial reality.


CONCLUSIONS
The causal stories told by participants demonstrate that those living with chronic obstructive pulmonary disease present a broader causal explanation for their illness, an orientation not commonly presented in the literature. They demonstrate the need for further examination of the important lay accounts of causes of illness in relation to chronic obstructive pulmonary disease.


CONCLUSIONS
Clinicians' ability to hear an alternative understanding may be impeded when they only listen for what they already know, 'facts' concerning the relationship between smoking and chronic obstructive pulmonary disease. Addressing vulnerable persons in such a manner may impede patients' efforts to be responsible for the development of their chronic illness and individualised care.
School of Nursing, Laurentian University, Sudbury, ON, Canada. Pbailey@laurentian.ca
Patricia Hill
PH
Bailey
Phyllis
P
Montgomery
Christina McMillan
CM
Boyles
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008906:Mining; D016273:Occupational Exposure; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects*