title: Life with chronic obstructive pulmonary disease: striving for 'controlled co-existence'.
abstract: OBJECTIVE
  To understand the meaning of chronic obstructive pulmonary disease (COPD) for people and their response to this disease.
  
  
  BACKGROUND
  COPD is a major cause of disability and death. The symptoms of COPD have the potential to impact on every aspect of a person's day-to-day life. To date most published qualitative studies have focused on the 'experience' of breathlessness and its impact on the person. Few studies have sought to 'understand' the meaning of COPD to people and their response to this disease. This study aimed to address this gap.
  
  
  METHODS
  Straussian grounded theory guided study design. Grounded theory was considered appropriate for this study because of its focus on how people respond to and act on the problems they encounter.
  
  
  METHODS
  Data were collected through semi-structured interviews with 26 people with COPD. Study participants were recruited from general practices on the western seaboard of Ireland.
  
  
  RESULTS
  Two interrelated categories were identified as contributing to 'co-existing with COPD': 'hiding' and 'battling'. 'Co-existing with COPD' was conceptualised as the core category. The potential to 'co-exist' with COPD was influenced by mediating factors.
  
  
  CONCLUSIONS
  The Theory of Co-existing with COPD was generated from the data. This theory explains the delicate balance people with COPD maintain to 'co-exist with COPD'. 'Controlled co-existence' enables the person to feel in control and live life to the optimum. This is a fragile balance however and the unpredictability of COPD can tip the person into 'strained co-existence' or 'uncontrolled co-existence'.
  
  
  CONCLUSIONS
  Understanding the experience of living with COPD and the balances involved in 'co-existing with COPD' can help health professionals provide more focused and empowered client care. Enabling people to achieve 'controlled co-existence' with COPD challenges health professionals to educate people with COPD on how to effectively manage their disease.
authors.affiliation: School of Nursing and Midwifery, National University of Ireland, Galway, Ireland. adeline.cooney@nuigalway.ie
authors.forename: Adeline
authors.initials: A
authors.lastname: Cooney
authors.forename: Lorraine
authors.initials: L
authors.lastname: Mee
authors.forename: Dympna
authors.initials: D
authors.lastname: Casey
authors.forename: Kathy
authors.initials: K
authors.lastname: Murphy
authors.forename: Collette
authors.initials: C
authors.lastname: Kirwan
authors.forename: Eimear
authors.initials: E
authors.lastname: Burke
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Conway
authors.forename: Denise
authors.initials: D
authors.lastname: Healy
authors.forename: Brona
authors.initials: B
authors.lastname: Mooney
authors.forename: Jill
authors.initials: J
authors.lastname: Murphy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D036301:Qualitative Research