title: Experience of anxiety among patients with severe COPD: A qualitative, in-depth interview study.
abstract: OBJECTIVE
  Anxiety often arises in conjunction with dyspnoea in patients with severe COPD. Considering the provoking symptomatology and the high mortality rate for COPD, it is reasonable to believe that these conditions trigger death-related and existential anxiety. Although anxiety causes considerable distress and reduces quality of life, people's experience of anxiety has been studied relatively little. The aim of this study was to explore severely ill COPD patients' experience of anxiety and their strategies to alleviate anxiety.
  
  
  METHODS
  This qualitative, in-depth interview study explored perceptions of anxiety and the alleviation strategies that are adopted. Interviews were analyzed using a thematic content analysis approach, involving interpretive coding and identification of themes. People suffering from COPD (stage III or IV) were recruited from a pulmonary outpatient clinic in the west of Sweden. Purposive sampling was used, and thirty-one (31) patients were included.
  
  
  RESULTS
  Most of the patients had experienced anxiety associated with COPD. Analyses revealed three major themes, death anxiety, life anxiety, and counterweights to anxiety. Death anxiety included fear of suffocation, awareness of death, fear of dying and separation anxiety. Life anxiety included fear of living and fear of the future. Counterweights to anxiety concerned coping with suffocation, avoiding strategy, and a sense of joy that defied their vulnerable situation.
  
  
  CONCLUSIONS
  The majority of patients experienced anxiety, which limited their lives. Although the patients experienced both life anxiety and death anxiety, they were able to cope with the situation and find a defiant joy to some extent.
authors.affiliation: Angered Local Hospital,Gothenburg,Sweden.
authors.forename: Susann
authors.initials: S
authors.lastname: Strang
authors.affiliation: Angered Local Hospital,Gothenburg,Sweden.
authors.forename: Ann
authors.initials: A
authors.lastname: Ekberg-Jansson
authors.affiliation: The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg,Gothenburg,Sweden.
authors.forename: Ingela
authors.initials: I
authors.lastname: Henoch
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000150:complications*; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000523:psychology; D036301:Qualitative Research; D013548:Sweden
keywords: Anxiety; COPD; Coping; Death; Existential; Palliative care
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