title: Breathlessness and crises in the context of advanced illness: A comparison between COPD and lung cancer patients.
abstract: OBJECTIVE
  The objective of this study was to explore and contrast the experience and meaning of breathlessness in patients with chronic obstructive pulmonary disease (COPD) or lung cancer at the end of life.
  
  
  METHODS
  We conducted a qualitative study embedded in a longitudinal study using topic-guided in-depth interviews with a purposive sample of patients suffering from breathlessness affecting their daily activities due to advanced (primary or secondary) lung cancer or COPD stage III/IV. All interviews were audiotaped, transcribed verbatim, and analyzed using framework analysis.
  
  
  RESULTS
  Ten COPD and eight lung cancer patients were interviewed. Both groups reported similarities in their experience. These included exertion through breathlessness throughout the illness course, losses in their daily activities, and the experience of breathlessness leading to crises. The main difference was the way in which patients adapted to their particular illness experience and the resulting crises over time. While COPD patients more likely sought to get their life with breathlessness under control, speaking of daily living with breathlessness under certain conditions, the participating lung cancer patients often faced the possibility of death and expressed a need for security.
  
  
  CONCLUSIONS
  Breathlessness leads to crises in patients with advanced disease. Although experiences of patients are similar, reactions and coping mechanisms vary and are more related to the disease and the stage of disease.
authors: Institute of Ethics and Communication in Health Care, University of Witten/Herdecke,58453 Witten,Germany.
authors: Christine
authors: C
authors: Dunger
authors: King's College London, Department of Palliative Care, Policy and Rehabilitation,Cicely Saunders Institute,London SE5 9PJ,United Kingdom.
authors: Irene J
authors: IJ
authors: Higginson
authors: Amsterdam Institute of Social Science Research,Amsterdam,The Netherlands.
authors: Marjolein
authors: M
authors: Gysels
authors: Palliative Care Team,Addenbrooke's Hospital,Cambridge CB2 0QQ,United Kingdom.
authors: Sara
authors: S
authors: Booth
authors: King's College London, Department of Palliative Care, Policy and Rehabilitation,Cicely Saunders Institute,London SE5 9PJ,United Kingdom.
authors: Steffen T
authors: ST
authors: Simon
authors: King's College London, Department of Palliative Care, Policy and Rehabilitation,Cicely Saunders Institute,London SE5 9PJ,United Kingdom.
authors: Claudia
authors: C
authors: Bausewein
mesh_terms: D000203:Activities of Daily Living; D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000368:Aged; D001293:Attitude to Death; D004417:Dyspnea / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D036301:Qualitative Research; D013315:Stress, Psychological / Q000503:physiopathology
keywords: Qualitative