title: How do informal self-care strategies evolve among patients with chronic obstructive pulmonary disease managed in primary care? A qualitative study.
abstract: BACKGROUND
  There is much description in the literature of how patients with chronic obstructive pulmonary disease (COPD) manage their breathlessness and engage in self-care activities; however, little of this is from the perspective of those with less severe disease, who are primarily managed in primary care. This study aimed to understand the self-care experiences of patients with COPD who are primarily managed in primary care, and to examine the challenges of engaging in such behaviors.
  
  
  METHODS
  Semistructured interviews were carried out with 15 patients with COPD as part of a larger project evaluating a self-management intervention. Thematic analysis was supported by NVivo software (version 8, QSR International, Melbourne, Australia).
  
  
  RESULTS
  Three main themes are described, ie, experiencing and understanding symptoms of COPD, current self-care activities, and the importance of family perceptions in managing COPD.
  
  
  CONCLUSIONS
  Self-care activities evolved spontaneously as participants experienced symptoms of COPD. However, there was a lack of awareness about whether these strategies would impact upon symptoms. Perceptions of COPD by family members posed a challenge to self-care for some participants. Health care professionals should elicit patients' prior disease experiences and utilize spontaneous attempts at disease management in future self-management. These findings have implications for promoting self-management and enhancing quality of life.
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, UK.
authors.forename: Lindsay D
authors.initials: LD
authors.lastname: Apps
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, UK.
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Harrison
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, UK.
authors.forename: Johanna E A
authors.initials: JE
authors.lastname: Williams
authors.affiliation: School of Applied Social Sciences, De Montfort University, Leicester, UK.
authors.forename: Nicky
authors.initials: N
authors.lastname: Hudson
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Steiner
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, UK.
authors.forename: Mike D
authors.initials: MD
authors.lastname: Morgan
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS Trust, UK ; Applied Research Centre Health & Lifestyle Interventions, Coventry University, Coventry, UK.
authors.forename: Sally J
authors.initials: SJ
authors.lastname: Singh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D032882:Comprehension; D005195:Family Relations; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010465:Perception; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D036301:Qualitative Research; D011788:Quality of Life; D012648:Self Care; D013997:Time Factors
keywords: chronic obstructive pulmonary disease; primary care; qualitative interviews; self-care