title: Understanding fear and anxiety in patients at the time of an exacerbation of chronic obstructive pulmonary disease: a qualitative study.
abstract: OBJECTIVE
  To determine the importance of fear and anxiety at the time of an exacerbation of chronic obstructive pulmonary disease. To assess the influence of carers and health professionals on this fear and anxiety.
  
  
  METHODS
  A qualitative study to elicit the views of patients and their carers during a hospital admission for exacerbations of chronic obstructive pulmonary disease.
  
  
  METHODS
  Interviews were conducted in a District General Hospital.
  
  
  METHODS
  Twenty patients were interviewed shortly after admission to hospital with an exacerbation.
  
  
  METHODS
  Key themes were identified using cross-sectional thematic analysis of transcripts where commonalities and differences were identified.
  
  
  RESULTS
  Four themes emerged: panic and fear; anxiety management techniques used during an exacerbation; intervention from family members and carers; response to medical services.
  
  
  CONCLUSIONS
  Panic and fear are important emotions prior to admission. Many patients recognised the link between panic-fear and a worsening of symptoms, and some were able to use self-management techniques to reduce their panic-fear. Some relatives were seen as helping and others exacerbating the symptoms of panic-fear. The emergency services were seen as positive: providing reassurance and a sense of safety. How best to help patients with chronic obstructive pulmonary disease manage panic and fear remains a challenge.
authors.affiliation: Department of Respiratory Medicine, Royal Devon and Exeter Hospital, Exeter EX2 5DW, UK.
authors.forename: David
authors.initials: D
authors.lastname: Halpin
authors.affiliation: School of Psychology, University of Plymouth, Plymouth PL4 8AA, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Hyland
authors.affiliation: The Honiton Group Practice, Honiton EX14 2NY, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Blake
authors.affiliation: The Honiton Group Practice, Honiton EX14 2NY, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Seamark
authors.affiliation: The Honiton Group Practice, Honiton EX14 2NY, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Pinnuck
authors.affiliation: The Honiton Group Practice, Honiton EX14 2NY, UK.
authors.forename: David
authors.initials: D
authors.lastname: Ward
authors.affiliation: School of Psychology, University of Plymouth, Plymouth PL4 8AA, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Whalley
authors.affiliation: Department of Primary Care, University of Exeter Medical School, Exeter EX1 2LU, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Greaves
authors.affiliation: GSK Respiratory Global Franchise, Exeter UB11 1BT, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Hawkins
authors.affiliation: The Honiton Group Practice, Honiton EX14 2NY, UK.
authors.forename: David
authors.initials: D
authors.lastname: Seamark
keywords: clinical; other respiratory disease/medicine; respiratory medicine