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Patient coping strategies in COPD across disease severity and quality of life: a qualitative study

Patient coping strategies in COPD across disease severity and quality of life: a qualitative study
Patient coping strategies in COPD across disease severity and quality of life: a qualitative study
Quality of life (QoL) has a weak relationship with lung function (LF) impairment in COPD; some cope well despite poor LF, while others suffer disproportionate QoL impairment despite well-preserved LF. Adjuvant non-pharmacological interventions such as rehabilitation and psychological/behavioural support may help if acceptable and targeted appropriately, but are under-used and sometimes declined by patients. This study aimed to explore and understand variations in experiences and coping strategies in patients with different severities of disease and disease-specific QoL. Thirty four participants were purposively sampled across a spectrum of LF and QoL impairment, to cover a grid of sub-groups (‘very severe LF, good QoL’, moderate LF, poor QoL’ etc.). Semi-structured interviews, digitally recorded, were analysed by thematic analysis. Data saturation was achieved. Four themes emerged: symptom impact, coping strategies, coping challenges, support needs. Most described employing multiple coping strategies yet over half reported significant challenges coping with COPD including: psychological impact, non-acceptance of diagnosis and/or disease progression, effects of comorbidities and inadequate self-management skills. Approximately half wanted further help, ideally nonpharmacological, across all LF impairment groups but mainly with lower QoL. Those with lower QoL additionally reported greater psychological distress and greater use of non-pharmacological support strategies where accessible. Patients who develop effective coping strategies, have better quality of life independent of objective LF, whereas others cope poorly, are aware of this, and report more use of non-pharmacological approaches. This study suggests that severely impaired QoL, irrelevant of lung function, is a powerful patient centred indication to explore the positive benefits of psychological and behavioural support for distressed C
2055-1010
Brien, Sarah
4e8e97cd-7bc3-4efd-857e-20790040b80f
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Brien, Sarah
4e8e97cd-7bc3-4efd-857e-20790040b80f
Lewith, George
0fc483fa-f17b-47c5-94d9-5c15e65a7625
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953

Brien, Sarah, Lewith, George and Thomas, Mike (2016) Patient coping strategies in COPD across disease severity and quality of life: a qualitative study. npj Primary Care Respiratory Medicine. (doi:10.1038/npjpcrm.2016.51).

Record type: Article

Abstract

Quality of life (QoL) has a weak relationship with lung function (LF) impairment in COPD; some cope well despite poor LF, while others suffer disproportionate QoL impairment despite well-preserved LF. Adjuvant non-pharmacological interventions such as rehabilitation and psychological/behavioural support may help if acceptable and targeted appropriately, but are under-used and sometimes declined by patients. This study aimed to explore and understand variations in experiences and coping strategies in patients with different severities of disease and disease-specific QoL. Thirty four participants were purposively sampled across a spectrum of LF and QoL impairment, to cover a grid of sub-groups (‘very severe LF, good QoL’, moderate LF, poor QoL’ etc.). Semi-structured interviews, digitally recorded, were analysed by thematic analysis. Data saturation was achieved. Four themes emerged: symptom impact, coping strategies, coping challenges, support needs. Most described employing multiple coping strategies yet over half reported significant challenges coping with COPD including: psychological impact, non-acceptance of diagnosis and/or disease progression, effects of comorbidities and inadequate self-management skills. Approximately half wanted further help, ideally nonpharmacological, across all LF impairment groups but mainly with lower QoL. Those with lower QoL additionally reported greater psychological distress and greater use of non-pharmacological support strategies where accessible. Patients who develop effective coping strategies, have better quality of life independent of objective LF, whereas others cope poorly, are aware of this, and report more use of non-pharmacological approaches. This study suggests that severely impaired QoL, irrelevant of lung function, is a powerful patient centred indication to explore the positive benefits of psychological and behavioural support for distressed C

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More information

Accepted/In Press date: 17 June 2016
e-pub ahead of print date: 15 September 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 397236
URI: https://eprints.soton.ac.uk/id/eprint/397236
ISSN: 2055-1010
PURE UUID: 156965c1-b4c6-4178-b80f-3eb765774673

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Date deposited: 24 Jun 2016 14:17
Last modified: 08 Aug 2018 16:31

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Contributors

Author: Sarah Brien
Author: George Lewith
Author: Mike Thomas

University divisions

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