Symptom Distress And Coping In Patients With Chronic Obstructive Pulmonary Disease: A Qualitative Study

Objectives:The purpose of this study is to explore the symptom distress and coping behaviours of patients with chronic obstructive pulmonary disease.It provides a basis for health care workers to develop relevant intervention plans.Methods:A qualitative study was adopted in this study.We selected the participants based on the largest difference sampling method.We conducted individual face-to-face,semistructured interviews of sixteen people with chronic obstructive pulmonary disease.Data were collected from April to September 2019 in Changchun,China.Giorgi's data analysis method was adopted to analyse the transcribed data.Data analysis was also aided by the computer software package Nvivo12.Results:The findings were divided into two parts: symptom distress and coping behaviours.We identified three themes for the patients' symptom distress: distressing symptoms,inescapable imprisonment and no choice in being a burden to family.Various coping behaviours applied by the patients to manage symptom distress were grouped into three themes: struggling during the medical treatment process,maintaining life carefully and coping with negative emotions.1.Three minor themes of “distressing symptom experience”(1)Physical symptoms(common symptoms include dyspnea,cough,fatigue,sleep disorders,etc.)(2)Psychological symptoms(participants often have negative mental states such as worry,anxiety,hopelessness,etc.)(3)Symptom variability(symptoms usually occurs at night)2.Four minor themes of “an inescapable imprisonment”(1)Restricting physical activities(walking,lifting heavy things,climbing stairs and doing housework.)(2)Losing opportunities for employment(3)Depriving hobbies and interests(4)Limiting social activities3.Four minor themes of “having no choice in being a burden to family”(1)Getting in the way of children's work(2)Increasing the burden of care(3)Bearing economic pressure(4)Bringing out negative emotions of family members4.Three minor themes of “struggling during the medical treatment process”(1)Seeking medical service stepwise(2)The inevitable choice—hospitalization(3)Heavy shackles—Daily Medication5.Four minor themes of “maintaining daily life carefully”(1)Preventing the flu(getting vaccination against influenza,reducing outdoor activities,wearing masks)(2)Avoiding smoke(3)Home oxygen therapy(4)Maintaining inactive6.Three minor themes of “coping with negative emotions”(1)Expressing emotion versus bearing the disease alone(2)Having a positive outlook versus Escaping from reality(3)Religious belief Conclusion:This research sought to elucidate the symptom distress and coping behaviours of chronic obstructive pulmonary disease patients.The participants have a variety of physical and psychological symptoms,which cause limitations to the patients in daily.And their original lifestyles have changed.Patients with acute exacerbation of chronic obstructive pulmonary disease choose to seek medical help.But they lack experience and skills to cope with the disease in daily life which results in negative emotions and aggravation of the disease.1.Health care workers should not only pay attention to the symptoms of COPD patients,but also focus on the adverse effects of symptoms on patients' lives.It is necessary to understand the symptoms distress they have in daily life and explore the specific reason of the problems.Help patients to eliminate controllable factors,so as to improve the living conditions of patients.2.Health care workers should understand the patients' coping behaviours,and identify the adverse factors that affect their coping behaviours.Coping resources of patients should be evaluated,so as to develop targeted coping intervention.3.Health care workers also need to accurately assess family caregivers' care ability,strengthen their knowledge about disease and enhance the confidence.