Abstract
ABSTRACT Purpose: Exploring real-life experiences of Chronic Obstructive Pulmonary Disease (COPD) patients during rehabilitation can contribute with new knowledge of what has significance for their participation and chance for improved health and well-being. Therefore, this study aims to gain in-depth knowledge of COPD patients’ lived experiences while following standard pulmonary out-patient rehabilitation. Methods: Combined participant observations and interviews were conducted among 21 participants in pulmonary rehabilitation. A three-leveled phenomenological-hermeneutic interpretation was applied. Results: Living with COPD was challenging due to dyspnea and other physical troubles. This caused a lack of trust in the body and complicated rehabilitation participation. When improving management of breath during rehabilitation, the patients gained a new sense of trust in the body. This was accompanied by a nascent hope and increased well-being. However, not succeeding in this left patients with a persistent lack of hope. Conclusions: Comprehensive troubles in living with COPD paradoxically prevents patients’ prospect of overcoming a perceived lack of trust in their body during standard pulmonary rehabilitation. Enhancing breath management has a significant impact on COPD patients’ trust in own capabilities to improve well-being and health. Future rehabilitation must accommodate COPD patients’ troubles by longer-lasting, well-coordinated, individually supportive and more easily accessible programmes.
Highlights
This paper illuminates what is at stake for patients with chronic obstructive pulmonary disease (COPD) during the trajectory of a Danish standard outpatient rehabilitation.COPD is a leading cause of disability and mortality and represents a considerable world-wide socio-economic burden
Qualitative interview studies suggest that patients may decline pulmonary rehabilitation if they do not find the offer appropriate, if they find the offer as conflicting with daily activities, or if they perceive themselves too frail
This study provides new insight into how multifaceted troubles challenge COPD patients when following an eight-week long standard out-patient rehabilitation programme in Denmark and that support to gain a new trust in one’s body and capability by breath management is crucial, difficult to achieve
Summary
This paper illuminates what is at stake for patients with chronic obstructive pulmonary disease (COPD) during the trajectory of a Danish standard outpatient rehabilitation.COPD is a leading cause of disability and mortality and represents a considerable world-wide socio-economic burden. This paper illuminates what is at stake for patients with chronic obstructive pulmonary disease (COPD) during the trajectory of a Danish standard outpatient rehabilitation. As estimated to be the third largest cause of death in 2030, there is an ongoing and global focus on improving treatment and management in pharmacological as well as non-pharmacological ways to COPD patients (Global Initiative for Chronic Obstructive Lung Disease, 2018; World Health Organization, 2018). Pulmonary rehabilitation is an internationally acknowledged intervention, which is shown to be effective to improve dyspnea, health status, and exercise tolerance (McCarthy et al, 2015). Access issues and transportation challenges have been shown to be of major importance (Cassidy et al, 2014; Global Initiative for Chronic Obstructive Lung Disease, 2018; Keating et al, 2011; Rochester et al, 2015). Qualitative interview studies suggest that patients may decline pulmonary rehabilitation if they do not find the offer appropriate, if they find the offer as conflicting with daily activities, or if they perceive themselves too frail
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