Abstract
Observations indicate that struggling with a burden of an incurable disease such as advanced chronic obstructive pulmonary disease (COPD) may result in the weakening of an individual sense of dignity, and be a source of spiritual suffering. Clinicians providing respiratory care to patients should be open to their spiritual needs, in the belief it may improve coping with the end-of-life COPD. The study aimed to assess overall feasibility and potential benefits of Dignity Therapy (DT) in patients with advanced COPD. Patients with severe COPD, in whom a DT intervention was implemented according to the protocol established by Chochinov et al. were included into the study. An self-designed questionnaire was applied to assess the patients' satisfaction after intervention. Subsequently, the patients' statements were allocated to specific problem categories, corresponding to the spiritual suffering concerns, as structured by Groves and Klauser. DT was completed in 10 patients, with no unexpected side effects. Satisfaction Questionnaire showed a positive effect of DT on the patient' well-being (3.9 on a 5-point Likert scale). The analyses of the patients' original statements enabled an effective identification of the spiritual suffering and spiritual resources and faced by COPD patients. DT is an intervention well received by COPD patients, which may help them in recognising and fulfilling their spiritual needs in the last phase of their life. Information acquired on the patients' resources and spiritual challenges may help clinicians improve their care, especially with regard to supporting their patients at the end-of-life stage.
Highlights
Dry powder inhalers (DPI) have been in use in the treatment of chronic respiratory diseases for decades
A total of 385 patients diagnosed with bronchial asthma or chronic obstructive pulmonary disease (COPD) were recruited from the outpatient departments of General Medicine and Pulmonary Medicine of this tertiary care hospital by consecutive non-random sampling for this cross-sectional study
Our study has shown an association of the inhaler technique with education, which has been echoed in various parts of the world in many previous studies [24]
Summary
Dry powder inhalers (DPI) have been in use in the treatment of chronic respiratory diseases for decades. In India, among adults, 2–12% are affected by asthma [1] and 6.5–7.7% by COPD [3] Even though they form two distinct diseases with different pathophysiology, disease progression, prognosis and treatment options, they manifest with similar symptoms like cough, wheezing and shortness of breath. Inhalers have been in use for decades in the treatment of these chronic respiratory diseases They are preferred over other dosage forms due to their local effect, immediate onset of action and reduced side effects. Unlike other dosage forms, inhalers require a proper technique to ensure appropriate dose delivery to the lungs. Similar results were seen in another study in which only 21% of patients demonstrated a correct technique while using the inhaler [9]
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