Abstract
Anxiety often arises in conjunction with dyspnoea in patients with severe COPD. Considering the provoking symptomatology and the high mortality rate for COPD, it is reasonable to believe that these conditions trigger death-related and existential anxiety. Although anxiety causes considerable distress and reduces quality of life, people's experience of anxiety has been studied relatively little. The aim of this study was to explore severely ill COPD patients' experience of anxiety and their strategies to alleviate anxiety. This qualitative, in-depth interview study explored perceptions of anxiety and the alleviation strategies that are adopted. Interviews were analyzed using a thematic content analysis approach, involving interpretive coding and identification of themes. People suffering from COPD (stage III or IV) were recruited from a pulmonary outpatient clinic in the west of Sweden. Purposive sampling was used, and thirty-one (31) patients were included. Most of the patients had experienced anxiety associated with COPD. Analyses revealed three major themes, death anxiety, life anxiety, and counterweights to anxiety. Death anxiety included fear of suffocation, awareness of death, fear of dying and separation anxiety. Life anxiety included fear of living and fear of the future. Counterweights to anxiety concerned coping with suffocation, avoiding strategy, and a sense of joy that defied their vulnerable situation. The majority of patients experienced anxiety, which limited their lives. Although the patients experienced both life anxiety and death anxiety, they were able to cope with the situation and find a defiant joy to some extent.
Highlights
COPD is nowadays a common cause of death throughout the world and an estimated 64 million people had COPD worldwide in 2004 (WHO, 2004)
Most of the patients had experienced anxiety associated with COPD
Counterweights to anxiety concerned coping with suffocation, avoiding strategy, and a sense of joy that defied their vulnerable situation
Summary
COPD is nowadays a common cause of death throughout the world and an estimated 64 million people had COPD worldwide in 2004 (WHO, 2004). Once the disease enters a more severe stage a substantial level of suffering associated with COPD occurs, such as shortness of Anxiety often appears together with dyspnoea in patients with COPD. The burden of these symptoms is comparable or even worse in patients with severe COPD than in patients with cancer or heart failure (Pantilat et al, 2012; Gore et al, 2000; Bausewein et al, 2010). Anxiety is a state of unease and worry about real or perceived future events and the source of the threat is more elusive. Fear is normally perceived as the emotional reaction to a specific, identifiable
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