Experiences of older people following an acute exacerbation of chronic obstructive pulmonary disease: A phenomenological study

Rosa, Francesca; Bagnasco, Annamaria; Ghirotto, Luca; Rocco, Gennaro; Catania, Gianluca; Aleo, Giuseppe; Zanini, Milko; Dasso, Nicoletta; Hayter, Mark; Sasso, Loredana

Abstract

Aims and objectives

To explore the experience of patients affected by COPD following hospitalization due to an acute exacerbation event.

Background

Chronic Obstructive Pulmonary Disease (COPD) is a progressively debilitating disease, often with very burdensome symptoms such as acute and chronic breathlessness and fatigue. Acute exacerbation often creates a life threatening event. Exacerbation can also have substantial psychological effects including anxiety and depression although this aspect is less well researched – especially amongst people with COPD recovering from an acute event and facing a return home.

Design

A descriptive phenomenological study.

Methods

In depth interviews were conducted with twelve COPD patients recently recovering from an acute exacerbation of their COPD. Data were analysed using Colaizzi's phenomenological framework.

Results

Four themes were identified from the data: a sense of loss and frustration, hopelessness, uncertainty about the future and fear of becoming a burden. Participants expressed quite negative views including a loss of hope, uncertainty about their future care and the burden they may become on their families. They appeared stressed and anxious as a result of the acute event they had experienced.

Conclusions

This study shows that an acute episode of illness can generate a sense of hopelessness and uncertainty about their future care in people with COPD. This occurs as they recover physically and think about the future, often in quite negative terms.
Relevance to clinical practice

For healthcare professionals it is important to take into account the potential feelings of loss, hopelessness and uncertainty that people can experience following an acute exacerbation of their COPD and ensure that psychological care is available as physical recovery takes place. Such care to include good discharge planning, giving patients time to express concerns and referral to counselling services if appropriate.

Citation

Rosa, F., Bagnasco, A., Ghirotto, L., Rocco, G., Catania, G., Aleo, G., Zanini, M., Dasso, N., Hayter, M., & Sasso, L. (2018). Experiences of older people following an acute exacerbation of chronic obstructive pulmonary disease: A phenomenological study. Journal of clinical nursing, 27(5-6), e1110-e1119. https://doi.org/10.1111/jocn.14189

• Journal Article Type: Article
• Acceptance Date: Nov 29, 2017
• Online Publication Date: Feb 21, 2018
• Publication Date: 2018-03
• Deposit Date: Dec 11, 2017
• Publicly Available Date: Feb 22, 2019
• Journal: Journal of Clinical Nursing
• Print ISSN: 0962-1067
• Electronic ISSN: 1365-2702
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 5-6
• Pages: e1110-e1119
• DOI: https://doi.org/10.1111/jocn.14189
• Keywords: COPD; Phenomenology; Patient; Older person; Hospital; Interviews; Chronic illness; Chronic obstructive pulmonary disease; Illness-meaning; Nursing
• Public URL: https://hull-repository.worktribe.com/output/499564
• Publisher URL: http://onlinelibrary.wiley.com/wol1/doi/10.1111/jocn.14189/abstract
• Contract Date: Dec 12, 2017