Abstract
Introduction: Grasping the complexity of COPD patients coping with breathlessness during daily living has not yet been achieved.
Purpose: To develop a grounded theory of COPD patients' coping styles by investigating possible interrelations between the physiological, cognitive, affective and psychosocial dimensions in coping.
Materiel and methods: Twelve patients with moderate to most severe COPD were included during hospitalization for an acute exacerbation of COPD. We chose a multi-modal grounded theory design with concurrent data collection and analysis, and a constant comparative analytic process of interpretation of the data material as a whole. Data were collected both at hospital and in the patients' home after discharge. Data were derived from video, interview, medical history, demographics, scores on a modified Borg Scale and recordings of SaO2, heart rate, energy expenditure and level of Mets. The data material comprised 24 interviews, 50 recordings of video, 50 video transcriptions, 50 sets of measurements of physiological parameters, 50 set of scores on the modified Borg Scale and 12 sets of demographic information.
Results: The main concern for the participants appeared to be an endless striving for economizing on intra-, extra-, and interpersonal resources with the main purpose of preserving their existence with breathlessness. Suggesting a coping trajectory, four coping styles emerged in this self-protective process corresponding with the degree of pulmonary function, level of physical activity, energy expenditure and social status.
Conclusion: COPD patients' coping styles appear to correspond with their physical and psychosocial condition suggesting a “COPD coping trajectory”.
- © 2011 ERS