Giving Voice to People - Experiences During Mild to Moderate Acute Exacerbations of COPD

Abstract

Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have a negative impact on health status and disease progression, but their clinical presentation is heterogenous. A comprehensive understanding of people's experience during AECOPD is needed to develop person-centred interventions, such as pulmonary rehabilitation (PR). This study aimed to explore people's experience during mild to moderate AECOPD, and their thoughts on PR during this period. Methods: Short, semi-structured interviews were conducted with people with mild to moderate AECOPD treated in the community, within 48h of the diagnosis. Interviews were audio recorded, transcribed and analysed by deductive thematic analysis using the Web Qualitative Data Analysis software. Results: Eleven people with AECOPD (9 male, 67 +/- 10 years, FEV1 41 +/- 16%predicted) participated. Four themes and seventeen subthemes were identified: impact of AECOPD (symptoms, physiological changes, limitations in activities of daily living, social constrains, psychological and emotional challenges, family disturbances); dealing with AECOPD ([not] depending on others, planning and compensation strategies); main needs during AECOPD (breath better, feel less tired, get rid of sputum, be able to walk); and (un)certainty about PR (lack of knowledge, get better, exercises, design and timing, trust in health professionals). Conclusion: AECOPD, even when not requiring hospital admission, have a huge negative impact on people's lives. People's thoughts about PR reflect the need to raise awareness for this intervention during AECOPD. This study provides a foundation for the development of meaningful person- centred interventions during AECOPD.