Accommodating to a troubled life – chronic obstructive pulmonary disease patients’ experiences and perceptions of self-image during the course of rehabilitation

Abstract

Background: To tailor future rehabilitation programmes for patients with chronic pulmonary obstructive disease, there is a need for more in-depth knowledge about what is essential to these patients and how they perceive their self-image while participating in rehabilitation. Therefore, this study aims to explore patients' experiences and perception of self-image during pulmonary rehabilitation. Methods: Twenty-one patients were followed by participant observations during standard rehabilitation complicity supplemented with final individual interviews. Phenomenologicalhermeneutic analysis and interpretation were applied. Results: Through a rewarding peer fellowship, patients became engaged in rehabilitation and improved their capacity to embrace and manage their illness. Through a humorous interplay, encouragement to live with the life-threating disease developed. While understanding themselves in a wider perspective, patients enhanced enablement to shape life according to personal satisfaction. Although participating in the group-based programme was mostly invigorating, it was, however, sometimes perceived as a stressful overload. More individualized support from healthcare professionals was warrented. Conclusions: Group-based pulmonary rehabilitation can support chronic pulmonary obstructive disease patients towards significant change in self-image and health behaviour, leading to improved illness management. Enlarged opportunities to benefit from peer-fellowship and enhanced focus on what is essential to the participants might expand the rehabilitation yields.

Striving for Confidence and Satisfaction in Everyday Life with Chronic Obstructive Pulmonary Disease: Rationale and Content of the Tele-Rehabilitation Programme >C☺PD-Life>>

“…Here we especially focused on what was essential to COPD patients in rehabilitation. In addition, previous findings from a preliminary study of COPD patients’ experiences of their participation in standard pulmonary rehabilitation [27,28] were considered along with practical issues.…”

“…Their topics were: patients’ needs, expectations and self-care, the physiology of the lungs, management of medicine and inhalation techniques, management of dyspnea and panic, cohabitation and sexuality, existential and palliative matters, smoking cessation, social options and issues related to additional illness (apnea, incontinence, diabetes, osteoporosis, malnutrition etc.) [9,27,28,38,39,40,41,42,43]. One of the nurses was available for individual consultations most days during the programme.…”

Breathing through a troubled life – a phenomenological-hermeneutic study of chronic obstructive pulmonary disease patients’ lived experiences during the course of pulmonary rehabilitation

“…Moreover, this type of data opens for insight into a movement in the patients' self-image. Focus on this particular part has been interpreted and described in another publication adding new knowledge about how a rewarding peer-fellowship increase COPD patients' engagement in the rehabilitation leading to improved illness management (Simonÿ, Andersen, Bodtger, & Birkelund, 2019). However, more studies of new solutions within rehabilitation to COPD patients is warranted to better target their particular situation.…”

The impact of a personalised action plan delivered at discharge to patients with COPD on readmissions: a pilot study

“…We did not find any significant association between reduction in HADS total or subscores in subgroup analyses (gender, age cut-off ≥ 70, GOLD class, living single or not) (data not shown). 208 (16) No controller, n (%) 2…”

“…According to included studies in the Cochrane reviews within the field, the research on APs has mostly been performed in outpatient settings in a stable phase of disease 12,13. Nevertheless, qualitative work has highlighted that not all patients have the ability to attend outpatient education after discharge due to an overall vulnerability, impairing the difficulty accepting the chronic disease, the understanding of being frail or the altered life situation 16. Besides, experiences of difficult access and contact to healthcare professionals after discharge can dominate and complicate COPD self‐management resulting in doubt and hopelessness over time 17.…”