Exploring the Experience of Breathlessness with the Common-Sense Model of Self-Regulation (CSM)

Abstract

Chronic breathlessness is a multidimensional, unpleasant symptom common to many health conditions. The Common-Sense Model of Self-Regulation (CSM) was developed to help understand how individuals make sense of their illness. This model has been underused in the study of breathlessness, especially in considering how information sources are integrated within an individual’s cognitive and emotional representations of breathlessness. This descriptive qualitative study explored breathlessness beliefs, expectations, and language preferences of people experiencing chronic breathlessness using the CSM. Twenty-one community-dwelling individuals living with varying levels of breathlessness-related impairment were purposively recruited. Semi-structured interviews were conducted with questions reflecting components of the CSM. Interview transcripts were synthesized using deductive and inductive content analysis. Nineteen analytical categories emerged describing a range of cognitive and emotional breathlessness representations. Representations were developed through participants’ personal experience and information from external sources including health professionals and the internet. Specific words and phrases about breathlessness with helpful or nonhelpful connotations were identified as contributors to breathlessness representations. The CSM aligns with current multidimensional models of breathlessness and provides health professionals with a robust theoretical framework for exploring breathlessness beliefs and expectations.

Patients’ response during the co-circulation of multiple respiratory diseases in China—based on the self-regulation common-sense model

“…The Common-Sense Model of Self-Regulation provides a theoretical framework for explaining how individuals interpret and respond to health threats. They assess symptoms based on their cognitive models, attempting to determine the identity, cause, and potential consequences of the symptoms, and decide their response accordingly ( 26 ). If they believe the symptoms can be managed through self-regulation, they might not seek professional medical help.…”

The Role of Illness Perceptions in Dyspnoea-Related Fear in Chronic Obstructive Pulmonary Disease

“…Why is that? * Insights previously reported [19]. Comments in italics are likely to be associated with an unpleasant emotional response, such as distress, fear and anxiety, and lead to avoidant coping strategies.…”

“…Table 1 provides definitions of these domains and examples of questions the person may ask themselves to create a personal construct of their dyspnoea. Whilst acknowledging that people will have varied situational stimuli, Table 1 also provides examples of beliefs and expectations around dyspnoea that have been previously reported [ 19 , 20 ] or have been commonly encountered as part of our own clinical and research experience working with people with COPD. In contrast to other common unpleasant symptoms, such as pain, the development of a personal construct of dyspnoea is likely to be influenced by the societal and self-stigma associated with this sensation.…”

“…[ 18 ]. In this narrative review, we draw on earlier work that has applied the CSM to understand beliefs and expectations around dyspnoea [ 19 ] as well as our own clinical and research experience working with people with COPD [ 20 ]. We also provide parallels of how the CSM has been used to understand another noxious symptom: chronic low back pain [ 21 , 22 ].…”

Mediation role of perceived social support between recurrence risk perception and health behaviour among patients with stroke in China: a cross-sectional study

“… 27 The CSM comprises six main components 28 : (1) situational stimuli, (2) cognitive illness representations, (3) emotional illness representations, (4) coping strategies, (5) illness and emotional outcomes and (6) coping appraisal. Previous studies have already applied the CSM model to predict health outcomes in diabetes, 29 explore the experience of breathlessness 30 and predict healthy eating among individuals at risk of metabolic syndrome. 29 For patients with stroke, the surrounding situational stimuli (including endogenous or social factors) cause patients with stroke to develop cognitive and emotional illness representation (recurrence risk perception).…”