Four types of coping with COPD-induced breathlessness in daily living: a grounded theory study

Abstract

Coping with breathlessness is a complex and multidimensional challenge for people with chronic obstructive pulmonary disease (COPD) and involves interacting physiological, cognitive, affective, and psychosocial dimensions. The aim of this study was to explore how people with moderate to most severe COPD predominantly cope with breathlessness during daily living. We chose a multimodal grounded theory design that holds the opportunity to combine qualitative and quantitative data to capture and explain the multidimensional coping behaviour among people with COPD. The participants' main concern in coping with breathlessness appeared to be an endless striving to economise on resources in an effort to preserve their integrity. In this integrity-preserving process, four predominant coping types emerged and were labelled: 'Overrater', 'Challenger', 'Underrater', and 'Leveller'. Each coping type comprised distinctive physiological, cognitive, affective and psychosocial features constituting coping-type-specific indicators. In theory, four predominant coping types with distinct physiological, cognitive, affective and psychosocial properties are observed among people with COPD. The four coping types seem to constitute a coping trajectory. This hypothesis should be further tested in a longitudinal study.

Coping with breathlessness among people with COPD: distinct physiological and behavioural indicators

“…The statistical analysis was the fourth and final step in merging data, finally saturating the theory on four types of coping (see Figure 3) (Jørgensen et al, 2013b). This process of merging data was done in the theoretical phase of the GT analysis ( Figure 1).…”

“…Thus, in a recent multi-modal GT study, we developed a theoretical account of four predominant types of coping with breathlessness among people with COPD. These four coping types were based on behavioural patterns and descriptive data (habitual FEV2 and level of activity) (Jørgensen et al, 2013b). In this paper, we present the statistical findings of other behavioural and physiological data with the ostensible ability to discriminate these coping types and function as coping-type-specific indicators.…”

“…This was done by conducting the constant comparative analysis in accordance with GT methodology (Jørgensen et al, 2013b).…”

“…Merging data (Four-step-procedure) types, several predominant and interacting strategies for economizing resources emerged (Jørgensen et al, 2013b). However, the regulation of activity level appeared to be the basic economizing feature, urging participants to avoid breathlessness-related stress, anxiety and physical and psychosocial defeat.…”

“…In a recent grounded theory (GT) study, we firstly identified four predominant types of coping with breathlessness among people with COPD (Jørgensen et al, 2013b) and subsequently identified possible coping-type-specific indicators on these four coping types. This paper reports the statistical findings on the coping-type-specific indicators, with the ability to discriminate between the four coping types.…”