Patients' experiences of oxygen therapy and dyspnoea: a qualitative study in home palliative care

Abstract

Background Dyspnoea is a common and distressing symptom in advanced cancer patients. Our preliminary work shows that in the home palliative care population sampled for this study, the prevalence of dyspnoea is 29.5% and of those, 26.2% used oxygen therapy. Previous studies suggested that oxygen therapy can be a burden to patients. Purpose This study seeks to report the prevalence and describe the experience of dyspnoea, pattern of oxygen use, and patients' perceived benefits and/or burdens of oxygen therapy in home palliative care patients receiving oxygen therapy. Methods Qualitative indepth interviews, using an interview guide, were conducted with eight participants in their homes. Thematic analysis was performed using a framework approach. Results All patients in this project used oxygen most of the time. The descriptions of shortness of breath varied and were non-specific. The patients identified more advantages than disadvantages. The advantages of oxygen use included increased functional capacity, patients' perceiving oxygen as a life-saving intervention, as well as a symptom-management tool. The identified disadvantages were decreased mobility, discomfort related to the nasal prongs, barriers to accessing oxygen therapy and noise related to the equipment. Conclusion The advantages of oxygen usage outweighed the disadvantages for this sample of patients in the home palliative setting.

A wolf in sheep's clothing? Patients’ and healthcare professionals’ perceptions of oxygen therapy: An interpretative phenomenological analysis

“…Oxygen as a positive therapy has been reported previously . This study uncovered patients’ reverent approach to oxygen, feeling grateful, enamoured and indebted to its ability to control dyspnoea.…”

How do respiratory patients perceive oxygen therapy? A critical interpretative synthesis of the literature

“…49 This association with death appears as a direct contradiction to previous constructs of faith in and keep alive. 22,23,34 Reflection on previous experiences is seen further. Exploration of oxygen in respect of living with COPD revealed recalled memories of others using oxygen, ' .…”

“…It is apparent within several reviewed studies that patients often regard oxygen as tantamount to keeping them alive. 22,23,34,57,59 A key finding in Ring and Danielson's 59 phenomenological study of chronic obstructive pulmonary disease (COPD) patients with long-term oxygen therapy (LTOT) was 'an advantage to the body'. How this correlated to patients' knowledge and understanding was unclear.…”

“…Patients identify oxygen as a life-saving intervention: 'I don't know if I'd be around if I didn't have it'. 22 Likewise Adams 23 discusses oxygen as 'enabling patients to live', whilst other studies reported patients feeling safe through increased confidence 45 or relief of dyspnoea. 31 Earnest 42 highlights patients stated trust in the prescribing physician.…”

“…Similarly, perceptions regarding oxygen as being 'essential' 34 fail to illuminate what manifested this belief. Patients identify oxygen as a life-saving intervention: 'I don't know if I'd be around if I didn't have it' 22. Likewise Adams 23 discusses oxygen as 'enabling patients to live', whilst other studies reported patients feeling safe through increased confidence…”