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

ABSTRACT

Purpose: Exploring real-life experiences of Chronic Obstructive Pulmonary Disease (COPD) patients during rehabilitation can contribute with new knowledge of what has significance for their participation and chance for improved health and well-being. Therefore, this study aims to gain in-depth knowledge of COPD patients’ lived experiences while following standard pulmonary out-patient rehabilitation.

Methods: Combined participant observations and interviews were conducted among 21 participants in pulmonary rehabilitation. A three-leveled phenomenological-hermeneutic interpretation was applied.

Results: Living with COPD was challenging due to dyspnea and other physical troubles. This caused a lack of trust in the body and complicated rehabilitation participation. When improving management of breath during rehabilitation, the patients gained a new sense of trust in the body. This was accompanied by a nascent hope and increased well-being. However, not succeeding in this left patients with a persistent lack of hope.

Conclusions: Comprehensive troubles in living with COPD paradoxically prevents patients’ prospect of overcoming a perceived lack of trust in their body during standard pulmonary rehabilitation. Enhancing breath management has a significant impact on COPD patients’ trust in own capabilities to improve well-being and health. Future rehabilitation must accommodate COPD patients’ troubles by longer-lasting, well-coordinated, individually supportive and more easily accessible programmes.

KEYWORDS:

• Rehabilitation
• chronic obstructive pulmonary disease
• patients’ experience
• participant observation
• interviews
• phenomenological-hermeneutic design

Acknowledgments

This study is fully dependent on the generous participation of the patients. We thank them for allowing us to gain insight into their lives and rehabilitation. For language editing, we thank Jørgen Refshauge.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by The Research Foundation of Naestved, Slagelse and Ringsted Hospitals; The Foundation for Health Research in Region Zealand and The Fund of Development and Research by Danish Regions & Danish Health Confederation.

Notes on contributors

Charlotte Simonÿ

Charlotte Simonÿ’s research has a patient and healthcare professional perspective within the field of interdisciplinary rehabilitation for chronic illnesses. At the time, being the research is based on practice-related issues regarding standard and tele rehabilitation for COPD patients in both the primary and the secondary healthcare sector. The research approach is predominantly within the qualitative methods and takes a phenomenological-hermeneutic approach. Nevertheless, is also beginning to include methods of complex intervention and quantitative angels. The development of new knowledge for practice is made with a health promoting and interdisciplinary aim, in collaboration with project assistants, Ph.D. students and other national and international colleagues.

Ingrid Charlotte Andersen

Ingrid Charlotte Andersen works with research that seeks to address challenges of providing care and rehabilitation for chronic illnesses. Patient and family participation in care within the context of clinical nursing is the focus of the research. Her research is based on qualitative methods and takes a phenomenological-hermeneutic approach. The development of new knowledge for practice within the field of chronic illness is made with a patient involvement approach, in collaboration with research colleagues.

Uffe Bodtger

Uffe Bodtger works in the field of respiratory medicine with a focus on the impact of non-pharmaceutical interventions including rational diagnostic work-up and use of bedside radiology, as well as physiotherapy and pulmonary rehabilitation. The research methods are diverse and often involve interdisciplinary collaboration.

Regner Birkelund

Regner Birkelund works in the field of humanistic health research with a focus on qualitative research methods, especially aimed at studying patients’ perspective on their situation as a basis for developing a person-centered practice. He has initiated a number of research projects on patients' experiences, preferences and needs in relation to their disease and treatment as its focal point.