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.

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.…”

“…This mainly concerned consultation according to their goals including adjustment in techniques and workload during exercising, injury treatment, instructions and guidance in performing daily activities in a more energy-conserving matter. Predefined educational topics were: breathing techniques, e.g., instruction in the use of the positive expiratory pressure (PEP) device, physical activity and training principles, lung anatomy and COPD, incontinence and pelvic exercise, maintaining physical activity and pain management [2,28]. During these educational sessions, the techniques were trained with intensive guidance from the physiotherapist.…”

“…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.…”

A Fully Longitudinal Mixed Methods Case Study Design: An Example Based on the Illness Trajectory of a Person With Chronic Conditions in Home-Monitoring-Based Telenursing During the COVID-19 Pandemic

“…The findings of the present study suggest that constant dialogue with a telenurse may help individuals who are chronically ill to develop a broader perspective and resilience through their illness trajectory. Simonÿ et al (2019) reported that the considerable difficulty patients face when living with COPD hinder their prospects of overcoming the perceived lack of trust in their body during standard pulmonary rehabilitation. Providing breath management and physical recovery interventions on time is essential to allow people living with COPD to achieve vitality.…”

Paul Ricoeur on the Recognition of Anxiety: Phenomenological Hermeneutics in Action

“…In the last section of this paper I would like to develop the idea of recognition of the presence of anxiety in the so-called "affective niche", or affective scaffolding, which is a form of self-styled environment constructed in everyday life by the particular shaping of the affective tonality of our routines (by colors, music, lightning) 3 [4]. For this reason I would like to briefly consider two cases of implementing the phenomenological hermeneutics as sufficient approach in the research of anxiety protocols (see Simonÿ et al' research of nursing protocols and interviews on the patients' lived experience, and Alberto de Castro's implementation of hermeneutic technique) [7][8][9][10].…”