Living with chronic obstructive pulmonary disease: Part I. Struggling with meal‐related situations: experiences among persons with COPD

Abstract

Reduced nutritional intake with low and decreased body weight can be a component of normal ageing. There is, however, also a greater risk for reduced nutritional intake within certain diagnoses, especially for chronic diseases. Malnutrition in chronic obstructive pulmonary disease (COPD) is caused by many factors. The relationship between COPD and low values of body mass index (BMI) is a known independent risk for mortality. For optimal support and care with special focus on nutritional status and interventions, caregivers need more knowledge about the meal-related situations (i.e. shopping for food, cooking and eating) of COPD patients. The aim of this study was to describe experiences of meal-related situations as viewed from the individual's perspective. The sample included eight women and five men with COPD recruited from five primary health clinics. The participants' average age was 68.9 years, with values of forced expiratory volume in 1 second (FEV(1) percentage) ranging from 18 to 69 and BMI values from 15 to 40. A descriptive design with qualitative interviews and self-reported diaries were used and the data were later analysed using content analysis. Findings showed consistency between informants' COPD, nutritional status and descriptions of experiences in meal-related situations. Findings were disease-specific but were also found to be general- and age-related. Respondents described physical influences and positive and negative feelings in their meal-related situations. Feelings of dependence, level of activity, transport of food, having company or being alone, appetite, hunger and need of time were also mentioned. Most research reports reduced nutritional status from a medical perspective. To our knowledge, no study has reported the positive and negative feelings that arise when eating in persons with COPD. Malnutrition for persons with COPD is not only caused by eating difficulties: eating is an integral part of social situations as shown in this study.

The Experiences of Elderly People Living at Home Related to Their Receiving Meals Distributed by a Municipality in Sweden

“…Further, it was shown in a study by Odencrants, Ehnfors and Grobe (2005) that solitude was sometimes chosen actively as some elderly people felt as if they were being observed while they were eating and found it hard to follow new socio-cultural codes (Odencrants, Ehnfors, & Grobe, 2005). Another study showed that elderly people chose to eat alone because they do not feel comfortable having company during meals they had not chosen freely, for example in the presence of assistant nurses (Leppänen, 2008).…”

Nutrition impact symptoms and body composition in patients with COPD

“…2 Comorbidities-for example, osteoporosis, depression, ischemic heart disease, diabetes and so on-are common in COPD patients 3 and the general symptom distress is high. 4,5 Many of the common symptoms and problems experienced by COPD patients are likely to negatively affect a patient´s will or ability to eat and have been shown to be common in patients with COPD [6][7][8] and even more so among malnourished patients. 8 Multiple nutrition impact symptoms (NIS) are also common 6 and has been associated with a lower energy intake compared with patients without NIS.…”

Psychosocial Dimensions of COPD for the Patient and Family

“…Fungal infections or a dry mouth resulting from the use of puffers can make chewing painful. Coughing before or during meals can tire the person and reduce the focus on the meal, making food a real challenge during exacerbations (Odencrants et al, 2005). Keith (73 yrs) defended his poor eating to his wife Marcia, "Do you want me to eat or do you want me to breathe?…”

“…People experience bloating, feel full before finishing meals and are often embarrassed by the food left on their plate. They report having their intake watched during mealtimes by family members and experienced feelings of failure, anger or sadness when they are not able to eat (Odencrants et al, 2005).…”

“…The study of Odencrants et al (2005) focussed on the experience of meals and their findings noted a number of barriers to sustainable eating. The problems began in obtaining food, with difficulty parking, breathlessness during shopping and difficulty transporting heavy groceries being contributors.…”