Juggling the management of everyday life activities in persons living with chronic obstructive pulmonary disease

Young adults living with chronic illness: disclosure strategies and peers' understanding

PURPOSE

Many young adults living with chronic illness fear being perceived as different by their peers and excluded from social activities. This forces them to consider whether to disclose or conceal their illness. This article analyses young adults' disclosure strategies and links them to peers' understanding of illness.

MATERIALS AND METHODS

The explorative study is based on episodic interviews with sixty young adults living with chronic illnesses (type 1 diabetes, cancer, chronic inflammatory bowel disease or a rare disease) and thirty peers. The interviews were thematically coded. The young adults' statements were compared to the peer perspectives on a case-by-case basis.

RESULTS

We identified three groups of young adults: 1) those who are generally open with peers about their illness and its subjective meaning; 2) those who share selected health-related information's with selected peers; 3) those who refrain from active disclosure and are unsure how they might talk about their illness when it becomes apparent. Our findings also indicate that peers differ in the sophistication of their illness perceptions and the meaning they ascribe to living with a chronic illness.

CONCLUSION

Trainings should target both young adults and peers, and should assist both sides in talking about (serious) chronic illness.

Living with COPD: understanding patient experiences through the lens of photovoice

BACKGROUND

Conventional quantitative or qualitative methodologies may not encompass the wide array of experiences of individuals living with Chronic Obstructive Pulmonary Disease (COPD). We used a novel approach - photovoice-to understand the impact of COPD on activities of daily living (ADLs) in a multicultural Asian country.

METHODS

We recruited a purposive sample of eight patients from the outpatient clinics of the National University Health System, Singapore, between December 2020 and August 2021. We adopted a photovoice approach for data collection; participants were invited to take photos of how ADLs were impacted by COPD and attend a follow-up interview. An Interpretative Phenomenological Analysis method was used to analyze the data. Data saturation was reached by the seventh patient.

RESULTS

COPD and the resulting breathlessness had a profound and diverse impact on our participants' lives. Living with COPD required substantial changes to how everyday tasks are performed, and participants learnt new strategies to deal with such tasks. A mixture of active and passive coping styles was evident. Feelings of frustration, anxiety and a sense of isolation were also reported. Contextual factors impacting ADLs included challenging climatic conditions and the local popularity of traditional or alternative medicine.

CONCLUSION

The photovoice technique improved our understanding of the lived experiences of COPD patients and can benefit those who struggle to articulate their views by offering a different way to communicate beyond conventional interviewing.

Photovoice exploration of physical activity norms and values among rural and remote pulmonary rehabilitation participants in British Columbia, Canada

PURPOSE

Individuals with chronic obstructive pulmonary disease (COPD) engage in less physical activity compared to the general population, which can lead to worsened symptoms. In pulmonary rehabilitation (PR) programs, participants learn strategies to complete activities more easily. For such strategies to be effective, however, PR clinicians must understand their clients' activity values and practices within their geocultural contexts. In this qualitative study, our aim was to explore physical activity norms and values among people with COPD living in remote and rural locations, using Photovoice methodology.

MATERIALS AND METHODS

We recruited 12 participants from rural PR sites in British Columbia, Canada. During two distinct seasons (winter and summer), participants photographed meaningful activities then completed semi-structured interviews. We analyzed transcripts using a three-step hermeneutic method, which revealed three themes.

RESULTS

Participants discussed feeling conflicted regarding their COPD symptoms and physical activity, as difficulties in activity engagement cause stress, but remaining active also fosters a sense of purpose and well-being. Meanwhile, participants' activities are inextricably linked to their rural, remote, and seasonal environment.

CONCLUSIONS

Our study provides insight into how people with COPD resiliently engage in activities in a rural environment with distinct weather variations. Findings highlight the importance of considering individual factors when recommending activities in PR programs.Implications for rehabilitationAlthough people with chronic lung disease often encounter difficulty and stress in completing their daily activities, they both recognize the importance of and derive great personal meaning from remaining active.The unique social, geographical, physical, and climatic environments of rural and remote dwelling people with chronic lung disease can both enable and challenge their activity engagement.Pulmonary rehabilitation (PR) programs and clinicians must situate their activity recommendations within the geographic contexts of their clients - which can vary across the seasons.Support for participants' mental health is a vital aspect of PR.

Common Mental Disorders, Functional Limitation and Diet Quality Trends and Related Factors among COPD Patients in Spain, 2006-2017: Evidence from Spanish National Health Surveys

Certain conditions such as common mental disorders (CMDs), functional limitation (FL) and poor diet quality may affect the lives of individuals who suffer from chronic obstructive pulmonary disease (COPD). This study sought to examine time trends in the prevalence of CMDs, FL and diet quality among male and female COPD patients living in Spain from 2006 to 2017 and to identify which factors were related to CMDs, FL and a poor/improvable diet quality in these patients. We performed a cross-sectional study among COPD patients aged ≥ 40 years old using data from the Spanish National Health Surveys conducted in 2006, 2011 and 2017, identifying a total of 2572 COPD patients. Binary logistic regressions were performed to determine the characteristics related to CMDs, FL and poor/improvable diet quality. Over the years of the study, the prevalence of FL among female COPD patients increased (p for trend <0.001). In addition, CMDs were associated to body mass index (BMI), educational level, physical activity, smoking status, occupation, chronic conditions and alcohol consumption; FL was related to age, living with a partner, educational level, physical activity and chronic conditions; and poor/improvable diet quality was associated to age, smoking status, BMI and physical activity.