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Evid Based Nurs 8:61 doi:10.1136/ebn.8.2.61
  • Qualitative

Patients with acute exacerbations of COPD saw anxiety as a sign, rather than cause, of breathlessness


 
 Q How do patients describe the relation between anxiety and the experience of dyspnoea (ie, perception of shortness of breath) during an acute exacerbation of chronic obstructive pulmonary disease (COPD)?

DESIGN

Focused ethnography with narrative analysis.

SETTING

2 hospitals in a mining community in northern Ontario, Canada.

PATIENTS

10 family-nurse units of patients who were admitted to hospital with acute exacerbation of COPD characterised by extreme dyspnoea; had ⩾2 previous acute exacerbations of COPD that required hospital admission; and had named family members as next of kin. The nurse-family units comprised 10 patients, 15 family caregivers (FCs), and 10 nurses.

METHODS

Indepth interviews were conducted during the patient’s hospital stay. Questions were based on the chronic illness model of Strauss et al, which defined acute COPD exacerbation as a medical crisis of a chronic illness. Narrative analysis was used to analyse 3 genres of the 503 stories identified from transcribed interviews: first-person event-specific stories recreating a discrete moment in time; generic or habitual stories of the general course of events over time; and kernel stories suggesting untold first-person event-specific personal …

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