Annemarie L Lee1,2, Samantha L Harrison1,2,3, Roger S Goldstein1,2,4, Dina Brooks1,2. 1. a Department of Respiratory Medicine , West Park Healthcare Centre , Toronto , Ontario , Canada. 2. b Department of Physical Therapy , University of Toronto , Toronto , Ontario , Canada. 3. c Health and Social Care Institute, Teesside University , Middlesbrough , United Kingdom. 4. d Department of Medicine , University of Toronto , Toronto , Ontario , Canada.
Abstract
BACKGROUND: Pain is a common symptom in people with chronic obstructive pulmonary disease (COPD) which negatively influences quality of life and psychological well-being. However, our understanding of how those with COPD interpret the experience of pain is very limited. OBJECTIVES: To explore how individuals with moderate to severe COPD experience pain. METHODS: Eight patients diagnosed with COPD who reported experiencing pain for greater than three months participated in in-depth interviews. Transcripts were subjected to interpretative phenomenological analysis. RESULTS: Five themes were identified: 1) pain complicates the clinical profile of COPD; 2) uncertainly of the pain experience: frustrations related to health care professionals' explanation for their pain and the need to legitimize; 3) language and behavior of pain: portraying pain as frustrating and unpredictable; 4) psychological reactions toward pain: depression and fear-avoidance behavior; and 5) altered identity perception: reduced self-worth, guilt in not meeting the expectations of others. CONCLUSIONS: Patients report difficulty in explaining the persistence of pain. This fosters a need to legitimize their pain, which influences feelings of frustration and self-worth. An understanding of these responses will assist health care professionals in managing on-going pain in those with COPD.
BACKGROUND:Pain is a common symptom in people with chronic obstructive pulmonary disease (COPD) which negatively influences quality of life and psychological well-being. However, our understanding of how those with COPD interpret the experience of pain is very limited. OBJECTIVES: To explore how individuals with moderate to severe COPD experience pain. METHODS: Eight patients diagnosed with COPD who reported experiencing pain for greater than three months participated in in-depth interviews. Transcripts were subjected to interpretative phenomenological analysis. RESULTS: Five themes were identified: 1) pain complicates the clinical profile of COPD; 2) uncertainly of the pain experience: frustrations related to health care professionals' explanation for their pain and the need to legitimize; 3) language and behavior of pain: portraying pain as frustrating and unpredictable; 4) psychological reactions toward pain: depression and fear-avoidance behavior; and 5) altered identity perception: reduced self-worth, guilt in not meeting the expectations of others. CONCLUSIONS:Patients report difficulty in explaining the persistence of pain. This fosters a need to legitimize their pain, which influences feelings of frustration and self-worth. An understanding of these responses will assist health care professionals in managing on-going pain in those with COPD.
Authors: Samantha L Harrison; Annemarie L Lee; Helene L Elliott-Button; Rebecca Shea; Roger S Goldstein; Dina Brooks; Cormac G Ryan; Denis J Martin Journal: Int J Chron Obstruct Pulmon Dis Date: 2017-11-08
Authors: Eléonore F van Dam van Isselt; Karin H Groenewegen-Sipkema; Monica van Eijk; Niels H Chavannes; Wilco P Achterberg Journal: Chron Respir Dis Date: 2019 Jan-Dec Impact factor: 2.444