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COPD patients' perspectives at the time of diagnosis: a qualitative study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
2007 (English)In: Primary Care Respiratory Journal, ISSN 1471-4418, E-ISSN 1475-1534, Vol. 16, no 4, 215-221 p.Article in journal (Refereed) Published
Abstract [en]

Aims: To gain understanding of chronic obstructive pulmonary disease (COPD) patients´ perspectives and perceptions of their disease at the time of diagnosis. Methods: Qualitative study; grounded theory. Ten patients in primary care in Sweden, newly diagnosed with COPD or diagnosed with suspected COPD were interviewed. Results: The analysis created a process model with a core category “Consequences of smoking” and main categories “Shame”, “Appearance of symptoms”, “Adaptation”, “Reflection”, and “Action”. “Restrictions in physical capacity” was a key indicator of evolving disease and “Getting a diagnosis” was crucial for the patient. Conclusions: The COPD patient needs a clear diagnosis at an early stage. It is important to seize the moment when the presumptive COPD patient is receptive towards support and further action. To detect and support the patient, health professionals must be aware of minor symptoms and underlying mechanisms of possible shame.

Place, publisher, year, edition, pages
2007. Vol. 16, no 4, 215-221 p.
Keyword [en]
COPD, primary health care, qualitative research, shame, smoking
National Category
Medical and Health Sciences
Research subject
Lung Medicine
Identifiers
URN: urn:nbn:se:uu:diva-11790DOI: 10.3132/pcrj.2007.00033PubMedID: 17625785OAI: oai:DiVA.org:uu-11790DiVA: diva2:39559
Available from: 2010-02-23 Created: 2007-10-18 Last updated: 2017-12-11Bibliographically approved
In thesis
1. Chronic Obstructive Pulmonary Disease: Patients´ Perspectives, Impact of the Disease and Utilization of Spirometry
Open this publication in new window or tab >>Chronic Obstructive Pulmonary Disease: Patients´ Perspectives, Impact of the Disease and Utilization of Spirometry
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe subjects with chronic obstructive pulmonary disease (COPD) from different perspectives. Focus was on patients at the time of diagnosis, impact of the disease in comparison to other chronic diseases, factors associated with good health and quality of life (QoL), and diagnostic spirometry in clinical practice.

Methods: Qualitative method, grounded theory, was used to analyse patients´ perspectives at the time of diagnosis in a primary care setting (n=10). Public health surveys in the general population were used to compare chronic diseases (n=10,755) and analyse factors associated with health outcomes in COPD (n=1,475). Medical records and spirometry reports, from primary and secondary care, were analysed to assess diagnosis of COPD in clinical practice (n=533).

Results: In clinical practice, 70% of patients at the time of diagnosis of COPD lacked spirometry results confirming the diagnosis. Factors related to consequences of smoking, shame and restrictions in physical activity (PA) in particular, were described by patients at the time of diagnosis of COPD. In general subjects with COPD (84%), rheumatoid arthritis (74%) and diabetes mellitus (72%) had an activity level considered too low to maintain good health. In COPD, the most important factor associated with good health and quality of life was a high level of PA. Odds ratios (OR (95%CI)) varied from 1.90 (1.47-2.44) to 7.57 (4.57-12.55) depending on the degree of PA, where subjects with the highest PA level had the best health and QoL.

Conclusions: Subjects with COPD need to be diagnosed at an early stage, and health professionals should be aware that feelings of shame could delay patients from seeking care and thus obtaining a diagnosis. The use of spirometry and the diagnostic quality should be emphasised. In patients with COPD greater attention should be directed on increasing the physical activity level, as patients with a low level of physical activity display worse health and quality of life.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 70 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 529
Keyword
chronic disease, chronic obstructive pulmonary disease, diabetes mellitus, diagnosis, health status, spirometry, physical activity, public health survey, qualitative method, quality of life, rheumatoid arthritis.
National Category
Respiratory Medicine and Allergy
Research subject
Lung Medicine
Identifiers
urn:nbn:se:uu:diva-113813 (URN)978-91-554-7738-7 (ISBN)
Public defence
2010-04-16, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskjölds väg 20, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2010-03-26 Created: 2010-02-04 Last updated: 2010-03-26Bibliographically approved

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Arne, MatsEmtner, Margareta

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