Creating possibilities for 'being': living with chronic obstructive pulmonary disease: a hermeneutic phenomenological study

Abstract

The purpose of this research is to describe the essence of the experiences of living with Chronic Obstructive Pulmonary Disease (COPD), from the perspective of the people who suffer from it. COPD is a degenerative respiratory condition that causes breathlessness, fatigue, reduced mobility and repeated chest infections. As the disabling effects of COPD worsen, people become less able to manage normal daily activities. They become more reliant on others for assistance and often experience repeated hospital admissions. Much of the existing literature is concerned with the physiological and psychological symptoms of COPD. These studies have described COPD as a disease to be treated or studied and are devoid of personal meaning for the people afflicted with this condition. In addressing this question from the personal perspective I used the human science approach of hermeneutic phenomenology, informed by Martin Heidegger and Max van Manen. This method seeks an understanding grounded in the experience without imposing predictory perspectives or conceptualisations. All of the participants had COPD and had experienced more than three admissions to hospital in the previous year. The six male and one female participants ranged in age from 43 to 80 years. Five of the participants were interviewed with, a family member and the remaining two were interviewed alone. All of the interviews were taped, transcribed and thematically analysed. Within this analysis COPD is identified as a catastrophic event that drastically changes the lives of those it effects. The participants' stories illustrate the way in which breath connects them to life in both a biological and an ontological sense. Breathless attacks threaten the bond between 'body" and 'self throwing the person into a state of disharmony and inner conflict. As the person struggles to gain a sense of ‘self’ anxiety prevails as a reflexive state of mind occurring in response to a concern about one's future existence. Through anxiety people begin to reflect on both their possibilities for 'being' and for not 'being'. The awareness that people have of their death impacts on the way in which they accept their illness. It is suggested that to see death as a possibility is to also sec life as a possibility. This research also provides insights into the way in which health care professionals impact on peoples' illness experiences and makes suggestions for the way in which health care professionals can assist by further acknowledging the personal perspective of illness. This research will be of interest to all health care professionals involved in the care of people with COPD. This thesis highlights the need for health care professionals to listen to the voices of people with COPD in order to assist them to make sense of their illness experiences.