Experience of advanced chronic obstructive pulmonary disease: Metasynthesis of qualitative research

Rebecca Disler, Anna Green, Tim Luckett, Phillip Newton, Sally Inglis, David Currow, PAtricia Davidson

    Research output: Contribution to journalReview articlepeer-review

    70 Citations (Scopus)

    Abstract

    Context Chronic obstructive pulmonary disease (COPD) is a life-limiting illness. Despite best available treatments, individuals continue to experience symptom burden and have high health care utilization. Objectives To increase understanding of the experience and ongoing needs of individuals living with COPD. Methods Medline, PsycINFO, CINAHL, and Sociological s were searched for articles published between January 1990 and June 2013. Metasynthesis of qualitative data followed the principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Metasyntheses are increasingly used to gain understandings of complex research questions through synthesizing data from individual qualitative studies. Descriptive and analytical themes were developed through thematic synthesis and expert panel discussion of extracted primary quotes, not the primary data themselves. Results Twenty-two studies were included. Four hundred twenty-two free codes were condensed into seven descriptive themes: better understanding of condition, breathlessness, fatigue, frailty, anxiety, social isolation, and loss of hope and maintaining meaning. These seven themes were condensed further into three analytical themes that described the experience and ongoing needs of individuals with COPD: the need for better understanding of condition, sustained symptom burden, and the unrelenting psychological impact of living with COPD. Conclusion Combining discrete qualitative studies provided a useful perspective of the experience of living with COPD over the past two decades. Further studies into the ongoing needs of individuals with COPD are unlikely to add to this well-established picture. Future research should focus on solutions through the development of interventions that address patients' ongoing needs.

    Original languageEnglish
    Pages (from-to)1182-1199
    Number of pages18
    JournalJournal of Pain and Symptom Management
    Volume48
    Issue number6
    DOIs
    Publication statusPublished - 1 Dec 2014

    Keywords

    • advanced disease
    • Chronic obstructive pulmonary disease
    • experience
    • metasynthesis
    • ongoing needs
    • qualitative

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