TY - JOUR
T1 - Experience of advanced chronic obstructive pulmonary disease
T2 - Metasynthesis of qualitative research
AU - Disler, Rebecca T.
AU - Green, Anna
AU - Luckett, Tim
AU - Newton, Phillip J.
AU - Inglis, Sally
AU - Currow, David C.
AU - Davidson, Patricia M.
N1 - Publisher Copyright:
© 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - 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.
AB - 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.
KW - advanced disease
KW - Chronic obstructive pulmonary disease
KW - experience
KW - metasynthesis
KW - ongoing needs
KW - qualitative
UR - http://www.scopus.com/inward/record.url?scp=84905438961&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2014.03.009
DO - 10.1016/j.jpainsymman.2014.03.009
M3 - Review Article
C2 - 24780181
AN - SCOPUS:84905438961
VL - 48
SP - 1182
EP - 1199
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
SN - 0885-3924
IS - 6
ER -