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Breathlessness and crises in the context of advanced illness: A comparison between COPD and lung cancer patients

Published online by Cambridge University Press:  13 February 2014

Christine Dunger ,
Irene J. Higginson ,
Marjolein Gysels ,
Sara Booth ,
Steffen T. Simon  and
Claudia Bausewein
Christine Dunger
Affiliation:
Institute of Ethics and Communication in Health Care, University of Witten/Herdecke, 58453 Witten, Germany
Irene J. Higginson
Affiliation:
King's College London, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, London SE5 9PJ, United Kingdom
Marjolein Gysels
Affiliation:
Amsterdam Institute of Social Science Research, Amsterdam, The Netherlands
Sara Booth
Affiliation:
Palliative Care Team, Addenbrooke's Hospital, Cambridge CB2 0QQ, United Kingdom
Steffen T. Simon
Affiliation:
King's College London, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, London SE5 9PJ, United Kingdom Department of Palliative Medicine and Clinical Trials Center (BMBF 01KN0706), University Hospital Cologne, 50924 Cologne, Germany Institute of Palliative Care, 26121 Oldenburg, Germany
Claudia Bausewein*
Affiliation:
King's College London, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, London SE5 9PJ, United Kingdom Department of Palliative Medicine, University of Munich, 81377 Munich, Germany
*
Address correspondence and reprint requests to: Claudia Bausewein, Department of Palliative Medicine, Munich University Hospital, Marchioninistr. 15, 81377 Munich. E-mail: [email protected].
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Abstract

Objective:

The objective of this study was to explore and contrast the experience and meaning of breathlessness in patients with chronic obstructive pulmonary disease (COPD) or lung cancer at the end of life.

Method:

We conducted a qualitative study embedded in a longitudinal study using topic-guided in-depth interviews with a purposive sample of patients suffering from breathlessness affecting their daily activities due to advanced (primary or secondary) lung cancer or COPD stage III/IV. All interviews were audiotaped, transcribed verbatim, and analyzed using framework analysis.

Results:

Ten COPD and eight lung cancer patients were interviewed. Both groups reported similarities in their experience. These included exertion through breathlessness throughout the illness course, losses in their daily activities, and the experience of breathlessness leading to crises. The main difference was the way in which patients adapted to their particular illness experience and the resulting crises over time. While COPD patients more likely sought to get their life with breathlessness under control, speaking of daily living with breathlessness under certain conditions, the participating lung cancer patients often faced the possibility of death and expressed a need for security.

Significance of Results:

Breathlessness leads to crises in patients with advanced disease. Although experiences of patients are similar, reactions and coping mechanisms vary and are more related to the disease and the stage of disease.

Keywords

DyspneaSymptom experienceCOPDCancerPalliative careQualitative
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 2 , April 2015 , pp. 229 - 237
Copyright
Copyright © Cambridge University Press 2014 

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