The experience of hospitalisation in people with advanced chronic obstructive pulmonary disease : A phenomenological study

Bakthavatsalu, Barathi and Walshe, Catherine and Simpson, Jane (2021) The experience of hospitalisation in people with advanced chronic obstructive pulmonary disease : A phenomenological study. PhD thesis, Lancaster University.

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Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a chronic disease of the lung and the fourth leading cause of death in the world. People with advanced COPD are frequently hospitalised and have high physical, psychological and spiritual suffering. Hospitalisation caused considerable economic burden on the individuals and countries and a setback in the quality of life. A systematic literature review explored the experience of hospitalisation in people with advanced COPD, utilising a thematic synthesis approach. The studies reviewed focused on the discrete aspects of hospitalisation such as care and treatment, which limited the development of a complete picture of the phenomenon of hospitalisation. Consequently, the research question asked was: ‘what is the experience of hospitalisation in people with advanced COPD?’ Method: A qualitative, descriptive phenomenological approach, using unstructured interview was employed to study the phenomenon of hospitalisation. Fifteen participants hospitalised with advanced COPD, in a south Indian, tertiary care hospital were recruited. Giorgi’s descriptive phenomenological analysis method guided the analysis. Results: Five themes were identified: experience of admission, repeated hospitalisation, perception of care, trust in hospitalisation and multi-dimensional suffering. Repeated hospitalisations due to acute breathlessness were often emergency admissions. Although hospitalisation gave a sense of safety, it was perceived to be chaotic. Care influenced trust in hospitalisation and both shaped the experience of hospitalisation. Multi-dimensional suffering was central to the experience, which affected the physical, psychological and spiritual aspects. Persistent suffering, despite repeated hospitalisation negatively impacted the experience of hospitalisation. Conclusion: Hospitalisation is perceived largely as a negative experience due to the perception of uncertainty and continuing suffering. Integrating palliative care into the routine care of people with advanced COPD is urgently required to improve care.