Psychosocial impact of the progress of chronic respiratory disease and long-term domiciliary oxygen therapy

Purpose: The psychosocial impact of the progress of chronic respiratory disease and long-term domiciliary oxygen therapy (LTOT) was examined to develop an appropriate intervention strategy for pulmonary rehabilitation programmes. Methods: Psychosocial factors were investigated using a self-administered questionnaire. A total of 144 patients receiving LTOT were compared with 100 chronic respiratory patients (RES) who were not yet suffering from respiratory failure and therefore not under LTOT, and a control group of 51 healthy subjects (HCS). Results: With the progress of the disease, there was a decrease in daily activities as well as in body mass index. Support of family members and others, life satisfaction, and morale decreased, while the tendency for depression increased significantly. These patterns appeared to begin before initiation of LTOT and worsened in the respiratory failure stage. The negative emotions ranged from 'feeling helpless', 'feeling being a burden and miserable', 'denying LTOT', and 'feeling dependent and anxious'. Conclusions: For pulmonary rehabilitation programmes, an effective intervention strategy that is suggested from this study should address these psychosocial issues at the initiation of LTOT, and follow through with continuous care throughout life under therapy to counter the development of negative attitudes.