Early symptom recognition and symptom management among exacerbation COPD patients: A qualitative study

Background: An acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is the most cause of deaths in COPD patient. It induces COPD patients often end in unexpected or unpredictable death. Objectives: The purposes were to explore the lived experiences of symptom recognition and to explain the pattern of symptom management successfully among exacerbation COPD patients. Design: A Heideggerian hermeneutic phenomenology approach. Setting: The interviews took place in participants' home by using android or iOS (iPhone) phone. Participants: Twenty participants were recruited until saturation by purposive sampling technique. Methods: The semi-structured interview was used to capture detailed experiences verbatim. Data analysis based on a seven-stage hermeneutical process. Results: Two constitutive patterns with relational themes were identified. First, symptom recognition, consisted of four themes: meaning of AECOPD, pattern of AECOPD, warning signs and prodromal symptoms, and risk factors of AECOPD. Second, symptom management, consisted of four themes: methods of symptom management (during AECOPD state), methods of symptom management (during stable COPD state for helping to prevent AECOPD state), knowledge source of symptom management, and factors influencing symptom recognition and symptom management. Conclusions: The use of a Heideggerian hermeneutic phenomenology as a research methodology fulfilled the aims of this study. It will enable healthcare professionals to select and advise the strategies or methods that will be the most likely to appropriate within the limits set by individual capabilities for promoting the best quality of life in COPD patients.