Article

Objective: To explore the perception of dyspnoea in patients with severe chronic
obstructive pulmonary disease. Design: Cross-sectional study using mixed methods.
Methods: Thirty-two patients with severe chronic obstructive pulmonary disease
were included. Data collected included 3 health-related quality of life
questionnaires (SF-36, St George and Maugeri respiratory questionnaires) and the
Hospital Anxiety and Depression scale (HADS) to assess the impact of chronic
obstructive pulmonary disease on quality of life and psychological functioning.
Patients were then asked to draw their body and represent difficulties related to
breathing. Drawings were coded and categorized. Patients' comments were
transcribed. Results: HADS showed scores of depression and anxiety as high as
12.3 +/- 2.6 and 9.3 +/- 2.2, respectively; SF-36 subscales were severely
affected, and the St Georges and Maugeri questionnaires indicated a high impact
of chronic obstructive pulmonary disease (79 +/- 13 and 60 +/- 18, respectively).
Drawings illustrated the pervasiveness of dyspnoea; patients' comments stressed
breathlessness. Obstruction and tightening were salient, with a prominent
representation of the head and internal structures, e.g. the lungs and the
airways. Conclusion: Patients' drawings capture a global expression of illness
experience. They provide insight into the heterogeneity of patients' perceptions,
and allow acknowledgement of patients' representations and experiences. This may,
in turn, help in gaining patients' participation in rehabilitation programmes or
adherence to new medications.

Langue : ANGLAIS