Exploring the experiences of chronic respiratory patients during the COVID-19 pandemic using interpretative phenomenological analysis

ABSTRACT

Background: During a coronavirus pandemic, respiratory patients may be more vulnerable to mental health problems in addition to their physical vulnerability. Due to the specific nature of their illness, they are more likely to have pre-existing experience of crisis situations, serious existential issues and coping with them. Despite a growing body of literature based on quantitative research, there is still a lack of insight into the subjective experiences of those affected. Aim: Our aims were to explore and deepen our understanding of the experiences of chronic respiratory patients at risk of pandemic COVID-19. Our research questions were 1. How do the interviewees relate to their underlying respiratory condition? 2. What does it mean to experience vulnerability? 3. How do the initial experiences of the underlying disease affect the experience of vulnerability to pandemic disease? Methods: We used interpretative phenomenological analysis. The study involved 8 participants: 7 women and one man, aged 29-60, with one of the following diagnoses asthma, chronic obstructive pulmonary disease, cystic fibrosis. Results: Three main themes emerged from the analysis of the semi-structured interviews 1. respiratory illness as a defining experience in everyday life, 2. the impact of the COVID-19 pandemic on the self and identity organisation, and 3. adaptation to experiencing vulnerability. Breathlessness is the most frightening feature of progressive lung disease, and can be linked to fear and anxiety in different ways. The potentially contagious nature of COVID-19 draws a sharp line between the endangered Self and the dangerous Other, and represents a critical life situation for the satisfaction of social needs and desires. In coping with them, we observe essentially self-defense mechanisms and emotion-focused strategies. Conclusions: The current pandemic is having a widespread and powerful impact on the lives of affected patients. Because of the nature of the coronavirus, which primarily affects the airways, those affected consider themselves to be at risk. Experiencing vulnerability fundamentally determines their lives their decisions, their connection to the world, organization of identity, coping and their belief in the security of the world. Identifying their experiences and difficulties is of particular importance for the development of strategies to mitigate the psychosocial impact of the epidemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Hungarian) Elmeleti hatter A koronavirus vilagjarvany idejen a kronikus legzoszervi betegek fizikai serulekenyseguk mellett a mentalis problemakra is fokozottan erzekenyek lehetnek. Betegseguk sajatossagaibol kifolyolag nagyobb valoszinuseggel rendelkeznek mar meglevo tapasztalattal krizishelyzetek, sulyos egzisztencialis kerdesek es az ezekkel valo megkuzdes teruleten. Ezeknek a korabbi tapasztalatoknak szerepe lehet a COVID-19-jarvannyal kapcsolatos veszelyeztetettseg megelese szempontjabol. Az egyre nagyobb szamu kvantitativ kutatason alapulo szakirodalom ellenere az erintettek szubjektiv tapasztalatainak megismerese tovabbra is hianyzik. Cel Kutatasunk celja a kronikus legzoszervi betegek COVID-19-vilagjarvany altali veszelyeztetettsegelmenyenek, tapasztalatainak feltarasa es melyebb megertese volt kvalitativ, idiografias modszerrel. Az alabbi kutatasi kerdesekre kivantunk valaszt kapni 1. Hogyan viszonyulnak az interjualanyok a legzoszervi alapbetegsegukhoz? 2. Mit jelent a szamukra a veszelyeztetettseg megelese? 3. Hogyan hatnak az alapbetegseggel kapcsolatos eredeti tapasztalatok a vilagjarvannyal jaro serulekenyseg megelesere? Modszerek Vizsgalatunkhoz az interpretativ fenomenologiai analizis modszeret hasznaltuk. A kutatasban 8 fo vett reszt 7 no es 1 ferfi, 29-60 evesek, a kovetkezo diagnozisok valamelyikevel asztma, kronikus obstruktiv tudobetegseg, cisztas fibrozis. Eredmenyek A felig strukturalt interjuk elemzese soran harom fotema bontakozott ki 1. legzoszervi betegseg mint a mindennapokat meghatarozo tapasztalat, 2. a koronavirus vilagjarvany hatasa az enre es az identitasszervezodesre, illetve 3. a veszelyeztetettseg megelesehez valo alkalmazkodas. A levegotlenseg a progressziv tudobetegsegek legnehezebben toleralhato, leginkabb felelmetes velejaroja, amely elmeny kulonbozo modokon kapcsolodhat a felelemmel es a szorongassal. A COVID-19 potencialis fertozo volta eles hatarvonalat huz a veszelyeztetett En es a veszelyes Masik;vagyis az en es a vilag koze, tovabba kritikus elethelyzetet jelent a tarsas szuksegletek es vagyak kielegithetosege szempontjabol. Adaptaciojukban alapvetoen envedo mechanizmusok, illetve erzelem-fokuszu strategiak bontakoztak ki. Kovetkeztetesek A jelenlegi vilagjarvany jelentos hatast gyakorol az erintett betegek eletere. A koronavirus elsosorban legutakat erinto termeszete miatt az erintettek veszelyeztetettkent tekintenek onmagukra, a veszelyeztetettseg megelese pedig alapvetoen meghatarozza eletuket;donteseiket, a vilaghoz valo kapcsolodasukat, identitasszervezodesuket, megkuzdesuket, s megkerdojelezi a vilag biztonsagossagaba vetett hituket. A kronikus legzoszervi betegek tapasztalatainak feltarasa kiemelt jelentoseggel bir a jarvany pszichoszocialis hatasait merseklo strategiak kidolgozasaban. (PsycInfo Database Record (c) 2023 APA, all rights reserved)