Article Text


Clinical interventions in COPD
P150 How well do patients with chronic respiratory failure secondary to COPD and their carers adapt to long-term oxygen therapy at home?
  1. C Wrench
  1. Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK


Introduction and objectives Long-term oxygen therapy for the treatment chronic respiratory failure requires a commitment by patients to use 15 h oxygen per day and yet little is known about the impact of this demanding treatment on daily living. A phenomenological appro/ach was used to explore the personal experiences of patients starting long-term oxygen therapy at home and their carers. All patients had a primary diagnosis of COPD with chronic respiratory failure and had completed formal oxygen assessment in the Oxygen Assessment Clinic. The study was ethically approved.

Methods The research tool was a single, semi-structured recorded interview carried out within the participants’ own home within 4 weeks of commencing oxygen. Participants were recruited from clinic over a 2-month period and consisted of seven patient participants (6 female, 1 male) and four carer participants (3 female, 1 male). For the purpose of this study, a carer was defined as someone who had daily contact with the patient. A semi-structured interview was carried out in the participants' own home. Interviews were recorded and then transcribed verbatim. Patients and carers were interviewed separately to ensure confidentiality. Due to the chronic breathlessness of the patient participants, interview times were limited to between 30 and 45 min. Analysis was carried out using Colaizzi's seven stage process (1978).

Results Patient participants described emotions ranging from initial fear, anger, and frustration to final acceptance. This journey was echoed in the experiences of the carers and shared elements of the grieving process (Kubler–Ross). Some patients and carers had begun to develop coping strategies to help with day-to-day activities, such as using ambulatory oxygen to complete simple chores or using breathing exercises to relax.

Conclusions The impact of long-term oxygen therapy on the participants of this study, both emotionally and physically, was considerable. Formal oxygen assessment is undoubtedly essential but patients and their carers need additional educational and emotional support from an experienced Health Care Professional, particularly during the initial stages of their treatment.

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