The aim of this grounded theory study was to illuminate the main concern of people suffering from chronic obstructive pulmonary disease (COPD) and how they handle their everyday life. Data were collected through interviews with 23 people with COPD at different stages, from mild to severe. A substantive theory was generated showing that the main concern was feelings of guilt due to self-inflicted disease associated with smoking habits. This core category was related to five managing strategies termed making sense of existence, adjusting to bodily restrictions, surrendering to fate, making excuses for the smoking-related cause and creating compliance with daily medication.
Biskobing, D. ( 2002). COPD and osteoporosis. Chest, 121, 609-620.
2.
Blumer, H. ( 1969). Symbolic interactionism: Perspective and method. New Jersey: Prentice Hall.
3.
Burckhardt, C., Woods, S., Schultz, A., & Ziebarth, D. ( 1989). Quality of life of adults with chronic illness: A psychometric study. Research in Nursing & Health, 12, 347-354.
4.
Carling Elofsson, L., & Öhlén, J. (2004). Meanings of being old and living with chronic obstructive pulmonary disease. Palliative Medicine, 18, 611-618.
5.
Cully, J.A., Graham, D.P., Stanley, M.A., & Kunik, M.E. ( 2007). Depressed and anxious COPD patients: Predictors of psychotherapy engagement from a clinical trila. Journal of Clinical Psychology in Medical Settings, 14, 160-164.
6.
de Godoy, D., & de Godoy, R. ( 2003). A randomized controlled trial of the effect of psychotherapy on anxiety and depression in chronic obstructive pulmonary disease. Archives of Physical Medicine and Rehabilitation, 84, 1154-1157.
7.
Eiser, N., West, C., Evans, S., Jeffers, A., & Quirk, F. ( 1997). Effects of psychotherapy in moderately severe COPD: A pilot study. European Respiratory Journal, 10, 1581-1584.
8.
Ek, K., & Ternestedt, B.-M. (2008). Living with chronic obstructive pulmonary disease at the end of life: A phenomenological study. Journal of Advanced Nursing, 62, 470-478.
9.
Frankel, V. ( 1986). Livet måste ha mening. Stockholm : Natur och Kultur.
10.
Fridlund, B., & Hildingh, C. ( 2000). Health and qualitative analysis methods. In B. Fridlund & C. Hildingh (Eds.), Qualitative research methods in the service of health (pp. 13-25). Lund: Studentlitteratur .
11.
Glaser, B. ( 1992). Basic of grounded theory analysis. Mill Valley, CA: Sociology Press.
12.
Glaser, B., & Strauss, A. ( 1967). The discovery of grounded theory: Strategies for qualitative research. New York: Aldine de Gruyter .
13.
Global Initiative for Chronic Lung Disease (GOLD). ( 2004). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO workshop report. Available at http://www.goldcopd.com (accessed 15 September 2006).
14.
Goffman, E. ( 1990). Stigma: Notes on the management of spoiled identity. London: Penguin Books.
15.
Grönberg, A.M., Slinde, F., Engström, C.P., Hulthén, L., & Larsson, S. ( 2005). Dietary problems in patients with servere chronic obstructive pulmonary disease. Journal of Human Nutrition & Dietetics , 18, 445-452.
16.
Guthrie, S., Hill, K., & Muers, M. ( 2001). Living with severe COPD: A qualitative exploration of the experience of patients in Leeds. Respiratory Medicine , 95, 196-204.
17.
Guyatt, G.H., Berman, L.B., Townsend, M., Pugsley, S.O., & Chambers, L.W. (1987). A measure of quality of life for clinical trials in chronic lung disease. Thorax, 42, 773-778.
18.
Hall, W.A., & Callery, P. ( 2001). Enhancing the rigor of grounded theory: Incorporating reflexivity and relationality. Qualitative Health Research , 11, 257-272. Hallberg , L.R.-M. (2002). Qualitative methods in public health research: Theoretical foundations and practical examples. Lund: Studentlitteratur .
19.
Hallberg, L.R.-M. (2006). The ‘core category’ of grounded theory: Making constant comparisons. International Journal of Qualitative Studies on Health and Well-being, 1, 141-148.
20.
Hansen, E.C., Walters, J., & Wood-Baker, R. (2007). Explaining chronic obstructive pulmonary disease (COPD): Perceptions of the role played by smoking. Sociology of Health & Illness, 29, 730-749.
21.
Haughney, J., Partridge, M.R., Vogelmeier, C., Larsson, T., Kessler, R., Ståhl, E. et al. (2005). Exacerbations of COPD: Quantifying the patient’s perspective using discrete choice modelling. European Respiratory Journal, 26, 623-629.
22.
Jonsdottir, H. ( 1998). Life patterns of people with chronic obstructive pulmonary disease: Isolation and being closed in. Nursing Science Quarterly , 11, 160-166.
23.
Koob, P.B., Roux, G., & Bush, H. ( 2002). Inner strenght in women dwelling in the world of multiple sclerosis. International Journal for Human Caring, 6, 20-28.
24.
Koch, T., & Kraklin, D. ( 2001). Chronic illness: Reflections on a community-based action research programme. Journal of Advanced Nursing, 36, 23-31.
25.
Lazarus, R. (1973). Personality. Stockholm: Wahlström & Widstrand.
26.
Mead, G.H. (1967). Mind, self and society: From the standpoint of a social behaviorist. Chicago, IL: University of Chicago Press.
27.
Murphy, R. (2001). The body silent. London: W. W. Norton & Company.
28.
Nicholls, D. ( 2003). The experience of chronic breathlessness. Physiotherapy Theory and Practice, 19, 123-136.
29.
Nygren, B., Norberg, A., & Lundman, B. ( 2007). Inner strenght as discloses in narratives of the oldest old. Qualitative Health Research, 17, 1060-1073.
30.
Odencrants, S., Ehnfors, M., & Grobe, S. ( 2007). Living with chronic obstructive pulmonary disease (COPD): Part II. RNs’ experience of nursing care for patients with COPD and impaired nutritional status. Scandinavian Journal of Caring Science, 21, 56-63.
31.
Oliver, S.M. ( 2001). Living with failing lungs: The doctor-patient relationship . Family Practice, 18, 430-439.
32.
O’Neill, E.S. ( 2002). Illness representation and coping of women with chronic obstructive pulmonary disease: A pilot study. Heart & Lung, 31, 295-302.
33.
Roux, G., Dingley, C., & Bush, H. ( 2002). Inner strenght in women: Metasynthesis of qualitative findings in theory development. Journal of Theory Construction and Testing, 6, 86-93.
34.
Sarbin, T.R. ( 1986). Narrative psychology: The storied nature of human conduct . New York: Praeger.
35.
Seamark, D.A., Blake, S.D., & Seamark, C.J. ( 2004). Living with severe chronic obstructive pulmonary disease (COPD): Perceptions of patients and their carers. Palliative Medicine, 18, 619-625.
36.
Van den Bemt, L., Schermer, T., Bor, H., Smink, R., Van Weel-Baumgarten, E., Lucassen, P., & van Weel, C. ( 2009). The risk for depression comorbidity in patients with COPD. Chest, 135, 108-114.
37.
Vickers, M.H. ( 2000). Stigma, work and unseen illness: A case and notes to enhance understanding. Illness, Crisis & Loss, 8, 131-151.1.
38.
Williams, V., Bruton, A., Ellis-Hill, C., & McPherson, K. ( 2007). What really matters to patients living with chronic obstructive pulmonary disease? An exploratory study. Chronic Respiratory Disease, 4, 77-85.
39.
World Medical Association Declaration of Helsinki. ( 2000). Ethical principles for medical research involving human subjects. Available at http://www.wma.net/policy
