Self-reported illness behavior related to chronic obstructive pulmonary disease and rehabilitation: a theory-guided qualitative study

Illness behavior effects the quality of life of patients with COPD but is scarcely described in literature. The aim of this study is to explore self-reported illness behavior of patients with COPD, who have declined non-pharmacological rehabilitation. The study has a qualitative design using semi-structured interviews. The subsequent analysis is a theory-guided mapping of actions reported by the patients in order to manage symptoms. These actions are understood and categorized according to the styles of coping described by Alonzo. Four categories of illness behavior are identified: containment of symptoms, coping with symptoms through formal and informal interventions, adjustment of situations through compensating and economizing interventions, and crisis coping by surrendering. The analysis shows that behavior, that may seem unhelpful from a healthcare perspective may seem rational in the everyday life perspective of the patient. Findings show that reluctance to participation in rehabilitation should not only be interpreted as lack of motivation or health literacy. In the patients perspective non - pharmacological interventions might be perceived as a threat that could tip the delicate balance of everyday life with severe COPD.