چکیده (انگلیسی):

Background:Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease with repeated exacerbations
resulting in gradual debilitation. The quality of life has been shown to be poor in patients with COPD despite
efforts to improve self-management. However, the evidence on the benefit of self-management in COPD is conflicting.
Whether this could be due to other unmet needs of patients have not been investigated. Therefore, we aimed to
explore unmet needs of patients from both patients and doctors managing COPD.
Methods:We conducted a qualitative study with doctors and patients inMalaysia. We used convenience
sampling to recruit patients until data saturation. Eighteen patients and eighteen doctors consented and were
interviewed using a semi-structured interview guide. The interviews were audio-recorded, transcribed verbatim
and checked by the interviewers. Data were analysed using a thematic approach.
Results:The themes were similar for both the patients and doctors. Three main themes emerged: knowledge and
awareness of COPD, psychosocial and physical impact ofCOPD and the utility of self-management. Knowledge
about COPD was generally poor. Patients were not familiar with the term chronic obstructive pulmonary disease
or COPD. The word‘asthma’ was used synonymously with COPD by both patients and doctors. Most patients
experienced difficulties in their psychosocial and physical functions such as breathlessness, fear and helplessness.
Most patients were not confident in self-managing their illness and prefer a more passive role with doctors
directing their care.
Conclusions:In conclusion, our study showed that knowledge of COPD is generally poor. There was mislabelling
of COPD as asthma by both patients and physicians. This could have resulted in the lack of understanding of
treatment options, outcomes, and prognosis of COPD. The misconception that cough due to COPD was
contagious, and breathlessness that resulted from COPD, had important physical and psychosocial impact, and
could lead to social isolation. Most patients and physicians did not favour self-management approaches, suggesting
innovations based on self-management may be of limited benefit.