COPD-related fatigue: Impact on daily life and treatment opportunities from the patient's perspective.

Background: Fatigue is a highly prevalent, challenging and understudied symptom of COPD, which influences the quality of life of patients. This study addresses the patient's perspective on the impact of fatigue on their daily lives and explores possible treatment options to tackle the burden of fatigue.
Methods: Twenty semi-structured interviews were conducted with ten patients hospitalised for a COPD exacerbation and ten outpatients with COPD. Data were transcribed verbatim and coded in an iterative (deductive and inductive) coding process.
Findings: Patients perceived severe negative impact of fatigue on their daily lives and emphasized that they were limited in physical, emotional, cognitive and social functioning. These limitations caused a high mental burden which challenged patients' coping resources and making fatigue a symptom difficult to accept. The majority of patients mentioned that they had, to some degree, lost the joy in life or in some cases, even lost the will to live. Patients reported the need for effective treatment and recommended a multidisciplinary approach and blended care, in which an online treatment to improve fatigue management is combined with face-to-face contact with a healthcare professional to increase social support.
Discussion: These findings indicate that patients perceive the impact of fatigue on their daily lives to be a key factor in decreasing their quality of life. To increase awareness of fatigue in healthcare professionals and patients and to facilitate early fatigue self-management, a pro-active approach by healthcare professionals might be the best way to realize effective tailored treatment.
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