Wang Juliet, Ly Lena, Barson Elizabeth, Smallwood Natasha
Psychiatry, Austin Health, Heidelberg, VIC, Australia.
Department of Respiratory Research at The Alfred, School of Translational Medicine, Monash University, Melbourne, VIC, Australia.
NPJ Prim Care Respir Med. 2025 Apr 29;35(1):27. doi: 10.1038/s41533-025-00430-0.
Psychological distress is highly prevalent in people with chronic obstructive pulmonary disease (COPD), however, remains under-recognised and under-treated. A qualitative study using semi-structured interviews was undertaken to explore lived experiences of psychological distress of people with COPD and their informal carers, as well as barriers and facilitators to uptake of mental health treatments. Participants were recruited via purposive sampling from respiratory clinics at two Australian tertiary hospitals. Thirteen people with COPD and comorbid mental illnesses and two informal carers participated. Interview transcripts were analysed using the Theoretical Domains Framework (TDF). Barriers to patients' acceptance of structured management for psychological distress in COPD included: limited understanding of overlapping symptoms, high burden of care from physical issues, stigma, and healthcare that did not align with individual preferences. Increased psychoeducation, supported self-management, and individualised care were possible facilitators. Multidisciplinary care integrating mental health services within primary care and pulmonary rehabilitation settings are required to overcome current challenges and improve patient outcomes.
心理困扰在慢性阻塞性肺疾病（COPD）患者中非常普遍，然而，仍然未得到充分认识和治疗。本研究采用半结构化访谈进行定性研究，以探索COPD患者及其非正式护理人员心理困扰的生活经历，以及接受心理健康治疗的障碍和促进因素。通过目的抽样从澳大利亚两家三级医院的呼吸诊所招募参与者。13名患有COPD和合并精神疾病的患者以及2名非正式护理人员参与了研究。使用理论领域框架（TDF）对访谈记录进行了分析。COPD患者接受心理困扰结构化管理的障碍包括：对重叠症状的理解有限、身体问题导致的高护理负担、耻辱感以及不符合个人偏好的医疗保健。增加心理教育、支持自我管理和个性化护理可能是促进因素。需要在初级保健和肺康复环境中整合心理健康服务的多学科护理，以克服当前的挑战并改善患者结局。
