COPD is predicted to become the 3rd biggest cause of death worldwide by 2030, placing palliative care provision a high priority. COPD palliative care provision currently focuses upon physical symptom management with less attention paid to the holistic ethos of palliation. A integrative review of existing literature across twelve databases was undertaken to explore the presence of existential suffering for those living with COPD and associated palliative care needs. 35 papers were included within the review of both qualitative and quantitative underpinnings. Thematic analysis was completed, identifying key themes explaining the impact of existential suffering:
‘Liminality’ Patients are unsure of who they currently are and who they will become throughout disease progression.
‘Lamented Life’ Feelings of life ceasing to exist, fuelled by grief of former life prior to illness.
‘Loss of Personal Liberty’ – Frustration that they couldn’t do activities/hobbies they once could.
‘Existential Isolation’ Becoming isolated throughout disease progression from social and personal/family relationships. Feelings of being misunderstood had a significant impact upon low feelings of self–worth.
‘Life Meaning’ Some patients were able to identify some life meaning and purpose, through adapting hobbies and interests to within their physical capabilities.
This integrative review has given good insight into how existential suffering manifests within this patient population. Furthermore, it has identified the need for further research to explore how life meaning and purpose is found within their daily lives, alongside the need to adapt current palliative care policy to encompass addressing existential suffering.
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