Perceived barriers and facilitators to managing psychological distress in COPD: The perspectives of patients and carers – a qualitative study using the theoretical domains framework (TDF)

Abstract 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 w...

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Main Authors: Juliet Wang, Lena Ly, Elizabeth Barson, Natasha Smallwood
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:npj Primary Care Respiratory Medicine
Online Access:https://doi.org/10.1038/s41533-025-00430-0
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author Juliet Wang
Lena Ly
Elizabeth Barson
Natasha Smallwood
author_facet Juliet Wang
Lena Ly
Elizabeth Barson
Natasha Smallwood
author_sort Juliet Wang
collection DOAJ
description Abstract 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.
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spelling doaj-art-4b3aee9db347457c8ca62c94398b590d2025-08-20T03:52:24ZengNature Portfolionpj Primary Care Respiratory Medicine2055-10102025-04-0135111310.1038/s41533-025-00430-0Perceived barriers and facilitators to managing psychological distress in COPD: The perspectives of patients and carers – a qualitative study using the theoretical domains framework (TDF)Juliet Wang0Lena Ly1Elizabeth Barson2Natasha Smallwood3Psychiatry, Austin HealthDepartment of Respiratory Research at The Alfred, School of Translational Medicine, Monash UniversityDepartment of Clinical and Health Psychology, Western HealthDepartment of Respiratory Research at The Alfred, School of Translational Medicine, Monash UniversityAbstract 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.https://doi.org/10.1038/s41533-025-00430-0
spellingShingle Juliet Wang
Lena Ly
Elizabeth Barson
Natasha Smallwood
Perceived barriers and facilitators to managing psychological distress in COPD: The perspectives of patients and carers – a qualitative study using the theoretical domains framework (TDF)
npj Primary Care Respiratory Medicine
title Perceived barriers and facilitators to managing psychological distress in COPD: The perspectives of patients and carers – a qualitative study using the theoretical domains framework (TDF)
title_full Perceived barriers and facilitators to managing psychological distress in COPD: The perspectives of patients and carers – a qualitative study using the theoretical domains framework (TDF)
title_fullStr Perceived barriers and facilitators to managing psychological distress in COPD: The perspectives of patients and carers – a qualitative study using the theoretical domains framework (TDF)
title_full_unstemmed Perceived barriers and facilitators to managing psychological distress in COPD: The perspectives of patients and carers – a qualitative study using the theoretical domains framework (TDF)
title_short Perceived barriers and facilitators to managing psychological distress in COPD: The perspectives of patients and carers – a qualitative study using the theoretical domains framework (TDF)
title_sort perceived barriers and facilitators to managing psychological distress in copd the perspectives of patients and carers a qualitative study using the theoretical domains framework tdf
url https://doi.org/10.1038/s41533-025-00430-0
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