How Patients Hospitalized for Chronic Obstructive Pulmonary Disease Exacerbation Understood Dyspnea Management in Acute Occupational Therapy

This qualitative study explored how patients hospitalized for chronic obstructive pulmonary disease (COPD) exacerbation interpreted dyspnea-management strategies learned during acute occupational therapy (OT) and how they related those strategies to anticipated use after discharge. Semi-structured interviews were conducted before discharge with 15 patients, 14 of whom were male, who received acute OT at a single acute care hospital in Japan, and the data were analyzed using reflexive thematic analysis. Patients described building a practical basis for judging how dyspnea-management strategies might be used after discharge by noticing bodily changes in dyspnea, linking strategies to daily activities, and adjusting them through trial and repetition. Anticipated use after discharge remained conditional. Participants re-evaluated strategies in relation to uncertainty about use at home, difficulty perceiving benefit, and the influence of safety concerns and long-standing habits. Acute OT may help patients judge whether and how dyspnea-management strategies could fit everyday life beyond therapist-guided sessions.