1. not seeing onself as ill except during an exacerbation
2. self-blame
2.1. helplessness
2.2. exiled in the world of the healthy
2.2.1. society's stigmatisation
3. story of COPD
3.1. chaos narrative
3.2. unpredictability
3.3. no clear beginning
3.3.1. exp of early copd
3.3.1.1. diagnosis
3.3.1.2. shame- think about smoking
3.3.1.3. examination-cxr ?what about sprimometry now
3.3.1.4. adaption
3.4. living with middle
3.4.1. living with/way of life
3.4.1.1. knowing
3.4.1.1.1. own limits
3.4.1.1.2. what to do
3.4.1.1.3. when you are in trouble
3.4.1.2. emotions
3.4.1.2.1. anxiety
3.4.1.2.2. fear
3.4.1.2.3. frustration
3.4.1.3. coping/adapting
3.4.1.3.1. disability
3.4.1.3.2. suport networks
3.4.1.3.3. financial
3.4.1.3.4. own attitude
3.4.1.3.5. conscious body management in shrinking life world
3.4.1.3.6. living with medication
3.4.1.3.7. poor sleep
3.4.1.4. balance
3.4.1.4.1. self-preservation
3.4.1.4.2. retaining control
3.4.1.5. relationships/caregivers
3.4.1.5.1. loss of intimacy
3.5. unpredictable end
3.5.1. end of life
3.5.1.1. living with deteriorating body
3.5.1.1.1. losing capacity
3.5.1.1.2. fear of next exacerbation
3.5.1.1.3. not talking about death
3.5.1.2. living with thought of dying
3.5.1.2.1. menace of death
3.5.1.2.2. leaving friends and family
3.5.1.3. dying means suffocation
3.5.1.4. death
3.5.1.4.1. in hospital
3.5.1.4.2. withj family and friends
4. breatlessness
4.1. self-inflicted
4.2. insidious
4.3. disability
4.3.1. mobility
4.4. dependence
4.5. isolation
4.6. fatigue
4.6.1. problem-focused
4.6.2. emotion-focussed
5. hope
5.1. schaufel11
5.1.1. relationships
5.1.1.1. family
5.1.1.2. friends
5.1.1.3. hcps
5.1.2. accepting mortality
5.1.3. accepting new phase of life
5.1.4. developing go ahead spirit
5.2. phillip11
5.2.1. tension between
5.2.1.1. ongoing life and increased capacity
5.2.1.2. possibility of death, ongoing ill heallth
5.2.2. optimism
5.2.3. treatment
5.2.3.1. burden
5.2.3.2. benefit
5.2.4. info about end of life and decisions
5.2.5. views on palliative care
6. pain
6.1. pain
6.2. breatlessness
6.3. sleep distrubance
6.4. anxiety
6.5. location- between shuolders/neck/upperarms/chest
6.6. lockedin my body and out of the world
7. smoking
7.1. not worth giving up
7.2. cigarette as freind
7.3. avoiding healthcare opportunities
8. admission to hospital
8.1. early discharge
8.1.1. difficulties with medicines, transport and coping on discharge
8.1.2. coudnt remember giving consent
8.1.3. coping
8.2. discharge
8.2.1. anxiety/depression
8.2.2. confusion about rx esp 02
9. oxygen treatment
9.1. ambulatory oxygen
9.1.1. confusion
9.1.2. doesn't work
9.1.3. might run out
9.1.4. embarrassment/stigma
9.1.5. cumbersome
9.1.6. role of carer
9.1.6.1. dependence vs autonomy
9.1.7. worries about dependency
9.2. living alone with severe copd- on ltot
9.2.1. protecting significant values of identity
9.2.1.1. striving to maintain one's self image
9.2.1.2. being aware of one's on death
9.2.1.2.1. expectatation that will be distressing
9.2.2. being subordinatd to the sick body
9.2.2.1. role of assistive devices eg o2
9.2.2.2. unpredictable body
9.2.2.3. entrusting onself to others
9.3. mask treatment/positive airward rx
9.3.1. anxiety/panic/loss of control
9.3.2. reganing control
9.3.2.1. relationship with staff
9.3.2.1.1. continuity
9.3.2.1.2. taken seriously
9.3.2.1.3. helped mobilise strength
9.3.2.1.4. need to be seen in good light by doctor
10. co-morbidity
10.1. can't act on risk factors
10.2. side effects of medication
10.3. recognising signs and symptoms of illness
11. pulmonary rehab increases
11.1. confidence
11.2. activity
11.3. social engagement
11.4. fear that it will
11.4.1. exacerbate other conditions
11.4.2. make breathless
11.5. droput
11.5.1. loss of privacy
11.5.2. confrontaion with severely ill patients