Understanding the psychosocial burden of living with advanced COPD in context of palliative care: A mixed methods study.

People with advanced chronic obstructive pulmonary disease (COPD) face substantial physical and psychosocial challenges influencing their quality of life. This study explored the psychosocial aspects of people with COPD attending palliative care services. Concurrent embedded mixed methods study with 22 individuals was conducted. Data collection involved semi-structured interviews and McGill Quality of Life-Revised and Hospital Anxiety and Depression Scale questionnaires. Findings revealed a negative correlation between quality of life and psychological distress, emphasising that as disease severity increased, so did psychological distress. From interviews emerged three themes: adjustment to living with a debilitating disease, loss of identity and developing lifestyle coping strategies. To conclude, a biopsychosocial perspective to understanding the impact of COPD is essential in identifying mitigating factors which exacerbate disease burden and increase psychological distress of people living with COPD. Implementing a biopsychosocial framework can enhance care by furthering self-management, reducing psychological distress and promoting a person-centred approach.