Meeting the mental health needs of people with chronic obstructive pulmonary disease: a qualitative study.

Objectives: This study aimed to understand the mental health needs of people living with chronic obstructive pulmonary disease: what they were experiencing, what they wanted (or did not want) which might be described as 'felt need', what they had accessed or received ('expressed need') and how, from their perspective, their emotional needs might be more effectively met by health care services.

Methods: Qualitative study with 14 patients with a confirmed diagnosis of chronic obstructive pulmonary disease, where a member of the clinical team had recognised that the patient was suffering from associated emotional distress.

Results: Three themes emerged: a sense of assuming a different identity as the disease challenged abilities, the experience of social isolation with fear of dependence and barriers the participants encountered acting as obstacles to coping, adapting and accessing treatments. There were mixed feelings about the value of talking about problems, with both psychological and physical barriers strongly militating against both expression of need and utilization of care offered.

Conclusions: Innovative research and clinical care should be aimed towards development of skills, strategies and systems required to engage sensitively and negotiate needs for care, in a patient-centred manner, with people who do not necessarily see the need to ask for emotional support.