The most frequently used coping strategy in this study was “concentrating on what to do next,” more so for patients with psychological distress. The extensive use of this coping strategy may well be understood as the concentration that a patient with dyspnea must devote to breathing; this view is supported by previous findings.10,45 The reasons for the more frequent use of this strategy in the group with psychological distress may be that the total burden of an exacerbation, including
muddled thoughts, extreme fear, heightened emotions, growing panic, feelings of suffocation, and decreased physical energy makes concentration on breathing even more urgent.44,45 DeVito’s phenomenologic study of acute dyspnea in patients with COPD as recalled after discharge uncovered how important it is that the patients’
perceptions of dyspnea are understood by the nurses, and that nurses take appropriate actions to alleviate breathing problems.