prevalence
of COPD varies across countries and is associated with the prevalence of tobacco smoking, which is the
most common risk factor for the development of COPD. COPD is associated with dyspnea, chronic cough and
sputum production [2]. Living with COPD means a consistent struggle against dyspnea [3] [4] feelings of anxiety,
fear [4] [5] and an overwhelming fatigue [4] [6]. The daily life deals with avoiding activities leading to a
troublesome breathlessness [7] and striving for an adjustment to limitations in daily life caused by breathlessness
[8]. Experiences of not being met with understanding [7] and feelings of physical, social [7] [9] and existential
isolation [9] have also been described.
COPD is characterized by progressive and chronic airway inflammation as a response to inhaled tobacco
smoke and other harmful particles. The inflammation leads to pathological changes of the small airways and the
parenchyma, which causes airflow limitation. Smoking cessation is the most important part of the treatment because
it has the strongest impact on the disease progression. Pharmacological treatment is used to reduce symptoms
and frequencies and severity of exacerbations and to improve health status and exercise tolerance. Non
pharmacological treatment options as pulmonary rehabilitation are used to reduce symptoms and to improve
quality of life for instance [2]. Long-Term Administration of Oxygen of at least 15 hours a day has proven to increase
survival in individuals with severe COPD who develop respiratory failure with severe chronic hypoxemia
[10] [11]. However, living with LTOT could be associated with feelings of being restricted in everyday life both
due to the oxygen equipment but also due to the dependence on oxygen many hours a day [12]. Ek and colleagues
found that individuals living with advanced COPD and LTOT experienced their everyday life as a
struggle to retain their living space and experiences of being restricted [13]. Despite the restrictions following
the oxygen treatment, LTOT in individuals with COPD could have a positive impact on health-related quality of
life [14].
Self-care is essential in order to manage in everyday life when living with a chronic illness and could be
viewed as a process involving behaviors that are used to maintain illness stability as well as both physical and
emotional stability and to promote well-being. Self-care can reflect recommendations from health care professionals
as for instance a prescribed treatment [15]. Self-care also entails those activities that individuals initiate
and perform on their own behalf in order to maintain well-being [16]. Supporting individuals with COPD with
their self-care management has a positive impact on health-related quality of life, improves dyspnea and decreases
hospital admissions [17]. It has been suggested that increased knowledge about how individuals with
COPD make sense of their illness could be useful in refining self-care management [18]. However, few studies
have addressed self-care strategies in individuals living with both COPD and LTOT. It could be hypothesized
that increased awareness of individuals’ experiences of living with COPD and LTOT and their self-care strategies
could be useful in efforts to refining self-care management for this group. Thus, the aim of this study was to
explore experiences and self-care strategies in patients living with both COPD and LTOT.