| Chronic obstructive pulmonary disease (COPD) is a major public health problem that affects millions of Americans. Adherence to treatment regimens is of critical importance to reduce disease progression and disability. This is particularly true in the early stages of COPD when symptoms are insidious not only in the late stages when symptoms are severe. Health care providers generally assume that once a treatment regimen is prescribed it will be followed. Yet it is not uncommon, particularly in chronic illnesses, for individuals to ignore or abandon treatment regimens.;The purpose of this study was to: (1) describe and explore the process by which an individual's perception and interpretation of symptoms related to COPD influenced behavioral responses over time, including decisions surrounding the prescribed treatment regimen; (2) explore the participants image of COPD as an illness, sickness or disease, and (3) determine how closely the experiences of the participants aligned with Leventhal, Nerenz and Steele's (1984) self-regulating processing theory of illness representation.;Three Caucasian adults, two women (age 69 and 78) and one man (age 84), diagnosed with COPD and living in New England, participated in a series of interviews in their homes and maintained a one week health diary. The participants' perception and interpretation of symptoms, not the diagnosis of COPD, provided the basis for behaviors including decisions surrounding the prescribed treatment regimen. Participants were actively involved in a reiterative process of symptom interpretation, which was influenced by four factors: the effect on functional ability, the suspected cause of the symptom, intensity and duration of the symptom, and past experience. Participants' experiences closely aligned with the self-regulating processing theory. A model depicting the process of symptom awareness, interpretation and behavioral response was developed.;The findings of this study are important because there was previously little known about the subjective experiences of individuals with COPD over time. This study led to new insights regarding the effect of a diagnostic label of COPD, and the perception and interpretation of symptoms, and behavioral responses including treatment seeking, reporting of symptoms and adherence to the treatment regimen. |
