Lay beliefs of patients using domiciliary oxygen: a qualitative study from general practice

Oxygen, given for 15 hours a day to certain patients with chronic obstructive pulmonary disease, is known to reduce mortality and improve morbidity. There is, however, an apparent mismatch in provision--some patients who would potentially benefit are not receiving it and, conversely, other patients may be receiving it 'inappropriately'.

To investigate lay beliefs about oxygen therapy of patients receiving domiciliary treatment.

Twenty-four patients receiving domiciliary oxygen therapy from three general practices in Middlesbrough were interviewed using qualitative, semi-structured interviews.

There were two contradictory approaches to oxygen use. On the one hand, oxygen helped the individual maintain mastery and self-control over illness by relieving symptoms, thus enabling daily activities and roles to continue, and by the reassurance that it was available, even if not used. In addition, self-control over the illness was maintained by individual experimentation with the best ways to use oxygen, which increased personal involvement in treatment. On the other hand, there were concerns that oxygen should not master the individual through inducing dependency on its use.

These ambivalent ideas about oxygen should be considered when assessing patients for use of domiciliary oxygen and by general practitioners maintaining treatment. Some patients who according to medical criteria would benefit from domiciliary oxygen may wish to restrict its use because of worries about dependency and these worries may need addressing. Other patients using domiciliary oxygen who do not meet medical criteria for long-term use may nevertheless gain benefits, including improved self-control over their illnesses.