Commentary on symptom experience of pulmonary arterial hypertension (PAH) patients

Pulmonary arterial hypertension (PAH) is a complex and rapidly progressing illness with few long-term treatment options to prolong life and improve quality of life. The complexity of the disease predisposes patients to a multitude of symptoms that have an effect on their biopsychosocial well-being. McDonough et al. have taken a qualitative approach to examine the dimensions of PAH symptomology. Using a telephone survey approach, 10 patients were questioned regarding their symptoms. Following coding and categorization of the responses, two main themes were found, "holding back" and redefining life.” The primary symptom associated with holding back was breathlessness. This symptom largely governed fears and behaviors associated with subthemes found within this main theme. Breathlessness also featured in the redefining life category; however, practical issues associated with medication and treatment were also assigned importance in this category by the study respondents. Symptoms of anxiety and depression were counteracted in many instances by a positive and sometimes stoic attitude toward the illness. This study presents important foundational information which will help direct further development of theoretical hypothesis related to PAH symptomology, as well as help focus clinical research toward venues that will enhance nursing care of this complex disease.