Understanding Breathing and Swallowing in Chronic Obstructive Pulmonary Disease Via a Holistic Lens
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Date
2021-09-13
Authors
Lin, Ting-fen
Journal Title
Journal ISSN
Volume Title
Publisher
University of Oregon
Abstract
Chronic obstructive pulmonary disease (COPD) impacts physiological and psycho-emotional aspects of life. COPD-related secondary sequalae also interact with each other, creating the potential for a synergistic downward spiral of quality of life. For example, dyspnea, one of the most common symptoms of COPD, not only affects the severity of breath and the functioning of the body, but also influences the mind (e.g., anxiety, panic, fear). This negative psycho-emotional state can then create a further cascading effect on the breath and the body. This is particularly relevant during oral intake, an activity that is negatively impacted by the high prevalence of dysphagia (swallowing impairments) in individuals with COPD. Given the breadth of the impact of COPD on multiple facets of health and well-being, it is therefore pivotal to investigate more comprehensive approaches to managing COPD, addressing the mind, body, and breath simultaneously. Sudarshan Kriya Yoga (SKY), a breath-based meditation program, has previously been shown to yield physiological and psycho-emotional benefits for other populations, including healthy individuals, veterans, and those affected by trauma, anxiety, and depression. Therefore, using qualitative phenomenology and single-case multiple-baseline methodologies, the feasibility and acceptability of SKY as well as its functional relation with dyspnea perceptions and mealtime enjoyment and difficulty were investigated among individuals with COPD. A total of nine individuals with varying severities of COPD participated. Data collection included: semi-structured, in-depth interviews; ratings of perceived dyspnea as related to work of breathing, shortness of breath, dyspnea-related distress, dyspnea-related anxiety, and mealtime enjoyment and difficulty; and surveys on psycho-emotional status (Hospital Anxiety and Depression Scale and Positive and Negative Affect Schedule), COPD impact (COPD Assessment Test), and oral intake experience (Eating Assessment Test and Dysphagia Handicap Index). Results suggested SKY to be feasible and acceptable for individuals with COPD. Additionally, the results demonstrated proof of concept that SKY can help alleviate aspects of COPD disease burden related to the mind, body, and breath more broadly as well as reduce the cyclical effect of the disease sequalae. This study is the first to demonstrate that SKY can be a viable complementary and integrative health approach among individuals with COPD.