Triggered chain reaction: The meanings of symptom clusters for patients with chronic obstructive pulmonary disease: A cross-sectional qualitative study

by Fei Fei, Richard J. Siegert, Xiaohan Zhang, Jonathan Koffman Purpose Symptoms in chronic obstructive pulmonary disease (COPD) commonly co-occur as ‘symptom clusters’, yet little is known about how patients interpret and make sense of these experiences.

This study aimed to explore the meanings patients with COPD attribute to symptom clusters, their impact on health-related quality of life, and the strategies used to manage them. Methods A qualitative study using semi-structured interviews was conducted with a purposive sample of 30 patients with COPD recruited from a university teaching hospital in China.

Data were analysed using the Framework approach, informed by the Theory of Unpleasant Symptoms and the concept of biographical disruption. Results Three interrelated themes were identified.

First, participants understood symptom clusters as dynamic, interacting experiences, often organised around “trigger symptoms” (e.g., cough precipitating breathlessness and fatigue), rather than as isolated symptoms. Second, these clusters disrupted multiple dimensions of everyday life, including physical functioning, social participation, and sense of self.