Symptom perspectives: Patient-professional differences and communication

Current research indicates considerable variation in everyday breathing intensity for individuals with chronic obstructive pulmonary disease (COPD). This evidence highlights the importance of coaching patients to effectively manage breathing intensity, in particular, to recognize levels of breathing intensity, select the right action for the level of breathing intensity, and call for professional support when self-management does not work. As part of coaching, healthcare professionals evaluate breathing intensity and make treatment decisions, relying heavily on self-report. Patients use their own words (natural language) in self-reports, contributing rich information for self-management that is not captured by objective measurement of breathing intensity. Moreover, early evidence suggests that natural language offers other clues about breathing intensity, for example negative emotion words increase as breathing intensity increases. Using the patient's natural language offers advantages to understanding the symptom experience, underlying cognitive representation for breathing intensity, and clues as to what level of breathing intensity the patient is experiencing. To increase communication, as well as data about breathing intensity, physicians and other healthcare professionals should ask patients with COPD to describe their breathing 'in their own words' and then use these words to evaluate and treat breathing intensity, as well as coach self-monitoring and self-management.