Theme: Self-regulating breathing The experience of learning more self-regulated breathing patterns | |
Sub-theme: CO2 biofeedback | I was amazed by the graphs on the computer – an immediate feedback. And there was a connection seeing that with the slow breathing. I have also seen the screen on her computer and how I can reach different levels of carbon dioxide being exhaled and the width and height of the breath; the inhale and the exhalation; and the impact on my body as far as the relaxation and the rhythmic quality…. Not only do I see it, I feel it. It gives you an idea of what you're doing right and wrong. It was very helpful to me to see the pattern of my breathing on the readout. It was a concrete example of my inhales and exhales and my timing. There was no cheating the device. From week to week, I could see my progress. The one thing I really enjoyed was the capnometer and seeing the breaths. |
Sub-theme: breathing interoception and mindfulness | [There were] so many different aspects of breathing and mindfulness… I was able to understand the connection between the way I was breathing and my body; becoming more aware of the impact of my thinking, my feelings, my bodily position, and their impact on my breathing, and also the exhale, because I've had a big problem with exhaling. I can't get out air…. I've learned to look at what's happening in the here and the now [and] what the impact is on me…. I think what I have learned is how I can regulate it [my breathing] rather than having it just be stuck. I think that has been extraordinarily helpful. Because I could kind of almost trust my lungs a little bit better. Well I became much more aware of my gasping for air even though I had plenty of air in me. It was sort of an automatic response when I try to exhale fully. |
Sub-theme: beliefs and motivation to change breathing | That to me was a big kind of leap forward in terms of how I am going to live with it – come to face with it…. I've got to be breathing through my nose. Even though I get the oxygen when I'm working out, I'll still be breathing mostly through my mouth. So I have to be conscious that I'm doing that. There was a great deal of resistance when I started. And then I felt there was a buildup and…. growing effect and profit; [I realised] that you have to keep at it. So then I found there was a time of the day that became easier to do it [home exercises]…. I think the success of the programme is tied to desire. What do you want? In Spanish, we say what's your gana?… What moves you? I'm enjoying them [home-based breathing exercises]. I'm still doing them. I'm committed to continuing to do those as long as I can continue to breathe. If I don't continue to do them, I'm afraid I'm going to lapse back into the short breathing. Being with [the therapist] was very positive…. It motivated me to go home and take what I've learned with me. I felt like everything about that was positive and we were on the same page and it was very beneficial. |
Theme: impact on health The perceived clinical benefit of adjunctive CART | |
Sub-theme: reduced dyspnoea | I've learned where I was getting shortness of breath on a daily basis. For example, I didn't realise that it was because I was holding my breath. I wasn't breathing properly…. I think I know now when I hit a stride and I'm doing it [breathing] properly. I'm not forcing the breath. I can feel it…. It seems to be paying off. The thing I got out of it was that I didn't realise that I was breathing the way I was. Like I would hold my breath sometimes, like I said on exertion…. So, now with walking and moving, I'm conscious of my breathing and I'm more in control…. Especially when I feel like my breathing is getting a little out of control, I've learned how to relax and slow down. I think if I'm walking up an incline or rushing, being able to regulate my breathing you know will help me feel more confident that I'm not going to run out of breath, or I may not have to slow down. |
Sub-theme: anxiety relief | One of the keys to that was that when I stood up straight, I could feel the benefit to the body. I didn't need worries. I knew it. Even when I'm in public, I hold my body more openly…. It's more open and things are easier. As far as feeling stressors and pressures, knowing that I can breathe into my ribcage and dissipate some of the tension is very beneficial. Because I think having trouble breathing is definitely a very scary thing. It helped me concentrate more on my breathing …. If I can't take a deep breath, I get frightened. So, it probably kind of snowballs. But now I'm learning…. There's no doubt, sometimes I start to hyperventilate a little bit, but that doesn't usually last long…. It's like all stops because you are concentrating on [breathing], and it's peaceful there. So, I really liked that part. It stays with you. Because you know, if you can be calm and you can be peaceful, you can be breathing all right. And you won't be feeling those frightening feelings. It helped me to control my breathing more, and to breathe slower, and what to do if I felt really short of breath and not panic. I have such a cough. It helped not only with the breathing itself, but even with the calming of the nerves. It made me aware of how fast I was breathing when I got nervous or anxious. |
Sub-theme: improved social participation | The interactions with my family have improved because I'm not upsetting everybody because I have a respiratory problem. I control my problem by controlling the way I laugh and the way I talk. The way I control my breathing affects the whole family.… It's very important that I've learned to control my breathing because so often I'm at a family gathering, all eyes would be on me because I'd be coughing and wheezing and having to use my nebuliser and that is all done with now, because I'm aware. I stop myself and let someone else have the floor…. So it taught me how to slow down when I'm talking, and I'm now having fewer distressing episodes. |
Theme: Patient satisfaction Perceived satisfaction of CART | |
Sub-theme: highlighted CART components | Learning how to breathe [was the best part about the process of participating]. What I liked best was probably learning how to relax more with my breathing, instead of getting a little bit nervous when I would get out of breath and start coughing.… I've become aware of my breathing and I think I was breathing much more shallow before and I would always hold my breath on exertion. When somebody would say take a deep breath, I would take it straight from my [upper] chest. I would never even think of feeling my ribs and my diaphragm expanding. And that was the best part of it. The techniques and recovery positions are very helpful. I purposefully learned to breathe with walking outdoors. She [my therapist] made me feel very comfortable and confident that I would get better. I wanted to mention my therapist who I found to be an excellent and patient teacher and instructor in breaking down the process of breathing and developing exercises that I could use to make my breathing more efficient. |
Sub-theme: recommended changes | I thought it was awesome. It showed me techniques that I could use throughout I guess the rest of my life…. I [recommend to] get the information out there because I'm sure there are a lot of people who can benefit from it. I think it was excellent. I think if possible it should be given to everyone with breathing problems … it is so helpful and it causes people to become more aware…. It has been very, very enlightening and very helpful. Six [sessions] is just too short. |
Sub-theme: exercise training adherence | It helped me to get along with and to keep up and not give up. I probably would have enjoyed and realised the benefit of rehab – the exercising – without the CART program. I probably would have enjoyed CART without the rehab. But the two of them together! |
CO2: carbon dioxide; CART: capnography-assisted respiratory training.