{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T14:02:15Z","timestamp":1778508135577,"version":"3.51.4"},"reference-count":44,"publisher":"Wiley","issue":"9-10","license":[{"start":{"date-parts":[[2019,2,15]],"date-time":"2019-02-15T00:00:00Z","timestamp":1550188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004700","name":"Taipei Medical University","doi-asserted-by":"publisher","award":["TMU106\u2010AE1\u2010B24"],"award-info":[{"award-number":["TMU106\u2010AE1\u2010B24"]}],"id":[{"id":"10.13039\/501100004700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims and objectives<\/jats:title><jats:p>To explore perceptions of experience exacerbations of chronic obstructive pulmonary disease among chronic obstructive pulmonary disease patients with comorbid gastrooesophageal reflux disease by focusing on unravelling how patients differentiate and react to symptoms of chronic obstructive pulmonary disease and gastrooesophageal reflux disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>While gastrooesophageal reflux disease has been suggested to be a risk factor for chronic obstructive pulmonary disease exacerbations, no study has explored perceptions of the symptoms leading up to severe exacerbation of chronic obstructive pulmonary disease events among chronic obstructive pulmonary disease patients with comorbid gastrooesophageal reflux disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Qualitative design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The analysis was performed in accordance with principles of Grounded Theory methodology. Data were collected via semi\u2010structured interviews from 12 chronic obstructive pulmonary disease patients with endoscopy\u2010diagnosed gastrooesophageal reflux disease who had experienced a chronic obstructive pulmonary disease exacerbation with hospitalisation. Appraisal and analysis using consolidated criteria for reporting qualitative research (COREQ) checklist were undertaken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The core category of this study was the ineffective management of exacerbation symptoms, which was associated with perceived symptoms pre\u2010exacerbation which contained three overlapping categories of symptom presentation experienced, and chronic obstructive pulmonary disease\u2010related coping strategies, high anxiety and a sense of helplessness in disease management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with severe chronic obstructive pulmonary disease with comorbid gastrooesophageal reflux disease presented with some distinctly different atypical symptoms yet used common respiratory symptom management strategies. Patients and practitioners alike need to be more aware of the possibility of other symptoms such as nonspecific symptoms being clues of exacerbation onset for a more effective intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>The medical community needs to educate patients to understand and manage not only chronic obstructive pulmonary disease but also gastrooesophageal reflux disease symptoms so that they are better able to identify the cause of their symptoms, treat them appropriately and seek out medical assistance when necessary.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.14814","type":"journal-article","created":{"date-parts":[[2019,1,30]],"date-time":"2019-01-30T14:19:07Z","timestamp":1548857947000},"page":"1925-1935","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Acute exacerbations of chronic obstructive pulmonary disease (COPD) experiences among COPD patients with comorbid gastrooesophageal reflux disease"],"prefix":"10.1111","volume":"28","author":[{"given":"Yu\u2010Huei","family":"Lin","sequence":"first","affiliation":[{"name":"School of Nursing College of Nursing Taipei Medical University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen\u2010Liang","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Department of Internal Medicine Tri-Service General Hospital National Defense Medical Center  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee\u2010Ing","family":"Tsao","sequence":"additional","affiliation":[{"name":"College of Nursing National Taipei University of Nursing and Health Sciences Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8012-5780","authenticated-orcid":false,"given":"Chii","family":"Jeng","sequence":"additional","affiliation":[{"name":"School of Nursing College of Nursing Taipei Medical University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,2,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.54.7.581"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00107004"},{"key":"e_1_2_10_4_1","unstructured":"Chen M. 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