Table 3 Research Question 2: Self-management approaches for psychological distress.

Respiratory self-management

“Oh I try and sit down and do deep breathing to 10, and then I’ll see how I am. And then I’ll start again with another 10 deep breaths until I’m quieter. And I just sit there and try and relax.” (Barbara, P2)

“And if I walk up to the street up the shops, which is about a 20 min walk might be a little more. I have to stop all the time to take my puffer and if I can’t catch my breath I have to sit down.” (Cynthia, P13)

Psychological self-management

“Well, I’ll go into my head. Where I’m either in a valley, where it’s just trees and stuff or it’s winter and it’s snowing everywhere… the others are, I can be in a desert somewhere just walking.” (Phyllis, P12)

“From now on when I got this, stress and everything, I go out. And I go and see my daughter, my granddaughter, or I go and play bingo.… It’s keeping your mind far, you know, from the everyday routine. So, you look forward to doing something else.” (Antonella, P6)

Technological competence/accessing digital healthcare

“He can send it [prescription] through to you.’ And I said, ‘what, send me an email?’ And she said, ‘no, on your phone, send a message on your phone. And then you’ll have a prescription number.’ I said, ‘okay, so what do I do with that?’ She said, well, ‘you give it to the chemist shop when you go in.’ I said, ‘for God’s sake, the chemist shop delivers my prescriptions and they’ve been doing it for a couple of years!’” (Kathy, P3)

“Then I’ve got an iPhone. So if I make an appointment on my phone, the next minute it’s on my iPad and on my computer as well.” (Neil, P11)

Confidence managing respiratory condition

“It’s more easy to have a broken, broken arms or broken leg, it’s easier to handle. But with the lungs, I can’t handle.” (Mario, P5)

“I mean, look, he does everything for me. So he’s very-, well, when it suits him, he does. You know, so I mean, I don’t know that I could cope without him.” (Fiona, P10)

Confidence managing mental health

“I don’t know. I’ve never asked for it [mental health care]. So I don’t even know what’s out there. And, um, am I that interested in it? No, because I don’t feel it is that big of a deal. I can handle it.” (Phyllis, P12)

“That’d be what I’d say about the way [patient’s name] operates. If she’s really stuck, she would ask for help and assistance, that’s for sure. But she doesn’t feel like she’s at that level yet.” (Brett, C2)

“‘I’ve got through all of those earlier things in my life, nothing’s coming, nothing that, you know. That’s not coming back to bite me or anything. I dealt with them all, I was strong. I dealt with everything I had to deal with.” (Kathy, P3)

Confidence managing comorbidities

“Terrible! I’m not happy. I mean, the pacemaker starts playing up. So I’ve got to try and relax myself and get that settled before I can do anything. I lose my balance. I’ve got to be careful how I walk… I’ve got osteoporosis and I can’t walk too good on my own.” (Barbara, P2)

Daily life activities

“Shopping-wise- I got to pace myself for shopping….and fortunately, the shopping carts are at the right height, so if I start having problems breathing, I can hang onto that and… just slowly get my breath back….If I feel like I need to…you know get away, then whatever I’ve got, I’ll pay for that. And then another day when I feel a bit better, I’ll go back and finish it off.” (Neil, P11)

Lifestyle choices

“Like all alkies (alcoholics), there’s a reason you drink. And the drink’s to put things…that you’re not happy with, behind you. Just to, to hide it away.” (Allen, P1)

“Oh, absolutely! I started smoking because of stress, I was not even 17. I was 16 years old. And my, one of my friends I’d grown up with all my life. She was killed in a car accident and you know, I was struggling to deal with it. My sister and me and our friends, and somebody said, have a smoke.” (Kathy, P3)

“I used to smoke. Anyhow, I stop smoke since I have attacks, that I dare not touch cigarette.” (Antonella, P6)

Self-identity type

“I cope with everything. Sooner or later I get out of it.” (Derrick, P4)

“No, I tried quite a few therapy sessions and for me they didn’t work. I’ve come to the conclusion, I’m not a person that finds it easy to talk to other people in a group… or with people there. I don’t like an audience.” (Phyllis, P12)

“I’m not a pill person. So that’s good being like that, isn’t it? Well, I think it is.” (Kathy, P3)

“All the doctors I’ve had, my own GPs, have all been people that are interested in asthma and lung problems, so I’ve sort of sought those… I seek those sort of people out.” (Pauline, P9)

Care acceptance

“He’s a strong man, so you know, he didn’t want to go to the doctor, or to hospitals.” (Rosemary, C1)

“I did have a psychiatrist tell me one day that a lot of my pain from my stomach…And if I talked about my childhood traumas that would take my pain away. I’m sorry, are you kidding, lady? Seriously? Those childhood traumas are… Back in those… I, I don’t usually talk about them.” (Irene, P8)

Role acceptance, carer

“…do what I’ve got to do. Because I know, if the role was reversed with [patient] and I, she would be doing the same thing for me. She’d be looking after me really well. And that’s what I do for her.” (Brett, C2)

Perceptions of illness and illness treatment

“He’s like “I don’t know what’s going on with me! I don’t know!” and I just tell him that it’s [anxiety] a part of the disease. It’s normal. It’s a part of what you have. You know?”(Rosemary, C1)

“I really think, she’d think it’s [mental health care] an insult to her capacity to live her own life, you know? Because she does okay. But just sometimes it all just boils up inside and it spills over and I catch what’s coming out of the mouth, but I can deal with it. And it’s not hard, you know?” (Brett, C2)

Input, carer

“Other things like, sort of, breathing techniques. Because then when he starts to, have a breathing change, he forgets to breathe through the nose with the oxygen, he’s like (imitates hyperventilating) you know? And he’s like “I can’t get breath” and I say well you’re not,… through the nose, out through the mouth, we’ve done that before… all the different exercises with the physio.” (Rosemary, C1)

“My daughter told me, mum, I know you. I saw you from before and now you improved a lot. That’s what my daughter say. You improved a lot. It’s not the same. And she tried to teach me how to breathe in when I’m agitated. To breathe in and breathe out….She say, are you feeling better like this or without, ooh, ooh? [Laughs]….See, that’s what you gonna do. Breathe in slowly and breathe out slowly.” (Antonella, P6)

Carers

“I do pretty much the bulk of the housework, all the washing and ironing. I try and keep the house as clean as I can, but I’m not an expert. She wants to go anywhere, I’ll drive her there now. And if she wants anything down the shop, I’ll just go and get it. I’m just like a run-around type of guy and to keep everything, do everything that she wants done, done. (Brett, C2)

“I give him all the medications. And just watch for signs of the breathing, before it starts to get any worse and I’ll give him, you know, if he’s starting to work it up, then I’ll get on to it, before it gets any worse.” (Rosemary, C1)

“….With my daughter. She does the best she can. And she said, mum, you know what, we go to do,….drop in at the centre. I wanna find out if they got this electrical scooter for you to walk all, you know, on that. Otherwise, if you get tired you've gotta sit and that’s no good.” (Antonella, P6)