How do people with COPD value different activities? An adapted meta-ethnography of qualitative research

Chronic Obstructive Pulmonary Disease (COPD) is a long-term condition where activities of daily living (ADLs) may be very restricted; people with COPD need to prioritize what is important to them. We conducted a meta-ethnography to understand which ADLs are valued and why, systematically searching for articles including experiences of ADLs and organizing themes from the articles into five linked concepts: 1) Caring for the Body; 2) Caring for the personal environment; 3) Moving between spaces; 4) Interacting with others and 5) Selfhood across time. Additionally, we identified three key aspects of personal integrity: Effectiveness, Connectedness and Control. We found that ADLs were valued if they increased integrity; however this process was also informed by gendered roles and social values. People whose sense of control depended on effectiveness often found accepting help very difficult to bear; therefore redefining control as situational and relational may help enjoyment of activities that are possible.