Summary: | Background: Despite common usage of oxygen as a therapeutic intervention, audit suggests the existence of poor prescribing and administration practices. Contemporary studies and guidelines propose an influencing culture whereby oxygen is given to alleviate breathlessness and to most acute clinical presentations, with disregard for potential drawbacks; but there is no evidence supporting this claim. The problem self-perpetuates as erroneous beliefs are passed to patients, their carers and the general public. Aim: To explore healthcare professionals’ (HCPs) and patients’ perceptions of oxygen therapy. Method: Semi-structured interviews were undertaken with 28 patients and 34 HCPs (including nurses, paramedics, pharmacists and general practitioners). Self-reported beliefs and behaviours were recorded, transcribed verbatim and analysed iteratively using interpretative phenomenological analysis (IPA). Results: Three master themes were identified: oxygen as a panacea, the burden of oxygen, and antecedents to beliefs. Sub-themes under these constants differed between HCPs and patients, but fundamentally both groups viewed oxygen as an innocuous therapy with numerous benefits. Patients used oxygen for breathlessness and as an enabler; they were grateful to the oxygen and accepted it as part of the disease. HCPs used oxygen because it helps patients; it works!; it makes HCPs feel better, and also out of compassion. But oxygen is not benign and a burden is evident, for patients it makes the disease visible and carries associated costs. For HCPs there is an awareness of the dangers and the patients’ burden, which often results in clinical dilemmas and an emotional cost to caring. The study exposed patients’ potential antecedents to beliefs as faith in HCPs and past experiences; for HCPs these were entrenched culture and expectations. Patients appeared not to think about oxygen and understanding was poor. All HCPs believed they had not received enough education specific to oxygen, and an approach of DIY education prevailed. Summary: These findings suggest that a set of fixed beliefs regarding oxygen therapy exist, influenced by several impacting factors. The overwhelming perception that oxygen is a universal remedy presides, but is, at times, contradictory, when benefits are countered by adverse effects of oxygen. These adverse effects, additional to physiological dangers, included psychosocial and emotional costs. This is the first time that perceptions of oxygen therapy have been reported and will be an important contribution to knowledge, supporting strategies to raise awareness of entrenched cultures, influence future educational and research strategies, and inform policy.
|