Psychological distress and associated factors among South Asian individuals with chronic obstructive pulmonary disease: a convergent mixed methods study.

Objectives: To develop a comprehensive understanding of psychological distress and associated sociocultural and disease related factors among South Asian Individuals with COPD. Methods: A convergent mixed methods study was used. The quantitative sample included 408 and qualitative sample included 22 individuals (11 patients and 11 family caregivers). Hospital Anxiety and Depression Scale was used for quantitative data collection and semi-structured interviews for qualitative phase. Descriptive and regression analyses were used for quantitative data and reflexive thematic analysis for qualitative data. Qualitative and quantitative data were integrated using merging integration procedure and statistics-theme joint display. Results: The mean depression score was 10.91 ± 2.42 and the anxiety score was 9.91 ± 2.69. Quantitative and qualitative integrated data showed that factors affecting psychological distress included sex, education level, primary decision maker in the household, years of living with COPD, financial constraints, fears of the future, self-care struggles, interrupted family decision-making process, and relational support. Conclusions: Individuals with COPD reported moderate to high levels of psychological distress influenced by societal, family, and disease related factors. Community based programs are also needed for providing adequate mental health and counselling resources to patients and their family caregivers.