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Title: Psychological exploration of the cognitions preventing smoking cessation or maintaining smoking in Chronic Obstructive Pulmonary Disease (COPD) sufferers
Author: Chimonides, Clive
ISNI:       0000 0004 7431 4301
Awarding Body: Staffordshire University
Current Institution: Staffordshire University
Date of Award: 2018
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This thesis has been undertaken as part of the academic requirements for a Professional Doctorate in Clinical Psychology. The research questions were derived from the author's prior clinical experiences. Smoking is linked to depression, anxiety and mortality amongst people with Chronic Obstructive Pulmonary Disease (COPD); cessation is the most important step in managing the condition. Chapter 1 of this thesis describes a review of the scientific literature that has researched why people with COPD continue to smoke. Twenty papers were found following a systematic search of electronic databases. All papers were assessed for quality and none were excluded on quality grounds. A thematic analysis identified fifty-two reasons under seven related themes: conflicting relationships in smoking; conflicting ideas about the relationship between COPD and smoking; conflicting views on control in smoking; damaging ways of treating the self; pessimism about change; mitigating and optimistic approaches to smoking; conflicting advantages of not quitting. Contradictory beliefs were found within each theme. Chapter 2 describes an empirical study that used Q-Methodology to understand how these individual reasons relate to one another to form viewpoints. Twenty-two people with COPD who smoked completed Q-sorts; by-person factor analysis identified three latent factors: 'Stoic Fatalism' describes smoking as an enjoyable choice that is justified by there being no point in stopping because the damage is done. 'Optimistic Passivity' is characterised by it not being too late to stop, but guilt from continued smoking is resolved by strategies such as planning to stop in future. 'Ambivalent Masochism' describes being a slave to cigarettes, desperate to quit, yet really enjoying smoking. Difficulties with nicotine withdrawal, and management of low mood and anxiety were also strongly cited as reasons for continuing to smoke in the first two viewpoints. The integration of psychotherapeutic and smoking cessation strategies is discussed. Chapter 3 is an accessible summary for service users.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available