P157 The Language of Cough: A Focus Group Study in Respiratory Diseases

Background Little is known about the sensations and triggers that provoke cough in patients, or their preferred language to describe their experiences. We have previously collected a list of descriptors covering the themes of triggers, sensations and secretions, generated from individual interviews in a range of respiratory disorders, with a view to developing a questionnaire. Aims To take the key descriptors and present these to focus groups diagnosed with chronic cough, COPD, ILD, asthma, and non-CF bronchiectasis. Methods Five semi-structured focus groups were conducted with 22 participants (7 chronic cough, mean age 67.7 years (range 57–80) 4 female; 5 asthma, age 66 years (60–71) 2 female; 4 COPD, age 68 years (66–73) 2 female; 3 ILD, age 70 years (65–74) 0 female; 3 non-CF bronchiectasis, age 67.3 years (53–77) 2 female). Using simple manifest content analysis, a list of descriptors was derived based on the frequency of use during individual interviews. These were presented to the focus groups, asking them to describe what each word meant to them, the image it conjured up and whether they could identify a most appropriate word. Results All focus groups favoured the terms ‘phlegm’ over ‘sputum’ (which was considered too “clinical”), ‘irritation’ over the word ‘tickle’ (which was considered too “gentle”) and the ‘need to cough’ over an ‘urge to cough’. In contrast, there were distinct differences in some disease groups for example, all groups, apart from COPD, recognised specific foods and eating as triggers of coughing. Similarly, all groups, apart from asthma, identified specific smells and odours as triggers of coughing. Patients with COPD, ILD and non-CF bronchiectasis related to the word ‘crackle’, but asthmatics only associated this word with “infection” and chronic cough patients did not identify with this terminology. Conclusion These focus group discussions would suggest that whilst some descriptors of cough are felt to be universally appropriate, other descriptors and triggers appear to discriminate between diagnoses. This study will inform the language and content of a future questionnaire to categorise patients by the sensations and triggers provoking their cough.