{
  "abstract": "Objectives To qualitatively explore the lived experiences and perceptions of patients with chronic obstructive pulmonary disease (COPD) using the harmonica as a therapeutic intervention.Design A qualitative study.Setting The study was conducted at a tertiary hospital in Guangzhou, China.Participants Patients with COPD who had participated in supervised harmonica playing for at least 12 weeks. (clinical trial registration: NCT05995847).Primary and secondary outcome measures The study focused on patients’ experiences, including perceived facilitators, barriers and needs regarding the intervention.Results We interviewed 19 patients with COPD between September and December 2024, with interviews lasting an average of 54 min (range: 36–77 min). Five primary themes were identified. Participants reported better physical functioning, including better breathing control, enhanced functional capacity and improved sleep quality. Psychological well-being improved with increased relaxation, emotional improvement and mental engagement. Patients also experienced increased social engagement and role shift, such as expanded social connections, family support and restored family roles. Harmonica playing promoted enhanced self-reliance and personal development, with increased self-management confidence, mastery of the harmonica and encouragement for lifelong learning. Barriers and challenges included physical limitations, breathing difficulties, adherence issues and concerns about the sustainability of long-term benefits.Conclusions Our study indicates that harmonica playing could improve physical health, psychological well-being, social participation and self-reliance, although barriers persist. Tailored programmes could enhance benefits and adherence, and future research should evaluate durability within comprehensive COPD care.Trial registration number NCT05995847.",
  "authors": [
    {
      "affiliations": [
        "Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Wenli Chen"
    },
    {
      "affiliations": [
        "Nursing Department, Hengqin Hospital, The First Affiliated Hospital of Guangzhou Medical University, Zhuhai, Guangdong, People's Republic of China"
      ],
      "name": "Jingye Huang"
    },
    {
      "affiliations": [
        "Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Qiuxuan Zeng"
    },
    {
      "affiliations": [
        "School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China"
      ],
      "name": "Zeng Jie Ye"
    },
    {
      "affiliations": [
        "School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA"
      ],
      "name": "Junxin Li"
    },
    {
      "affiliations": [
        "The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China"
      ],
      "name": "Jiaying Li"
    }
  ],
  "title": "Patient perspectives on harmonica playing as an intervention for chronic obstructive pulmonary disease: a qualitative study",
  "uid": "900f5c29-613e-5edd-9354-165aba8cd3de"
}