Playing the Harmonica with Chronic Obstructive Pulmonary Disease. A qualitative study

Abstract Introduction Pulmonary Rehabilitation (PR) is the gold standard, group-based intervention for individuals with Chronic Obstructive Pulmonary Disease (COPD). However, accessibility and adherence to PR is sub-optimal. Arts in Health interventions also improve health outcomes for people living with long term conditions. Playing the harmonica with COPD could be clinically beneficial. However, little is known about the patient experiences of playing the harmonica. Methods A qualitative, interpretivist, phenomenological study was undertaken, exploring COPD patient experiences of harmonica playing with a group of others living with chronic respiratory disease. Semi-structured interviews were completed, transcribed, and reflexive inductive thematic analysis performed. Results Eight people with COPD were interviewed. Thematic analysis generated five themes. Themes included “Hard in the beginning”, “Holding the condition”, “Breathing control”, “Gives you a high” and “Needing the Zoom class”. Playing the harmonica with COPD is difficult at first, particularly drawing a breath through the harmonica. With practice, experience in a fun activity, and quality teaching, individuals were able to become more attuned and embodied with their breathing. As breathing became easier the songs, rather than breathing, became the focus, and participants were able to escape living with respiratory disease when playing. The group was a priority in the weekly lives of participants, even though the buzz of being part of a group was lost. Discussion Playing the harmonica requires a different way of breathing and offers a breathing control strategy. Participants also reported the harmonica helped airway clearance and enabled a continued, regular social interaction through COVID-19. The results of this study compliment previous quantitative results and are relevant to physiotherapy. Further mechanistic studies and randomised controlled trials are needed to investigate the biopsychosocial benefits of playing the harmonica with COPD.