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OBJECTIVES: Patients with cystic fibrosis (CF) are asked to provide a sputum sample at clinic to test for potentially harmful pathogens. However, some appear to struggle with this request. Research into the difficulties experienced by these patients is lacking. This study set out to explore this issue in depth, using a qualitative research approach. METHODS: Semi-structured interviews were conducted with 18 patients identified as having difficulties with sputum by the physiotherapists involved in their care. Framework analysis was applied to collected data. RESULTS: An overarching concept derived from the interview material was a concern about sputum coming to be a defining feature of identity. This was reflected in the following four themes: (1) being seen as dirty because sputum is socially vilified as thus; (2) sputum exposing an invisible condition; (3) sputum acting as a reminder of having CF; (4) being seen as sputum producers by practitioners. DISCUSSION: Patients' difficulties with expectorating sputum were multifaceted and included psychosocial and physical factors. Practitioners need to appreciate that for some people, a request for sputum can cause significant discomfort. Individualized interventions to assist these patients may prove helpful.

Original publication




Journal article


Chronic Illn

Publication Date





192 - 201


Adult, Anecdotes as Topic, Attitude to Health, Cystic Fibrosis, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Patient Education as Topic, Self Concept, Shame, Specimen Handling, Sputum, Surveys and Questionnaires, Young Adult