Background: Endobronchial valve (EBV) treatment is offered in selected patients with severe emphysema ? mainly to reduce dyspnoea and improve quality of life.

Aim: To perform an in-depth exploration of patients? expectations and considerations while waiting for EBV treatment.

Methods: Patients referred to EBV treatment at Aarhus University Hospital, Denmark from October 2020 to June 2021, were invited to take part in a 30-minutes, semi-structured interview about 1) the experience of living with COPD and 2) expectations regarding EBV. Interviews were conducted via telephone and data was subjected to thematic analysis.

Results: Four themes were identified: A life of reduced quality; Hopes and expectations; Information about EBV; Perception of risks. Patients described their lives as not worth living, and they hoped that EBV would give them their physical and social lives back, while also being aware of the more realistic expectation that EBV would not work miracles. Patients? way of seeking and receiving information about EBV was influenced by their hopes and expectations. They filtered out negative information about EBV and chose to focus on the hope for a positive outcome. This influenced their risk perception and made them willing to run considerable risks of complications with the purpose of winning back their lives.

Conclusions: Living a life of considerably reduced quality, patients appear to have high hopes prior to EBV placement, which may influence the way they perceive information about potential effects and risks of the treatment. These findings are important for shared decision-making guidelines for EBV in the future.