• Respiratory medicine · Jun 2013

    Coping styles in patients with COPD before and after pulmonary rehabilitation.

    • Ana Stoilkova, Daisy J A Janssen, Frits M E Franssen, Martijn A Spruit, and Emiel F M Wouters.
    • Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), P.O. Box 616, 6200 MD Maastricht, The Netherlands. a.stoilkova@maastrichtuniversity.nl
    • Respir Med. 2013 Jun 1;107(6):825-33.

    IntroductionPulmonary rehabilitation (PR) improves physical and psychological symptoms in COPD patients. Patients' coping with daily symptoms and limitations may have more influence on important patient-centred outcomes than the impaired lung function. To date, it remains unknown whether and to what extent coping styles change following PR, and whether coping styles are associated with the outcomes of a comprehensive PR.MethodsCoping styles were assessed in 303 COPD patients before and after a PR programme using the Utrecht Coping List (UCL). Additionally, lung function, St. George's Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Scale, anxiety (HADS-A) and depression (HADS-D) subscales and six-minute walking distance (6MWD) were recorded.ResultsThe level of active confronting coping style increased (p < 0.05), whereas the levels of avoidance (p < 0.05), passive reaction pattern and reassuring thoughts coping styles decreased following PR (both p < 0.001). More than 50% of the patients changed their level of active confronting, passive reaction pattern or expressing emotions coping style. Coping styles and/or changes in coping styles after PR were related to changes in exercise tolerance, anxiety and depression, but were not related to changes in health status. Following PR, SGRQ total score, HADS-A and HADS-D scores decreased (all p < 0.001), while 6MWD increased (p < 0.05).ConclusionComprehensive PR results in change in coping styles of COPD patients. Coping styles are related to improvements in exercise tolerance, anxiety and depression, but they are not related with changes in health status after PR. Further studies are needed to evaluate the outcome of interventions actively targeting coping styles.Copyright © 2013 Elsevier Ltd. All rights reserved.

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