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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
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European Journal of Physical and Rehabilitation Medicine 2017 Apr 14

DOI: 10.23736/S1973-9087.17.04501-4

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Action plans and coping strategies in elderly COPD patients influence the result of pulmonary rehabilitation: an observational study

Patrizia RUSSO 1, Giulia PRINZI 1, Aliaksei KISIALOU 1, Vittorio CARDACI 2, Emanuele STIRPE 2, Vittoria CONTI 2 , Massimo FINI 3, Stefano BONASSI 1, 4

1 Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Rome, Italy; 2 Department of Pulmonary Rehabilitation, IRCCS San Raffaele Pisana, Rome, Italy; 3 Scientific Direction, IRCCS San Raffaele Pisana, Rome, Italy; 4 Department of Human Sciences and Quality of Life Promotion, San Raffaele University, Rome, Italy


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BACKGROUND: COPD management needs a comprehensive assessment of clinical features (symptoms severity, co-morbidities) together with life-style, behavioural, socio-economic and multi-omics parameters. Among the other issues, psycho-cognitive assessment plays a critical role. Coping strategies are used to manage psychological stress.
AIM: To evaluate the association between coping strategies and outcome of Pulmonary Rehabilitation (PR).
DESIGN: Observational study.
SETTING: Inpatients comprehensive 3 weeks PR programme.
POPULATION: Seventy-six patients, 70 years or older affected by COPD GOLD 3-4.
METHODS: Disease-specific status was examined using the Medical Research Council Dyspnea Scale, St. George's Respiratory Questionnaire, Maugeri Respiratory Failure, Borg And Barthel Scales. Cognitive And Psychological Clinical Alterations/Disorders Using: Mini-Mental State Examination; Montreal Cognitive Assessment; Center for Epidemiologic Studies Depression Scale; Zung Self-Rating Anxiety Scale. Quality of Life Using Activities of Daily Living; Instrumental Activities of Daily Living; 36-Item Short Form Health Survey General and Mental Health. Functional exercise capacity was measured at baseline and after PR using the Six-Minute Walking Test (6MWT). Coping strategies were measured with the Brief COPE. Internal consistency was determined examining Cronbach’s α values. Concurrent validity was determined by examining Spearman r correlations between the single-item and multi-items. Brief-COPE scores after PR between patients who had a different response to respiratory outcomes was evaluated using Student’s t and Mann-Whitney U tests.
RESULTS: The change in distance (Delta6MWD) between final and baseline value in meters was positively associated with Self-distraction, Active Coping, and Planning strategies. Respiratory disease-specific health status outcomes, as well as the presence of use of long-term oxygen therapy, were not associated with coping strategies.
CONCLUSIONS: Self-distraction and Planning strategies are associated to the success of rehabilitation.
CLINICAL REHABILITATION IMPACT: Self-distraction and Planning strategies may predict response to pulmonary rehabilitation in elderly patients affected by severe COPD.


KEY WORDS: Chronic obstructive pulmonary disease - Coping strategies - Cardio-pulmonary rehabilitation - Exercise tolerance - Disease specific health status

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stefano.bonassi@sanraffaele.it