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 KISIALIOU 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

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