Abstract
Pulmonary Rehabilitation (PR) is intervention promoting the long-term adherence of health-enhancing behaviors (ATS/ERS 2013), that impossible without studying of illness' behavior. Recently we showed 3 common desadaptive coping styles, united in 2 groups: illness anxiety disorder & depression (Style A) and the most prevalent opposite style - hyponosognosia (maladaptive denial of physical illness) (Style B).
Aim: To develop PR programs, differentiated according coping styles, and assess their effectiveness.
Methods: 30 COPD stable patients (male; mean age 64,5±10,4 yrs) were recruited in 3-weeks PR program. PR program consisted of PR participating motivation formation, typical physical training, individual or group educational and psychotherapeutic sessions, aimed at both self-management, and desadaptive coping correction. Psychopharmacology was used in the case of need. In this study were recruited 48,8 % patients from Style A (n=20) and only 22,7 % patients from Style B (n=10). Pulmonary function test, 6-MWT, CAT, mMRC, SF-36, SGRQ, original COPD knowledge questionnaire, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI) were used at baseline, in the end of PR and after 1, 3, 6 month post PR.
Results: Pulmonary function parameters did not changed in the end of PR. Regardless of coping style significant improvements were found by all the rest methods and rate of exacerbations (p<0,05). At 6 month benefits were conserved better in style A (p<0,05).
Conclusion: Differentiated PR is effective in all coping styles. Style B patients are more difficult to motivate, maintain achievements and require additional activity in the post-PR phase.
- © 2014 ERS