Abstract
Pulmonary Rehabilitation (PR) promotes the long-term adherence of health-enhancing behavior. Recently it was shown presence of 3 main desadaptive illness behavior types, that can be combined in 2 groups: illness anxiety disorder & depression (Style A) and the most prevalent opposite but not less important type – hyponosognosia (maladaptive denial of physical illness) (Style B). Patients with hyponosognosia are often excluded from PR due to low motivation and compliance.
Aim: To develop PR correcting desadaptive illness behavior and assess their effectiveness.
Methods: 42 COPD stable patients (male; mean age 62,4±9,0 yrs) were recruited in 3-weeks PR program, consisting of PR participating motivation formation, typical physical training, individual or group educational and psychotherapeutic sessions, aimed at both self-management, and desadaptive illness behavior correction. Psychopharmacology was also used in the case of need. Pulmonary function test, 6-MWT, CAT, mMRC, SF-36, SGRQ, original COPD knowledge questionnaire, BDI were used at baseline, in the end of PR and after 1, 3, 6 month post PR.
Results: In the both illness behavior types significant improvements in FEV1 (p<0,001-A, p=0,003-B); 6-MWT, CAT, mMRC, all the scales of SGRQ, physical health of SF-36, COPD knowledge, BDI were found (p<0,05). In the B group high baseline rate of psychic health SF-36 didn't increase (p≥0,1). At 6 month benefits were staying better in style A (p<0,05).
Conclusions: Differentiated PR effectiveness is relative high in the all illness behavior types. Style B patients are more difficult to motivate, maintain achievements and require additional interventions in the post-PR phase.
- Copyright ©ERS 2015