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

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.