Abstract
Living with severe lung disease like chronic obstructive pulmonary disease (COPD) is a very stressful situation. The way patients cope may impact their symptoms of anxiety and depression and physical function as well. We studied how ways of coping are associated with levels of emotional distress and lung function in patients with COPD being evaluated for lung transplantation. Sixty-five (mean age 57 years, 46% females) patients completed the General Health Questionnaire-30 (GHQ-30) assessing emotional distress and the Ways of Coping Questionnaire. Measurements of lung function and 6-minute walk test were included. Seventeen (26%) patients had elevated emotional distress. Logistic regression of chronic GHQ score with gender, age, body mass index, lung function, and coping scales as covariates showed that escape avoidance and self-controlling coping and forced vital lung capacity were significantly associated with high emotional distress. Odds ratio of emotional distress increased with 5.2 per tertile (P = .011) in escape avoidance coping score. Moreover, we revealed that emotionally distressed patients cope with their current situation by refusing to believe the current situation and taking their distress out on other people. Among patients with COPD, a high level of emotional distress was uniquely associated with escape-avoidance coping and lung function. Future work should ascertain whether coping style predicts distress or whether distress increases the use of escape-avoidance coping. Nevertheless, our findings indicate that if either element is present, health care professionals should be attentive to the need for interventions to improve patients' well-being.
Highlights
Living with end-stage lung disease like chronic obstructive pulmonary disease (COPD) and being assessed for lung transplantation are potent stressors
We believe that more information on how patients cope with living with severe COPD such as the emotional impact of the disease and the associated physical impairment may provide important knowledge that might be used to tailor interventions.[11]. Given these gaps in the knowledge base, the first aim of this study is to describe the associations between ways of coping and emotional distress in patients with COPD undergoing evaluation for lung transplantation
Fifteen of the 87 patients with COPD included in this study did not complete questions about coping
Summary
Living with end-stage lung disease like chronic obstructive pulmonary disease (COPD) and being assessed for lung transplantation are potent stressors. Knowing that one’s health will gradually deteriorate, continuously struggling with breathing due to impaired lung function, and knowing that premature death will occur in the absence of a transplant, create an untenable situation for most patients.[1,2,3] Stressors associated with evaluation for transplant maybe not knowing if one will be accepted for listing, worrying about changes to future life plans and financial strain.[4,5]. We previously reported that 35% of individuals presenting for lung transplant evaluation had symptoms of anxiety and depression.[6] Such emotional distress has been reported to increase the frequency of physical symptoms among lung transplant candidates.[7] to the best of our knowledge, no previous studies have addressed the way patients cope with
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