50 Years of psychological research on patients with COPD – Road to ruin or highway to heaven?

Abstract

In the past 50 years behavioural research on COPD patients has evolved considerably. Over time, a trend for the patient to become the central actor in the management of the illness is discernable. Evidence-based reviews indicate that self-management offers COPD patients effective options for managing their illness, leading to positive outcomes such as reduced frequency of hospitalization, greater exercise tolerance, and enhanced quality of life. Future research should focus on how self-management skills can be incorporated formally into medical care. In addition to offering suggestions on how clinicians may be instrumental in improving self-management behaviour in COPD patients, and thereby improve care outcomes, we highlight the importance of gaining insight into the perceptions of patients of their own situation, and incorporating a respect for patient perspectives into the philosophy of care.

Illness perceptions: impact on self-management and control in asthma

“…Given the empirical evidence on the effect of changing illness perceptions in patients with other chronic somatic disorders, studies in patients with asthma where illness perceptions are addressed and changed are called for 198 Outcome measures The psychological approaches to patients with chronic illness in the past half century (x axis), showing how patients increasingly have become more empowered in taking matters into their own hands (y axis). Data from [40].…”

“…If inadequate illness perceptions have been found, a nurse or a psychologist may discuss and attempt to change the patient's illness perceptions, together with a physician and, of course, active involvement of the patient (see Fig. 2) [40].…”

Perceived quality of life in chronic obstructive pulmonary disease patients: a cross-sectional study in primary care on the role of illness perceptions

“…The second step should be to discuss these perceptions and, if necessary, to correct them at an early stage. Realistic positive beliefs should be encouraged, and negative beliefs should be prevented or challenged [18,39,40]. This approach may result in better HRQoL in COPD patients.…”

Ego defense mechanisms in COPD: impact on health-related quality of life and dyspnoea severity

“…Chronic obstructive pulmonary disease patients may function at a reduced level of efficiency due to neuropsychological impairments, while some psychological characteristics such as high levels of catastrophic withdrawal coping strategy, illness cognitions, and lower levels of selfefficacy of symptom management behavior have been shown to be important variables associated with functional disability and reduced HRQoL [11][12][13][14]. Only a few studies, however, directly assessed the role of personality aspects in COPD, with most focusing on coping strategies [11,12,15].…”

“…Only a few studies, however, directly assessed the role of personality aspects in COPD, with most focusing on coping strategies [11,12,15]. To the best of our knowledge, no previous studies have systematically investigated the aspects of the COPD patients' underlying personality structure, such as ego defense mechanisms and defensive styles, and their associations with disease outcome parameters.…”