Behavioral exercise programs in the management of chronic obstructive pulmonary disease.

Atkins, Catherine J.; Kaplan, Robert M.; Timms, Richard M.; Reinsch, Sibylle; Lofback, Ken

doi:10.1037/0022-006x.52.4.591

Cited by 143 publications

(65 citation statements)

References 24 publications

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“…That these effects of psychological factors are mediated through motivation and adherence remains speculative, since neither adherence to the medical regimen nor motivation were measured directly in this study. However, this is consistent with evidence from other studies [33].…”

Section: Discussionsupporting

confidence: 81%

“…Where psychological factors contribute to an unfavourable outcome, they are amenable to change, for example using cognitive-behavioural therapy [35,36]. Such therapy has been shown to improve exercise tolerance and subjective well-being among people with chronic obstructive pulmonary disease, and is also likely to improve patients' adherence to their rehabilitation programme [33]. Further work should aim to identify in more detail those psychological factors likely to influence rehabilitation outcomes, and to extend rehabilitation programmes to incorporate interventions focused on these factors.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Psychosocial predictors of long-term success of in-patient pulmonary rehabilitation of patients with COPD

S¹,

Villiger²,

Sensky³

et al. 1997

Eur Respir J

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In this prospective clinical study, baseline data (FEV1 % pred, arterial oxygen tension (Pa,O 2 ), QOL, HS, dyspnoea, coping scales) were studied at entry (t1); follow-up on discharge (t2); and 1 yr after hospitalization (t3) in 54 consecutive patients (mean age 64 yrs) with chronic obstructive pulmonary disease (COPD). Complete data were obtained at follow-up on 32 subjects. FEV1 % pred improved from 42% (t1) to 52% (t2) (p<0.001) but dropped to 46% at t3 (t1-t3: p<0.05). QOL improved significantly during hospitalization but dropped to initial levels 1 yr after discharge. A significant increase in health satisfaction during hospitalization was maintained at follow-up. Improvements in lung function were greater in patients with higher QOL scores on entry; subjects with the greatest tendency to use wishful thinking as a coping strategy had less improvement.In conclusion, the effects of pulmonary rehabilitation on lung function and health satisfaction are positive and enduring. Quality of life and coping have an effect on the long-term outcome of pulmonary rehabilitation, probably as expressions of patients' personality traits.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Psychosocial predictors of long-term success of in-patient pulmonary rehabilitation of patients with COPD

S¹,

Villiger²,

Sensky³

et al. 1997

Eur Respir J

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show abstract

“…There is little published information on the relative importance of psychological support, but ATKINS et al [17] found that a much longer rehabilitation programme than that used in the present study, including psychological sessions, was more effective in reducing anxiety than psychological sessions alone. In another large study, SASSI-DAMBRON et al [18] found a significant improvement in the transitional dyspnoea index of MAHLER et al [19] 6 months after treatment, in patients who had received six weekly sessions in which they were taught coping strategies by a psychotherapist, compared with patients who had general education sessions.…”

Section: Discussionmentioning

confidence: 49%

Effects of psychotherapy in moderately severe COPD: a pilot study

Eiser

West²,

Evans³

et al. 1997

Eur Respir J

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Anxiety is common in the "pink puffer" syndrome associated with chronic obstructive pulmonary disease (COPD). The degree of anxiety correlates well with perceived dyspnoea. This pilot study examines the effect of group psychotherapy on anxiety, exercise tolerance, dyspnoea and quality of life.Ten patients with moderately severe, stable COPD (mean forced expiratory volume in one second (FEV1)=1.15 L) had six 90 min sessions of cognitive and behavioural psychotherapy at weekly intervals. Patients completed the Hospital Anxiety and Depression Scale (HADS), Medical Research Council Questionnaire (MRCQ) and St George's Respiratory Questionnaires (SGRQ), 1 week before and after therapy. FEV1, forced vital capacity (FVC), slow vital capacity (SVC), blood gas tensions and 6 min walking distance (6MWD) were measured. Eight control patients attended weekly for lung function and 6MWD for 6 weeks, but had no psychotherapy.Mean baseline HADS score was significantly higher in the psychotherapy group (12) than in controls (7), but otherwise there were no differences in lung function, blood gas tensions, 6MWD, or the other questionnaire scores between groups. After treatment, the physiological and psychological parameters where unchanged in both groups with the exception of the mean 6MWD, which had improved in the psychotherapy group only, from 351 to 423 m (p<0.001), an increase of 24%. Three months after treatment, the 6MWD was still 16% above the baseline value (p=0.02).In conclusion, six sessions of cognitive and behavioural psychotherapy produced a sustained improvement in exercise tolerance in a group of 10 anxious patients with severe chronic obstructive pulmonary disease, without any change in anxiety scores on the Hospital Anxiety and Depression Scale. Further studies of more prolonged, intensive psychotherapy would establish whether better symptom and quality of life scores accompany more dramatic increases in exercise tolerance in "pink puffers". Eur Respir J 1997; 10: 1581-1584 In patients with chronic obstructive pulmonary disease (COPD), dyspnoea often correlates poorly with physiological impairment [1][2][3]. Anxiety is closely associated with dyspnoea, and may be one of the most important factors determining quality of life in patients with severe COPD [4,5]. Attempts at improving dyspnoea, by means of psychotherapy, relaxation and retraining of breathing patterns, have met with varying success [6][7][8][9].The aim of the present study was to assess the effect of general cognitive and behavioural psychotherapy, directed by a psychiatrist, on the level of anxiety, quality of life, dyspnoea and exercise tolerance in patients with moderately severe COPD. Methods PatientsHospital Anxiety and Depression Scale (HADS) questionnaires were completed by patients attending the monthly COPD clinic at Lewisham Hospital over a 3 month period. The HADS [10] is a self-administered questionnaire, comprising 14 questions, seven of which are aimed to detect anxiety. Questions are based on psychic symptoms only, without r...

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“…Of the control conditions discussed in this paper, no-treatment controls most often produce the largest effect size for experimental treatments, because they are least likely to positively affect the outcome [34]. It might be argued that these control conditions set the bar too low, particularly given that many psychological targets will improve somewhat with almost any intervention [35].…”

Section: Commonly Used Control Conditionsmentioning

confidence: 99%

The Selection and Design of Control Conditions for Randomized Controlled Trials of Psychological Interventions

Mohr¹,

Spring²,

Freedland

et al. 2009

Psychother Psychosom

431

449

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The randomized controlled trial (RCT) provides critical support for evidence-based practice using psychological interventions. The control condition is the principal method of removing the influence of unwanted variables in RCTs. There is little agreement or consistency in the design and construction of control conditions. Because control conditions have variable effects, the results of RCTs can depend as much on control condition selection as on the experimental intervention. The aim of this paper is to present a framework for the selection and design of control conditions for these trials. Threats to internal validity arising from modern RCT methodology are reviewed and reconsidered. The strengths and weaknesses of several categories of control conditions are examined, including the ones that are under experimental control, the ones that are under the control of clinical service providers, and no-treatment controls. Considerations in the selection of control conditions are discussed and several recommendations are proposed. The aim of this paper is to begin to define principles by which control conditions can be selected or developed in a manner that can assist both investigators and grant reviewers.

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Behavioral exercise programs in the management of chronic obstructive pulmonary disease.

Cited by 143 publications

References 24 publications

Psychosocial predictors of long-term success of in-patient pulmonary rehabilitation of patients with COPD

Psychosocial predictors of long-term success of in-patient pulmonary rehabilitation of patients with COPD

Effects of psychotherapy in moderately severe COPD: a pilot study

The Selection and Design of Control Conditions for Randomized Controlled Trials of Psychological Interventions

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