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.