Assessment of illness acceptance by patients with COPD and the prevalence of depression and anxiety in COPD

Abstract

BackgroundCOPD is a civilization disease. It affects up to 8%–10% of population >30 years of age. Coexistence of depression occurs in 20%–40% of patients with COPD. Depression and anxiety reduce compliance and worsen prognosis.ObjectiveThe aims of this study were to determine the degree of illness acceptance among patients with COPD, to examine the relation between disease acceptance and perceived anxiety and depression, and to verify which of the sociodemographic and clinical factors are associated with illness acceptance, anxiety, and depression.Materials and methodsThe study included 102 patients with COPD (mean age 65.8 years), hospitalized due to exacerbations. Acceptance of Illness Scale and Hospital Anxiety and Depression Scale were used. For statistical analysis, Student’s t-test and Pearson’s r correlation coefficient were carried out.ResultsThe overall illness acceptance level was moderate with a tendency toward lack of acceptance (mean 20.6, standard deviation [SD] 7.62). The overall scores were 10.2 (SD 3.32) for anxiety and 10.8 (SD 4.14) for depression, which indicate borderline or high intensity of these symptoms. Acceptance of illness was negatively correlated with the intensity of depression symptoms (r=−0.46, P<0.05). Intensity of depression was significantly associated with intensity of smoking, duration of the disease, severity of dyspnea, and living in a rural area.ConclusionEarly identification and assessment of depression and anxiety symptoms allow health care providers to offer patients at risk of depression a special medical supervision. Rapid start of antidepressant therapy may increase illness acceptance and improve prognosis among patients with COPD.

COPD patients&rsquo; self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

“…Despite the well-known limits of adherence assessment by self-report tools, which may overestimate adherence,20 between one-third and one half of our patients report difficulties in adhering to behavioral prescriptions, thus stressing the necessity to intervene specifically on these aspects. Regarding disease perception, one-third of our patients struggle with DA and adaptation as shown in previous studies 33. On the other hand, most of them report that they live in a supportive environment in line with the WHO ICF model, which stresses the necessity to assess the environmental factors, both as barriers and as facilitators, when dealing with a chronic disease such as COPD 34…”

Adaptation to illness in relation to pain perceived by patients after surgery

“…Studies from the literature do not confirm any association between age and acceptance of illness;14,25 however, Uchmanowicz et al reported an insignificantly lower acceptance of illness in older patients who had additional burdens 13. The significant negative impact of age on illness acceptance shown by our study draws attention to the fact that elderly people are worse candidates for surgical treatment than younger ones, not only in terms of worse general health condition, longer convalescence, and longer wound healing process,29 but also in terms of metal attitude to such treatment as confirmed here by their lower level of acceptance of illness.…”

Alteration of the irisin&ndash;brain-derived neurotrophic factor axis contributes to disturbance of mood in COPD patients

“…COPD, by profoundly impacting the patient’s quality of life, poses great socio-economic burden for individual patients, their families, and society 1,2. COPD primarily worsens quality of life by developing chronic, progressive dyspnea and consequent limitation of physical activity 3.…”