Coping Patterns and Emotional Distress in Patients With Chronic Obstructive Lung Disease Who Are Undergoing Lung Transplant Evaluation

Abstract

Objectives: 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. Methods: 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. Results: 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. Conclusion: 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.

Preliminary study of the exploration patients' experiences of chronic respiratory experiences during the COVID-19 pandemic using interpretative phenomenological analysis

“…According to Gilman, severe existential fears are not kept inside us, but projected out into the world, where they can be localized and thus tamed ( Gilman, 1985 ). Soyseth et al (2020) , in their study of COPD patients with severe COPD, showed that in an extremely emotionally charged life situation, patients' withdrawal from the situation can manifest itself in the form of shifting unbearable anxiety to others ( Soyseth et al, 2020 ). This is consistent with the strong negative emotional reactions (anger, rage) that emerge in our research, which are experienced by the people concerned towards others.…”

Pretransplant Patient Education in Solid-organ Transplant: A Narrative Review

“…83,84 Emotional Support Transplant recipients face a multitude of distressing emotions and existential threats presented by their lifethreatening organ failure, and stressors related to treatment options. 15,16,85,86 These emotions may interfere with decision-making. 16,86 Therefore, pretransplant initiatives must provide emotional support and ensure they facilitate informed decision-making.…”

“…Treatment decisions are not made solely based on objective assessment of quantitative risk-benefit considerations; therefore, pretransplant education must explore and address fears, anxieties, existential concerns, and questions to support individualized, fully informed treatment decisions. 8,9,15,16 This necessitates a complex, interdisciplinary approach to pretransplant education, and the integration of the pretransplant psychosocial assessment with culturally safe and appropriate, personalized information, and professional and peer psychosocial support.…”

Do patient decision aids help people who are facing decisions about solid organ transplantation? A systematic review

“…20,21 Treatment decisions require balancing of rational and emotional assessments of benefits and risks, thus decision-making needs to address knowledge as well as individual patient concerns. 21,23,24 Patients with organ failure are not as informed as they would like about transplantation, despite being motivated to be involved in treatment decisions. [25][26][27][28][29] Patient decision aids (PDAs) are tools to communicate evidencebased information about the benefits and harms of different healthcare options.…”

“… 20 , 21 Treatment decisions require balancing of rational and emotional assessments of benefits and risks, thus decision‐making needs to address knowledge as well as individual patient concerns. 21 , 23 , 24 Patients with organ failure are not as informed as they would like about transplantation, despite being motivated to be involved in treatment decisions. 25 , 26 , 27 , 28 , 29 …”