Abstract
Patients undergoing PR may frequently have anxiety and depression, cognitive dysfunction and often need an educational approach to their respiratory disorder. We determined psychological symptoms, cognitive status and educational proficiency in patients with COPD and evaluated if a PsychInt inside a PR program is associated with changes in emotional status. Sixty COPD patients (66±10 years, 35 men, 46 retired and 52 with a medium-low educational level) consecutively admitted for the first time to our in-patient PR Dept. were evaluated on admission (Adm) and discharge (Dch) by means of different validated questionnaires: MOCA (cognitive dysfunction), HADS (anxiety and depression), EQ-5D (quality of life, QoL) and an educational questionnaire (Paneroni M et al. Respir Care 2013; 58:327-333). PsychInt consisted in support individual interviews and counseling, training of relaxation groups, educational programme. After PR we observed a significant improvement in anxiety (Adm 50% of patients with an anxiety score vs. Dch 20%, p=0.01). Similar data were present for depression (63% vs. 40%, p=0.03). QoL improved significantly (59.6 vs 71.0, p=0.01). No change was observed for the MOCA questionnaire (%positive score 63.3 vs. 61.7) and for the Educational Questionnaire (% of corrected answers 76.5 vs. 79.8). A structured PsychInt during a PR program can effectively ameliorate anxiety, depression and QoL. Cognitive dysfunction is a real issue in PR patients and obviously PsychInt is not able to induce changes on it. Educational activities are integral part of a PR program and should be evaluated by means of specific questionnaires.
- © 2014 ERS