Importance of psychosocial interventions in pulmonary rehabilitation

Abstract

Background. Depression and anxiety are considered to be the most frequent comorbidities of respiratory diseases. Shortness of breath (dyspnea) causes constant fear, limitations in daily activities, loss of social roles, avoidance and lowered quality of life. Psychosocial segment of pulmonary rehabilitation provides an ideal setting for psychological interventions to treat these important issues. We were interested in the influence of standard psychologcal interventions used in pulmonary rehabilitation program on variables - anxiety, depression, stress and quality of life in patients with chronic obstructive pulmonary diseases. Methods. In 45 subjects (22 asthma and 23 chronic obstructive pulmonary disease - COPD patients) we assessed levels of anxiety, depression, stress and quality of life, at the beginning and at the end of PR using DASS21 questionnaire and one-item quality of life (general). All patients went through standard three- week PR program. All were included in some kind of psychological support depending on their dominant problem– education, psychoeducation, cognitive-behavioral techniques, relaxation training, smoking cessation, weight reduction and/or emotional support. Findings. We found a significant decrease in depression, anxiety and stress levels (p<0.01) and a significant increase in quality of life (p<0.05) at the end of three week intervention period compared to the baseline data collected before PR. Discussion. Psychosocial support, as a part of pulmonary rehabilitation program is effective in decreasing anxiety, depression and stress levels, and in increasing quality of life. Comprehensive interdisciplinary program accentuates the importance of the whole person in disease with its biological, psychological and social characteristics.