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Scand J Caring Sci. 2013 Sep;27(3):541-50. doi: 10.1111/j.1471-6712.2012.01064.x. Epub 2012 Aug 28.

Anxiety and depression following pulmonary rehabilitation.

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  • 1Department of Health Education, Stord/Haugesund University College, Haugesund, Norway.



The aim of this study was to evaluate changes and predictive factors of anxiety and depression in patients with chronic obstructive pulmonary disease (COPD) before and up to 3 months after pulmonary rehabilitation (PR).


A single group longitudinal design of patients with COPD underwent a PR programme. The measurements took place at baseline (T1: N=100), immediately before (T2: N=66), immediately after (T3: N=54) and 3 months after (T4: N=43) the programme. The programme was a 6-week outpatient programme, including education, psychosocial support and training sessions. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale, self-efficacy by the COPD self-efficacy scale, lung function by spirometry and exercise capacity by incremental shuttle walking test. Mixed effect model analyses were used.


Results showed a tendency of less anxiety and depression immediately after (T3) compared with immediately before (T2) the PR programme, but the changes were not significant. Results also showed that female reported significantly more anxiety than male (p=0.019), better exercise capacity predicted significantly less depression (p=0.049), and higher self-efficacy predicted both significantly less anxiety (p=0.001) and less depression (p=0.005).


A tendency of less anxiety and depression during the PR programme was found, but the changes were not significant. Higher level of self-efficacy and better exercise capacity are suggested to relieve anxiety and depression.

© 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.


COPD; anxiety; depression; exercise capacity; predictors; pulmonary rehabilitation; self-efficacy

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