Format

Send to

Choose Destination
Chest. 2011 Sep;140(3):618-625. doi: 10.1378/chest.10-3257. Epub 2011 Apr 14.

Dyspnea perception in COPD: association between anxiety, dyspnea-related fear, and dyspnea in a pulmonary rehabilitation program.

Author information

1
Research Group Health Psychology, Department of Psychology, University of Leuven, Leuven, Belgium.
2
Pneumology Department, University of Leuven, Leuven, Belgium.
3
Pneumology Department, University of Leuven, Leuven, Belgium; Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Leuven, Belgium.
4
Research Group Health Psychology, Department of Psychology, University of Leuven, Leuven, Belgium. Electronic address: omer.vandenbergh@psy.kuleuven.be.

Abstract

BACKGROUND:

A growing body of research connects anxiety with poorer outcomes in COPD. However, more specific measures of dyspnea-related fear may be more closely related to critical processes involved in pulmonary rehabilitation (perception of dyspnea and avoidance of physical activity) and may have a predictive value for COPD outcome beyond general anxiety measures.

METHODS:

In this naturalistic outcome study, we investigated the effects of baseline anxiety and dyspnea-related fear on perceived dyspnea and other outcomes of a well-established pulmonary rehabilitation program for COPD.

RESULTS:

Seventy-three patients participated in the study. At baseline, higher dyspnea-related fear was associated with higher levels of dyspnea during ergometer exercise, but also with a steeper decrease of exercise dyspnea during the course of pulmonary rehabilitation, whereas lower dyspnea-related fear was associated with an increase in exercise dyspnea, even when controlling for anxiety, lung function, and exercise intensity. Furthermore, higher dyspnea-related fear was associated with reduced quality of life (mastery subscale) and maximal exercise capacity at baseline, but also with a steeper increase in quality of life (emotions and mastery subscale) and exercise capacity during rehabilitation. However, the association of dyspnea-related fear with worse 6-min walking distance and impairment in daily activities persisted throughout rehabilitation.

CONCLUSIONS:

Results indicate a mediating effect of dyspnea-related fear on the association between anxiety and exercise-related dyspnea. Exercise in pulmonary rehabilitation in people with higher baseline dyspnea-related fear may act as a correction of excessive symptom reports through exposure to dyspneic situations.

PMID:
21493698
DOI:
10.1378/chest.10-3257
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center