The results of a recent study published in the journal Psychology & Health show that psychological factors — such as illness perception and an internal locus of control — can influence health-related quality of life for patients with chronic obstructive pulmonary disease (COPD).
“These factors should be considered when designing treatments for individuals with COPD, and adequate interventions should be provided to enhance illness understanding and self-management skills,” Ricarda Mewes, PhD, from the division of clinical psychology and psychotherapy and department of psychology at Philipps-University of Marburg in Marburg, Germany, and colleagues wrote, according to a recent news release.
Chronic obstructive pulmonary disease is characterized by progressive airflow limitations that are associated with an abnormal inflammatory response to noxious particles or gases. Severe shortness of breath and coughing result in serious physical impairment and, subsequently, a low health-related quality of life (HRQL).
The prevalence of COPD in the U.S. is estimated at around 20%, and that rate is steadily increasing. COPD was also ranked third in the global incidence of disease-related deaths in 2010 and, worldwide, is expected to become the fourth leading cause of death and the seventh leading cause of loss from disability-adjusted life in 2030.
To explore the role of psychological factors on HRQL and disability, in the study titled “Psychological predictors for health-related quality of life and disability in persons with chronic obstructive pulmonary disease (COPD),” Mewes and colleagues administered an online survey to 502 individuals with a diagnosis of COPD.
The mean age of the participants was 59.7 years, and the majority had severe COPD as rated by the Global Initiative on Obstructive Lung Disease (GOLD) staging (Stage I = 3% of enrolled patients; Stage II = 17%; Stage III = 34%; Stage IV = 46%).
As part of the survey, the participants completed the COPD Assessment Test, the SF-12, Patient Health Questionnaire, and the Brief Illness Perception Questionnaire, which evaluates beliefs about illness and health.
The investigators found high variances in questionnaire responses, with mental health-related quality of life showing the highest variance at 63% (disability comprised 56%, and physical HRQL comprised 28%). The results further revealed that better mental health, more optimistic illness perceptions, attribution to psychological causes, and a stronger internal locus of control were associated with lower disability and improved HRQL.
Based on the findings, the researches suggest healthcare providers take psychological factors into account when designing treatments for COPD patients, and include interventions that enhance illness understanding and self-management skills.