Assessment of Stress, Depressive and Anxiety Symptoms in Patients with COPD during In-Hospital Pulmonary Rehabilitation: An Observational Cohort Study

Path analysis of the effect of positive psychological capital on health-promoting lifestyle in patients with COPD after pulmonary rehabilitation: An observational study

To investigate the effect of positive psychological capital on the health-promoting lifestyle of patients with chronic obstructive pulmonary disease (COPD) and the intermediary effects of life satisfaction and learned helplessness. A total of 482 patients who completed the pulmonary rehabilitation course at the Nantong Sixth People's Hospital of Jiangsu Province were surveyed using a self-designed questionnaire battery, encompassing the positive psychological capital, health-promoting lifestyle, life satisfaction, and learned helplessness scales. A total of 469 of the 482 questionnaires distributed were effectively returned, leading to an effective response rate of 97.3%. The mean scores on the positive psychological capital, life satisfaction, learned helplessness, and health-promoting lifestyle scales were 105.56 ± 10.44, 19.89 ± 6.33, 50.14 ± 5.47, and 104.22 ± 10.44, respectively. The structural equation model demonstrated good fit indexes. The path analysis revealed that positive psychological capital had a direct effect of 0.431 on health-promoting lifestyle, while life satisfaction and learned helplessness had a mediating effect on this relationship (both P < .05). Patients with COPD have low levels of positive psychological capital and health-promoting lifestyle. Thus, addressing psychological problems and providing continuous rehabilitation nursing to strengthen the psychological construct are essential in this patient group. Moreover, the positive psychological capital of patients with COPD can directly predict their health-promoting lifestyle and exert an influence via the chain mediating effect of life satisfaction and learned helplessness. Therefore, clinical medical staff should assess the positive psychological capital of patients with COPD and adjust the daily rehabilitation activities according to the patients' mental state. Furthermore, enhancing the patients' life satisfaction by employing diverse strategies to reduce learned helplessness can notably improve the health-promoting lifestyle of those with COPD.

Analysis of the relationship between perceived stress level and death anxiety in individuals with COPD

OBJECTIVES

The study aimed to investigate the relationship between perceived stress level and death anxiety in individuals with COPD.

METHOD

It was planned with a descriptive and relational screening design. It was carried out with the participation of 132 patients diagnosed with COPD. The study data were collected through Patient Information Form, Perceived Stress Scale, and Death Anxiety Scale. Descriptive statistics and multiple regression analysis were used in data analysis.

RESULTS

The COPD patients' total perceived stress scale and perceived insufficient self-efficacy and perceived stress/distress subscale mean scores were found as 32.75 ± 5.32, 15.81 ± 3.60, and 16.93 ± 2.97, respectively. The patients' Anxiety total scale mean score was determined to be 6.96 ± 3.40. A positive and statistically significant relationship was found between COPD patients' Perceived Stress total scale mean score and their Death Anxiety Scale mean score (F = 4.332, p < 0.05).

CONCLUSION

Perceived stress level of COPD patients was found to be at a high level, while their death anxiety level was determined as moderate. It was also determined that as perceived stress levels of the patients increased, their death anxiety levels also increased.

Proprietary Model of Qualification for In-Hospital Rehabilitation after COVID-19

BACKGROUND

Since the beginning of the SARS-CoV-2 epidemic in Poland, 6,128,006 people have been diagnosed, of which 116,798 died. Patients who recovered from COVID-19 and require rehabilitation due to varied impairments should be provided an opportunity to participate in an individualized, complex rehabilitation program starting from acute care and being continued in the post-acute and long-term rehabilitation phase. It is recommended to offer out-patient and in-hospital rehabilitation procedures depending on the type and persistence of symptoms and dysfunctions. The aim of this paper is to present the qualification process of post-COVID19 patients for an in-hospital complex rehabilitation program developed on the basis of pulmonary physical therapy.

METHODS

The presented qualification program was developed on the basis of clinical experience of over 2000 patients participating in the pilot program of in-hospital rehabilitation launched in September 2020 and based on the Regulation of the Polish Minister of Health of 13 July 2020.

RESULTS

The proposed model of patients' qualification rests on well-known and validated tools for functional assessment: exercise tolerance assessment, dyspnea intensity assessment, functional fitness assessment, assessment of arterial blood saturation, lung ventilation function assessment, assessment of long-lasting COVID-19 symptoms, and patient's basic mental health condition.

CONCLUSIONS

The proposed qualification model for the post-COVID rehabilitation program allows us to introduce adequate qualifications followed by much needed assessment of the health effects.

The Relationship Between Hospitalization Frequency of Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Anxiety and Depression

Depression and anxiety are common in patients with COPD (chronic obstructive pulmonary disease), and anxiety and depression can increase the risk of hospitalization and the acute exacerbation of chronic obstructive pulmonary disease. The relationship between the frequency of hospitalization for acute exacerbation of COPD (AECOPD) and the anxiety and depression of patients is not fully understood. This study aims to analyze the relationship between the frequency of hospitalizations and anxiety and depression of patients of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). A collection of 309 AECOPD patients admitted to the emergency department in our hospital from 2019 to 2020 were divided into anxiety group A and depression group D according to the Hospital Anxiety and Depression Scale (HADS) score and divided into A1 and D1 negative groups (≤7 Score), A2 and D2 suspicious groups (8-10 points), A3 and D3 confirmed groups (≥11 points) for paired analysis of anxiety and depression correlation and difference and comparison of the frequency of hospitalization in each group within 2 years. The results found that anxiety and depression were significantly positively correlated (r = 0.654, p = 0.000). Intra-group comparison shows that the difference between the anxiety-diagnosed and non-diagnosed groups and the depression subgroups are statistically p < 0.05; the comparison between the anxiety subgroup and the depression subgroup showed that there was a statistical difference between the confirmed group and the non-diagnosed group (p < 0.01). In short, AECOPD anxiety is positively correlated with depression, and depression is affected by the frequency of hospitalization earlier and gradually, and anxiety should be prioritized in the acute phase.

Effect of Singing on Symptoms in Stable COPD: A Systematic Review and Meta-Analysis

Background

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease which feature is progressive airflow obstruction. Singing is a popular and convenient activity that requires people to manage their lung volumes and airflow actively. Despite the well-known benefits of singing to healthy people, the specific effect still remains unclear.

Objective

To investigate the mental and psychological benefits of singing in patients with stable COPD.

Search Methods

We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) on randomized controlled trials (RCTs) including singing exercise as the main intervention in stable COPD. We searched 8 electronic databases, including Web of Science, PubMed, Embase, Cochrane Library, Clinical Trials.gov, and the Physical Therapy Evidence Database (PEDro), CNKI, and Wanfang Database from inception until May 2022. The searching languages was English or Chinese. Data extraction using standardized templates was performed by two independent reviewers. The quality of the studies was assessed using the PEDro scale. Data synthesis was performed with Revman 5.4. The pooled effect sizes are reported by MD and 95% CI.

Results

Five RCTs involving 333 patients with stable COPD were included in this meta-analysis. Singing was regarded as the main intervention in the experimental group. Meta-analysis revealed that singing improves quality of life on Short Form 36 physical component summary (SF-36 PCS) (MD = 12.63, 95% CI: 5.52 to 19.73, P < 0.01) and respiratory muscle in maximal expiratory pressure (PE_max) (MD = 14.30, 95% CI: 0.87 to 27.73, P = 0.04) in patients with COPD. However, it has limited effects on Short Form 36 mental component summary (SF-36 MCS), lung function, exercise capability, and adverse mental state.

Conclusion

Based on results of the meta-analysis, singing could be used to improve quality of life (SF-36 PCS) and respiratory muscles (PE_max) in patients with COPD.

Resilience and Subjectively Experienced Stress Among Paramedics Prior to and During the COVID-19 Pandemic

INTRODUCTION

Paramedics play a vital role in the healthcare system by providing professional support in situations of direct threat to patient health and life. They experience numerous difficulties during their work, which result in occupational stress. During the COVID-19 pandemic, their work has become even more demanding. The aim of the current study was to examine the role of resilience in the subjective experience of stress among paramedics during the COVID-19 pandemic.

MATERIALS AND METHODS

The study was carried out in two phases, in October-November 2019 (N = 75) and in May-June 2020 (N = 84), using the Sense of Stress Questionnaire (Skala Poczucia Stresu) and the Resilience Scale (Skala Pomiaru Prężności).

RESULTS

Paramedics exhibited higher intrapsychic stress before the COVID-19 pandemic. Tolerance of failure and treating life as a challenge were higher during the pandemic, in contrast to optimism and the ability to mobilize in difficult situations. Paramedics who were in contact with patients with COVID-19 experienced higher stress. Perseverance and determination, openness to new experiences and sense of humor, as well as competences and tolerance of negative emotions were revealed to play a key part in mitigating subjectively experienced stress.

CONCLUSION

Paramedics' subjectively experienced stress was lower during the COVID-19 pandemic. Paramedics who were in direct contact with patients with COVID-19 experienced higher stress. They had sufficient psychological resources, in the form of resilience (perseverance and determination, openness to new experiences, sense of humor, and competences and tolerance of negative emotions), which allowed them to cope with the situation of the COVID-19 pandemic.