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Dyspnea perception in COPD: Association between anxiety, dyspnea-related fear and dyspnea in a pulmonary rehabilitation program.
MedLine Citation:
PMID:  21493698     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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 effects of baseline anxiety and dyspnea-related fear on perceived dyspnea and other outcomes of a well-established pulmonary rehabilitation program for COPD. RESULTS: 73 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-minute 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 persons with higher baseline dyspnea-related fear may act as a correction of excessive symptom reports through exposure to dyspneic situations.
Authors:
Thomas Janssens; Steven De Peuter; Linda Stans; Geert Verleden; Thierry Troosters; Marc Decramer; Omer Van den Bergh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-14
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aResearch Group Health Psychology, Department of Psychology, University of Leuven, Belgium.
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