Paper
Saturday, 22 July 2006
This presentation is part of : Care Models and Programs for the Chronically Ill
Differences in Functional Performance, Well-Being, and Coping Resources Based on Level of Anxiety and Depression Symptomatology in COPD Patients
Mary Patricia Wall, PhD, RN, BC, School of Nursing, University of Louisville, Louisville, KY, USA
Learning Objective #1: explain two research findings that support implementation of the U.S. Preventive Services Task Force recommendations on screening for depression in adults
Learning Objective #2: explain the implications of the research findings for primary care, acute care, and long-term care settings
Purpose: These analyses tested the hypothesis that COPD patients would report different levels of functional performance, well being, and coping resources based on their level of anxiety symptomatology or depression symptomatology. Method: Participants (n = 119, 68.17 ± 8.48 years, 53.8% male) were recruited through a pulmonary medicine practice and completed a battery of self-report instruments. Pulmonary function data were obtained through medical record review. The mean FEV1 % predicted (47.71) indicated severe pulmonary disease. Scores of 8 or greater on the Hospital Anxiety and Depression Scale (HADS) Anxiety and Depression subscales indicated higher incidence of anxiety and depression symptoms, respectively. Data analysis strategies included independent t tests and Mann-Whitney tests. Findings: Participants, as a group, did not exhibit high levels of anxiety or depression symptoms. However, participants exhibiting higher incidence of anxiety symptomatology reported worse functional performance, less social support, less mastery, less happiness, less life satisfaction, and greater depressive symptomatology than those with lower incidence. Participants exhibiting higher incidence of depressive symptomatology reported an identical pattern of results, including greater anxiety symptomatology (p < .025 for all analyses). The severity of pulmonary disease was similar for both groups in all analyses. Discussion: The HADS is not diagnostic for psychiatric pathology. These results clearly illustrate, however, the negative influence of higher levels of anxiety and depression symptomatology on functional performance, well being, and coping resources in this sample. These findings support the implementation of the U.S. Preventive Services Task Force recommendations on screening for depression in adults. Longitudinal studies of COPD patients may identify the point in the illness trajectory at which anxiety and depression symptoms initially influence functional performance, well being, and coping resources.

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