title: Differences in change in coping styles between good responders, moderate responders and non-responders to pulmonary rehabilitation.
abstract: BACKGROUND
  Pulmonary rehabilitation (PR) improves exercise tolerance and health status in patients with chronic obstructive pulmonary disease (COPD). Data on the effects of PR on coping styles are limited. Aim of the present study was to compare changes in coping styles between patients who had a good, moderate and no improvement in either exercise tolerance or health status after PR.
  
  
  METHODS
  Coping styles of 439 COPD patients undergoing PR were assessed by the Utrecht Coping List (UCL) at baseline and after PR. Patients' pulmonary function, six-minute walking distance (6MWD), St. George's Respiratory Questionnaire (SGRQ) and Hospital Anxiety and Depression Scale (HADS-A and HADS-D) were recorded. Good, moderate and non-responders were defined on the basis of minimally clinically important difference (MCID) for SGRQ total score and/or 6MWD.
  
  
  RESULTS
  Overall, 54.0% of the patients fulfilled the criteria for good responders, while 22.1% were moderate responders. Change in passive reaction pattern coping style differed significantly between good responders and non-responders following PR (p < 0.001). Moreover, within the groups, changes in coping styles after PR occurred among the good responders, whereas the majority of moderate responders' and non-responders' coping styles were not significantly influenced by PR.
  
  
  CONCLUSIONS
  Good responders decreased their passive reaction pattern coping style in contrast to non-responders after PR. In general, PR did not change the coping among moderate and non-responders. Further research is warranted to determine whether including interventions targeting coping styles may modify coping behaviour of COPD patients, as well as improvement in exercise tolerance or health status after PR.
authors.affiliation: Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), PO Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: a.stoilkova@maastrichtuniversity.nl.
authors.forename: Ana
authors.initials: A
authors.lastname: Stoilkova-Hartmann
authors.affiliation: Department of Research & Education, CIRO, Centre of Expertise for Chronic Organ Failure, Hornerheide 1, 6085 NM Horn, The Netherlands; Centre of Expertise for Palliative Care, Maastricht University Medical Centre+ (MUMC+), PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Daisy J A
authors.initials: DJ
authors.lastname: Janssen
authors.affiliation: Department of Research & Education, CIRO, Centre of Expertise for Chronic Organ Failure, Hornerheide 1, 6085 NM Horn, The Netherlands.
authors.forename: Frits M E
authors.initials: FM
authors.lastname: Franssen
authors.affiliation: Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), PO Box 616, 6200 MD Maastricht, The Netherlands; Department of Research & Education, CIRO, Centre of Expertise for Chronic Organ Failure, Hornerheide 1, 6085 NM Horn, The Netherlands.
authors.forename: Emiel F M
authors.initials: EF
authors.lastname: Wouters
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D005081:Exercise Therapy / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006304:Health Status; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D012189:Retrospective Studies; D012648:Self Care / Q000379:methods; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology
keywords: Chronic obstructive pulmonary disease; Coping styles; Disease-specific health status; Exercise tolerance; Pulmonary rehabilitation; Self-management