title: With the strength to carry on.
abstract: People with chronic obstructive pulmonary disease (COPD) are affected by somatic as well as psychological symptoms such as anxiety and depression and reduced quality of life. Protective psychological factors exist which enable people to adapt successfully to disease, but research about these factors in COPD is sparse. The aim of this study was to investigate whether sense of coherence (SOC), resilience and social support are potential protective factors and thus associated with reduced levels of symptoms of anxiety and depression and lower perceived disability in people with COPD. An online study was conducted in which n = 531 participants with COPD completed questionnaires assessing protective psychological factors, anxiety and depressive symptoms (Hospital Anxiety and Depression Scale) and disease-specific disability (COPD Disability Index). Regression analyses were conducted. SOC and resilience contributed significantly to reduced levels of symptoms of anxiety and depression and to lower disease-specific disability after controlling for confounding variables and disease severity. Symptoms of anxiety and depression were most strongly predicted by SOC. This study's results indicated that SOC and resilience could represent helpful individual resources due to their protective potential helping people adjust to COPD. Limitations and implications of this study are discussed.
authors.affiliation: 1 Department of Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Keil
authors.affiliation: 1 Department of Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vaske
authors.affiliation: 2 Department of Pneumology, Allergology and Sleep Medicine, SchönKlinikBerchtesgadener Land, Schönau am Königssee, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kenn
authors.affiliation: 1 Department of Clinical Psychology and Psychotherapy, Philipps University Marburg, Marburg, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Rief
authors.affiliation: 3 Department of Clinical Clinical Psychology and Psychotherapy, University of Leipzig, Leipzig, Germany.
authors.forename: Nikola M
authors.initials: NM
authors.lastname: Stenzel
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D011788:Quality of Life; D055500:Resilience, Psychological; D060685:Sense of Coherence; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Anxiety; COPD; depression; quality of life; resilience; sense of coherence