Coping and quality of life in patients awaiting lung transplantation

Abstract

Objective: Patients with end-stage lung disease (ESLD) experience significant decrements in quality of life (QOL). Although coping strategies are related to QOL in patients with ESLD, the extent to which specific native lung disease moderates this relationship is unknown.

Methods: We investigated the relationship between coping, native lung disease, and QOL among 187 patients awaiting lung transplantation, including 139 patients with chronic obstructive pulmonary disease (COPD) and 48 with cystic fibrosis (CF). Participants completed a psychosocial battery assessing psychological QOL, physical QOL, and coping strategies.

Results: For both COPD and CF patients, higher levels of Active Coping (P< .0001) and lower levels of Disengagement (P< .0001) were associated with better psychological QOL. For physical QOL, we observed a Native Disease x Coping interaction (P=.01) such that Active Coping was associated with better physical QOL in patients with COPD but not in patients with CF.

Conclusions: The relationship between coping and QOL may vary as a function of native lung disease. Patients' native disease may need to be considered in order to develop effective interventions to help patients cope successfully with ESLD.

Figure 1

The Active Coping factor was comprised of the planning, suppression of competing activities, seeking emotional social support, seeking instrumental social support, positive reinterpretation and growth, and active coping subscales from the COPE Inventory. In the plot above, a unit-weighted composite measure of psychological QOL was created by standardizing and summing scores from the GHQ, PSSS, PSS, T-STAI, S-STAI, BDI, SF-36 Psychological QOL, and PQLS Psychological QOL for each individual. Scores were adjusted for income, psychiatric medication usage, education, race, current or previous psychological treatment, and six minute walk test.

Figure 2

The Disengagement factor was comprised of the mental disengagement, behavioral disengagement, venting of negative emotions, and denial subscales from the COPE inventory. In the plot above, a unit-weighted composite measure of psychological QOL was created by standardizing and summing scores from the GHQ, PSSS, PSS, T-STAI, S-STAI, BDI, SF-36 Psychological QOL, and PQLS Psychological QOL for each individual. Scores were adjusted for income, psychiatric medication usage, education, race, current or previous psychological treatment, and six minute walk test.

Figure 3

The Active Coping factor was comprised of the planning, suppression of competing activities, seeking emotional social support, seeking instrumental social support, positive reinterpretation and growth, and active coping subscales from the COPE inventory. In the plot above, a unit-weighted composite measure of physical QOL was created by standardizing and summing scores from the SOBQ, PQLS Physical QOL, and the SF-36 Physical QOL for each individual. Scores were adjusted for income, psychiatric medication usage, education, race, current or previous psychological treatment, and six minute walk test.