Impact of panic disorder upon self-management educational goals in chronic obstructive pulmonary disease?

Abstract

The rationale for introducing self-management plans for the whole chronic obstructive pulmonary disease (COPD) population is uncertain. This study's aim was to investigate whether people with panic disorder (PD), compared to non-panic-disordered (NPD), derived additional educational or psychological benefits from having a self-management plan. The 24-week prospective study followed 76 participants hospitalized with an exacerbation of COPD. Participants completed mental health questionnaires including psychological measures of self-management plan impact. Subsequently, a nurse provided education for using a self-management plan. All participants were Plan naïve irrespective of their PD status. Self-management knowledge was assessed before introducing the Plan (baseline), 1 week post discharge and at 24 weeks. At baseline 28 (37%) of participants met the criteria for PD and this group had higher scores (better knowledge) for an impending (p < 0.05) and severe exacerbation (p < 0.05) and capacity to act during a severe exacerbation (p < 0.01). No interaction effect was found between PD and NPD scores over time, indicating that the PD's knowledge did not improve or deteriorate over time relative to the NPD. Evidence was mixed regarding the Plan's psychological impact. Self-management confidence improved in both groups. Amongst the PD group, perceived control of self-management tasks increased but so did body vigilance and distress about having COPD. There is mixed evidence regarding educational and psychological benefits of COPD self-management plans for people with PD. No additional educational advantages were found for the PD group. Plans may increase confidence and control over self-management but may also increase body vigilance and distress about having COPD.