PSYCHOSOCIAL PREDICTORS OF LONG-TERM SUCCESS OF INPATIENT PULMONARY REHABILITATION OF PATIENTS WITH COPD

Studies of the long-term outcome of pulmonary rehabilitation have meas ured quality of life (QOL) mainly as disease-specific functional impai rment, but long-term effects on overall satisfaction with health or li fe have not yet been adequately evaluated, Furthermore, the influence of personality traits on the longterm outcome of pulmonary rehabilitat ion have not so far been examined, The following questions were studie d: I) What are the short- and long-term effects of a rehabilitation pr ogramme on lung function (forced expiratory volume in one second as pe rcentage of predicted (FEV1 % pred)), on satisfaction with life (defin ed as quality of life), and on health satisfaction (HS)? 2) Are there physical or psychosocial predictors for the success of pulmonary thera py? In this prospective clinical study, baseline data (FEV1 % pred, ar terial oxygen tension (Pa,O-2, QOL, HS, dyspnoea, coping scales) were studied at entry ttl); follow-up on discharge (t2); and I yr after hos pitalization (t3) in 54 consecutive patients (mean age 64 yrs) with ch ronic obstructive pulmonary disease (COPD). Complete data were obtaine d at follow-up on 32 subjects. FEV1 % pred improved from 42% (tl) to 5 2% (t2) (p < 0.001) but dropped to 46% at t3 (t1-t3: p < 0.05), QOL im proved significantly during hospitalization hair dropped to initial le vels 1 yr after discharge, A significant increase in health satisfacti on during hospitalization was maintained at follow-up, Improvements in lung function were greater in patients with higher QOL scores an entr y; subjects with the greatest tendency to use wishful thinking as a co ping strategy had less improvement. In conclusion, the effects of pulm onary rehabilitation on lung function and health satisfaction are posi tive and enduring, Quality of life and coping have an effect on the lo ng-term outcome of pulmonary rehabilitation, probably as expressions o f patients' personality traits.