A preliminary evaluation of a 6 week Anxiety Management Group for patients with Chronic Obstructive Pulmonary Disease (COPD)

Main Article Content

Nenna Ndukwe


Rationale, aims and objectives: Anxiety associated with breathlessness occurs at a high rate in people with chronic obstructive pulmonary disease (COPD), yet few clinical studies have examined the usefulness of psychological intervention to manage anxiety in this population. To address this issue a six week anxiety management group for patients with COPD was established in a UK hospital. This article describes an evaluation of the group. The purpose of evaluation was to obtain feedback from patients (n=12) about the usefulness of the group to manage anxiety associated with breathlessness.Method: Evaluation data included a self-devised audit tool, the hospital anxiety and depression scale (HADS), patient self report and an evaluation form.Results: COPD patients are often frightened by their experience of breathlessness. The anxiety management group helped patients understand the link between breathlessness and anxiety. They also reported gains in their psychological knowledge of anxiety, maintaining factors and management strategies.Conclusions: The evaluation has shown that clinical care of COPD patients can be enhanced through psychological and patient centred interventions. Clinical practice can be improved further by seeking ways to maximise patient attendance and routinely consulting with service users about aspects of their care.

Article Details

Person-centered care and chronic disease


National Collaborating Centre for Chronic Conditions (2004). Chronic obstructive pulmonary disease. National clinical guideline on management of chronic pulmonary disease in adults in primary care. Thorax, 59 (Supplement 1), 1-232.

Hill, K., Geist, R., Goldstein, R.S. & Lacasse, Y. (2008). Anxiety and depression in end-stage COPD. European Respiratory Journal 31, 667-677.

Maurer, J., Rebbapragada, V., Borson, S., Goldstein, R., Kunik, M., Yohannes, A. & Hanania, N. (2008). Anxiety and depression in COPD. Current understanding, unanswered questions, and research needs. Chest 134 (4), 43S-56S.

Heslop, A., De Soyza, A., Baker, C.R. & Stenton. C. (2009). Using individualised cognitive behaviour therapy as a treatment for people with COPD. Nursing Times 105 (14), 14-17.

Kunik, M.E., Veasy, C., Cully, J.A., Souchek, J., Graham, D.P. & Hopko, D. (2008). COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial. Psychological Medicine 38 (3), 385–396.

Johnston, G., Crombie, I.K., Davies, H.T.O., Alder, E.M. & Millard, A. (2000). Quality in Health Care 9, 23-26.

DHSSPS clinical psychology specialty advisory committee, (2004). Developing psychological services for adults with chronic obstructive pulmonary disease (COPD). A consultation document. The British Psychological Society.

Brenes, G.A. (2003). Anxiety and chronic obstructive pulmonary disease: prevalence, impact and treatment. Psychosomatic Medicine 65, 963-970.

Rose, C., Wallace, L., Dickson, R., Ayres, J., Lehman, R., Searle, Y. & Sherwood Burge, P. (2002). The most effective psychologically-based treatments to reduce anxiety and panic in patients with chronic obstructive pulmonary disease (COPD): A systematic review. Patient Education and Counselling 47, 311-318.

Zigmund, A. & Snaith, R. (1993). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67, 361-370.

Bailey, P.H. (2004). The dyspnea-anxiety-dyspnea cycle- COPD patients’ stories of breathlessness: “It’s scary/when you can’t breathe.” Qualitative Health Research 14, 760-778.

Gurney-Smith, B., Cooper, M.J. & Wallace, L.M. (2002). Anxiety and panic in chronic obstructive pulmonary disease: the role of catastrophic thoughts. Cognitive Therapy and Research, 26 (1), 143-155.

Gysels, M.H. (2009). Self management for breathlessness in COPD. The role of pulmonary rehabilitation. Chronic Respiratory Disease 6 (3), 133-140.

Bedi, G. (2004). Coping with COPD-can psychology help? GASP! 1 (6), 1-2.

Louie, S.W-S (2004). The effects of guided imagery relaxation in people with COPD. Occupational Therapy International 11 (3), 145-159.

Clarke, D. (1986). A cognitive approach to panic. Behaviour Research and Therapy 14, 461-470.

George, A. & Rubin, G. (2005). Non-attendance in general practice: a systematic review and its implications for access to primary health care. Family Practice 20 (2),178-184.

Yohannes, A.M., Baldwin, R.C. & Connolly, M.J. (2006). Depression and anxiety in elderly patients with chronic obstructive pulmonary disease. Age and Ageing Editorial 35 (5), 457-459.