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Efficacy of a minimal home-based psychoeducative intervention versus usual care for managing anxiety and dyspnoea in patients with severe chronic obstructive pulmonary disease: a randomised controlled trial protocol.

Bove DG, Overgaard D, Lomborg K, Lindhardt BØ, Midtgaard J - BMJ Open (2015)

Bottom Line: Anxiety is associated with an impaired quality of life and increased hospital admissions.Untreated comorbid anxiety can have devastating consequences for both patients and their relatives.The intervention is based on a manual, with a theoretical foundation in cognitive-behavioural therapy and psychoeducation.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital, Nordsjælland, Hillerød, Denmark.

No MeSH data available.


Related in: MedlinePlus

Cognitive model, negative circle.
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BMJOPEN2015008031F2: Cognitive model, negative circle.

Mentions: The goal of the psychoeducative intervention is that patients learn to interpret and react to physical and psychological symptoms that are related to dyspnoea and associated anxiety. The intervention is theoretically based on a patient-centred approach and a holistic view of the patient that focuses on handling of life with COPD, including managing anxiety and dyspnoea.40 The intervention has a planned duration of approximately 1 h, and occurs in the patient's home with or without the presence of a spouse and/or informal caregiver. The primary investigator (PI), who is a trained nurse, is responsible for delivering the psychoeducative intervention. To ensure that the intervention is transparent and can be replicated, it is based on a manual that was inspired by CBT as described by Aaron Beck.41–43 The intervention is based on the cognitive model, which is illustrated as a negative (figure 2) and positive (figure 3) circle. This model illustrates the interaction between thoughts, emotions, bodily sensations and behaviours; therefore, it is suitable for examining anxiety-related situations. The purpose is to help and guide the patient to restructure unfavourable thoughts and behaviour patterns that are related to dyspnoea, thereby changing interpretations of critical situations, as exemplified in figures 2 and 3. The dialogue is based on Socratic questioning, in which the PI is curious and asks open-ended questions about the patients’ interpretations of dyspnoea and anxiety situations. The PI explores the patient's feelings, cognitions, behaviours and bodily sensations in relation to situations with dyspnoea by asking questions that include: try to describe what you think when you experience breathlessness? This is followed by questions such as which emotions did that trigger? What happened in your body and what did that make you feel? Is it possible that you could interpret it in a different way? The purpose of this approach is to challenge the way that patients interpret situations which should help to change inappropriate patterns of thoughts, behaviours, emotions and bodily sensations (ie, cognitive restructuring). To enhance the patient's management of dyspnoea in acute and stable phases of the illness, breathing strategies were included in the psychoeducative intervention. The breathing strategies consisted of two techniques: pursed lip and diaphragmatic breathing (figure 4). Patients are encouraged to practise these techniques twice a day.


Efficacy of a minimal home-based psychoeducative intervention versus usual care for managing anxiety and dyspnoea in patients with severe chronic obstructive pulmonary disease: a randomised controlled trial protocol.

Bove DG, Overgaard D, Lomborg K, Lindhardt BØ, Midtgaard J - BMJ Open (2015)

Cognitive model, negative circle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499678&req=5

BMJOPEN2015008031F2: Cognitive model, negative circle.
Mentions: The goal of the psychoeducative intervention is that patients learn to interpret and react to physical and psychological symptoms that are related to dyspnoea and associated anxiety. The intervention is theoretically based on a patient-centred approach and a holistic view of the patient that focuses on handling of life with COPD, including managing anxiety and dyspnoea.40 The intervention has a planned duration of approximately 1 h, and occurs in the patient's home with or without the presence of a spouse and/or informal caregiver. The primary investigator (PI), who is a trained nurse, is responsible for delivering the psychoeducative intervention. To ensure that the intervention is transparent and can be replicated, it is based on a manual that was inspired by CBT as described by Aaron Beck.41–43 The intervention is based on the cognitive model, which is illustrated as a negative (figure 2) and positive (figure 3) circle. This model illustrates the interaction between thoughts, emotions, bodily sensations and behaviours; therefore, it is suitable for examining anxiety-related situations. The purpose is to help and guide the patient to restructure unfavourable thoughts and behaviour patterns that are related to dyspnoea, thereby changing interpretations of critical situations, as exemplified in figures 2 and 3. The dialogue is based on Socratic questioning, in which the PI is curious and asks open-ended questions about the patients’ interpretations of dyspnoea and anxiety situations. The PI explores the patient's feelings, cognitions, behaviours and bodily sensations in relation to situations with dyspnoea by asking questions that include: try to describe what you think when you experience breathlessness? This is followed by questions such as which emotions did that trigger? What happened in your body and what did that make you feel? Is it possible that you could interpret it in a different way? The purpose of this approach is to challenge the way that patients interpret situations which should help to change inappropriate patterns of thoughts, behaviours, emotions and bodily sensations (ie, cognitive restructuring). To enhance the patient's management of dyspnoea in acute and stable phases of the illness, breathing strategies were included in the psychoeducative intervention. The breathing strategies consisted of two techniques: pursed lip and diaphragmatic breathing (figure 4). Patients are encouraged to practise these techniques twice a day.

Bottom Line: Anxiety is associated with an impaired quality of life and increased hospital admissions.Untreated comorbid anxiety can have devastating consequences for both patients and their relatives.The intervention is based on a manual, with a theoretical foundation in cognitive-behavioural therapy and psychoeducation.

View Article: PubMed Central - PubMed

Affiliation: Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital, Nordsjælland, Hillerød, Denmark.

No MeSH data available.


Related in: MedlinePlus