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Dissertation

Brief cognitive-behavioral intervention for chronic obstructive pulmonary disease patients: A program development and evaluation plan

15 December 1995

Abstract

Chronic obstructive pulmonary disease (COPD) is a serious, debilitating medical problem in which the patient's breathing capacity is compromised. It may be accompanied by distressing psychological problems, such as depression or anxiety. Health care providers have attempted to assist COPD patients in managing their disease and improving their quality of life by providing education and rehabilitation groups. In today's changing health care environment, with its emphasis on more efficient and effective treatment interventions, these groups at one veterans hospital are comprised of brief presentations from various disciplines, including psychology. The program developed here is intended to provide consistent psychological interventions for use in these groups. An evaluation plan provides for the measurement and analysis of outcome results to determine the effectiveness of the program. For the evaluation, this project is designed as a two group study, with one group receiving the cognitive-behavioral treatment and the other group receiving supportive group treatment. To determine if equivalency exists between the treatment conditions, the plan includes analysis of two nonspecific treatment effect variables, credibility and expectancy, with separate one-way analyses of variance (ANOVA). Prior to and immediately following the group sessions, all participants are to complete self-report measures of symptoms of depression, symptoms of anxiety, and knowledge of the psychological aspects of COPD. Depression, anxiety, and knowledge are each to be analyzed for differences in pre- and post-treatment levels using analyses of covariance (ANCOVA). Possible outcomes of this evaluation are discussed, along with their potential value and associated clinical implications. The discussion concludes that, regardless of the degree of success of this specific intervention plan, the evaluation will provide valuable information and recommendations for improving the quality of life of COPD patients.


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