Psychological Flexibility in Pulmonary Rehabilitation engagement
Research type
Research Study
Full title
A mixed methods study to identify if Psychological Flexibility predicts engagement (uptake, attendance, completion) in pulmonary rehabilitation in patients admitted to hospital/ hospital at home with an acute exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD).
IRAS ID
219321
Contact name
Caroline Fernandes-James
Contact email
Sponsor organisation
North Tees and Hartlepool NHS Foundation Trust
Duration of Study in the UK
1 years, 2 months, 2 days
Research summary
Pulmonary rehabilitation an exercise and education programme reduces breathlessness, chest flare ups, hospital admissions and improves mood in Chronic Obstructive Pulmonary Disease (COPD).
Rehabilitation is offered to all patients after a COPD chest flare up however attendance is poor. Smoking, depression, disease severity, transport, lack of perceived benefit are reasons of non-attendance.
The psychological flexibility behavioural model involving acceptance, present moment attention, values identification and committed action predicted flu vaccine uptake in COPD. Those who took the vaccine were accepting of discomfort associated with the vaccine alongside its benefits. However, psychological flexibility has not been explored in relation to rehabilitation.
Using this model we are exploring if rehabilitation non-attendance results from avoidance of breathlessness,fatigue, perceived lack of ability and fear associated with exercising alongside difficulty linking rehabilitation to personal values.
This study aims to explore if psychological flexibility can predict rehabilitation engagement after a chest flare up.
Secondary research questions include: Is there a relationship between psychological flexibility and mood and quality of life at the time of a chest flare up?
What is the effect of rehabilitation on psychological flexibility?
Can psychological flexibility predict improvement following rehabilitation?100 patients with COPD chest flare ups will complete 3 short questionnaires at 3 time points during a chest flare up, before and after rehabilitation.
The Acceptance and Action Questionnaire and Engaged Living Scale (measures psychological flexibility). The Work and Social adjustment scale (measures functional impairment). Their scores will be compared with rehabilitation attendance, quality of life, breathlessness, number of flare ups and disease severity.
Audio-recordings will be conducted with 20 patients to explore the cognitive processes behind a decision to accept or decline a rehabilitation referral.
If psychological flexibility is found to predict engagement in rehabilitation this supports the development of Acceptance and Commitment therapy a new behavioural therapy in COPD.
REC name
North East - Newcastle & North Tyneside 1 Research Ethics Committee
REC reference
17/NE/0100
Date of REC Opinion
25 May 2017
REC opinion
Further Information Favourable Opinion