Caring for the chronically ill patient: understanding how fear leads to activity avoidance in individuals with chronic respiratory disease.

  • Sarah Miller University of Memphis Loewenberg School of Nursing
Keywords: respiratory disease, fear of dyspnea, activity avoidance, respiratory hyperperception, chronic respiratory disease

Abstract

The likelihood of taking preventative health actions, such as engagement in physical activity, is affected by individual motivation along with the perceived threat of existing disease. Chronic respiratory disease enhances perceived threat of activity-induced dyspnea and alters the perception of barriers to preventative action. This leads to decreased likelihood of taking the recommended positive health action and engaging in physical activity. Resulting behavior instead is focused on avoidance of disease exacerbation in the form of activity avoidance.

Author Biography

Sarah Miller, University of Memphis Loewenberg School of Nursing

Assistant Professor

Loewenberg School of Nursing

References

Abdool-Gaffar MS, Ambaram A, Ainslie GM, Bolliger CT, Feldman C, Geffen L, Irusen EM, et al. (2011) Guideline for the management of chronic obstructive pulmonary disease--update. S Afr Med J. Jan;101(1 Pt 2):63-73.

Alexander-Miller S, Davenport PW. (2010). Perception of multiple-breath inspiratory resistive loads in males and females. Biol Psychol. 84(1):147-9.

Anderson, Charles & Johnson (2003). The impressive psychology paper. Chicago: Lucerne Publishing.

American Lung Association (2011). Chronic Obstructive Pulmonary Disease: Fact Sheet.

American Thoracic Society. (1999) Pulmonary rehabilitation: official statement of the American Thoracic Society. Am J Respir Crit Care Med, 159:1666–82.

Barnett SB, Nurmagambetov TA. (2011). Costs of Asthma in the Unites States: 2002-2007. Journal of Allergy and Clinical Immunology. 127:145-52.

Bouton et al., 2001M.E. Bouton, S. Mineka, D.H. Barlow. (2001). A modern learning theory perspective on the etiology of panic disorder. Psychol. Bull., 108, pp. 4–32.

Buist AS, McBurnie MA, Vollmer WM, et al. (2007). International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet. 370:741-50.

Bundgaard A. (1985). Exercise and the asthmatic. Sports Med. 2(4), 254-66.

Burki, N. K., Davenport, P. W., Safdar, F., & Zechman, F. W. (1983). The effects of airway anesthesia on magnitude estimation of added inspiratory resistive and elastic loads. Am Rev Respir Dis, 127, 2-4.

Centers for Disease Control and Prevention. National Center for Health Statistics. Final Vital Statistics Report. Deaths: Final Data for 2007. Vol. 58, No. 19, May 2010.

Casaburi R , Porszasz J, Burns MR, et al. (1997) Physiologic benefits of exercise training in rehabilitation of patients with severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med;155:1541–51.

Centers for Disease Control and Prevention. National Center for Health Statistics. Final Vital Statistics Report. Deaths: Final Data for 2007. Vol. 58, No. 19, May 2010.

Cockroft AE. Randomised controlled trial of rehabilitation in chronic respiratory disability. Thorax 1981;36:200-3.

COPD Guidelines Group of the Standards of Care Committee of the BTS (1997). BTS guidelines for the management of chronic obstructive pulmonary disease. Thorax 52 (Suppl 5) :S1–28.

Cox NMJ (1990). Effects of a pulmonary rehabilitation program in patients with chronic obstructive lung diseases (in comparison with a control group). Dissertation, Meppel, Krips Repro.

Davenport PW, Vovk A. (2009) Cortical and subcortical central neural pathways in respiratory sensations. Respir Physiol Neurobiol. May 30;167(1):72-86.

Emery CF, Leatherman NE, Burker EJ, Maclntyre NR. (1999) Psychological outcomes of a pulmonary rehabilitation program. Chest;100:613-7.

Eves ND, Davidson WJ. (2011). Evidence-based risk assessment and recommendations for physical activity clearance: respiratory disease. Appl Physiol Nutr Metab 36:S80-100.

Garcia-Aymerich J, Lange P, Benet M, Schnohr P, & Antó JM. (2007). Correspondence: Does Regular Physical Activity Reduce Lung Function Decline and COPD Risk among Smokers? American Journal of Respiratory and Critical Care Medicine. 176:314-5.

Holman H, Lorig K.(2000) Patients as partners in managing chronic disease. Partnership is a prerequisite for effective and efficient health care. BMJ. 26;320(7234):526-7.

Jones PW. (2007) Activity limitation and quality of life in COPD. COPD. 4:273-8.

Ketelaars CA, Schlösser MA, Mostert R, Huyer Abu-Saad H, Halfens RJ, Wouters EF (1996). Determinants of health-related quality of life in patients with chronic obstructive pulmonary disease. Thorax. Jan;51(1):39-43.

Killian KJ, Mahutte CK, Howell JB, Campbell EJ. (1980) Effect of timing, flow, lung volume, and threshold pressures on resistive load detection. J Appl Physiol. Dec;49(6):958-63.

McGavin CR, Gupta SP, Loyd EL, McHardy GJR. (1977). Physical rehabilitation for the chronic bronchitic: results of a controlled trial of exercise in the home. Thorax. 32: 307-11.

McNally, R.J. (2002). Anxiety sensitivity and panic disorder. Biol. Psychiatry, 52 (2002), pp. 938–946

Nardi AE, Freire RC, Zin WA. (2009). Panic disorder and control of breathing. Respir Physiol Neurobiol. May 30;167(1):133-43.

Niederman MS, Henderson Clemente P, Fein AM, Feinsilver SH, Robinson DA, Ilowite JS, et al. Benefits of a multidisciplinary pulmonary rehabilitation program. Chest 1991;99:798-804.

Nishimura K, Oga T, Ikeda A, Hajiro T, Tsukino M, Koyama H. (2008). Comparison of health-related quality of life measurements using a single value in patients with asthma and chronic obstructive pulmonary disease. J Asthma. Sep;45(7):615-20.

Ofir D, Laveneziana P, Webb KA, et al. (2008). Mechanisms of dyspnea during cycle exercise in symptomatic patients with GOLD stage I chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 177:622

Pappens M, Smets E, Vansteenwegen D, Van Den Bergh O, Van Diest I. (2012) Learning to fear suffocation: a new paradigm for interoceptive fear conditioning. Psychophysiology. 2012 Jun;49(6):821-8.

Parsons JP, Craig TJ, Stoloff SW, Hayden ML, Ostrom NK, Eid NS, Colice GL. (2011) Impact of exercise-related respiratory symptoms in adults with asthma: Exercise-Induced Bronchospasm Landmark National Survey. Allergy Asthma Proc. Nov-Dec 32(6):431-7.

Rabinovich RA, Ardite E, Troosters T, et al. (2001) Reduced muscle redox capacity after endurance training in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 164:1114–8.

Rabinovich RA, Figueras M, Ardite E, et al. (2003) Increased tumour necrosis factor-alpha plasma levels during moderate-intensity exercise in COPD patients. Eur Respir J. 21:789–94.

Schmidt, N.B., Lerew, D.R., Jackson, R.J. (1997). The role of anxiety sensitivity in the pathogenesis of panic: prospective evaluation of spontaneous panic attacks during acute stress. J. Abnorm. Psychol., 106 (1997), pp. 355–364.

Shoemaker, M, Hurt, H, & Arndt, L (2008) The Evidence Regarding Exercise Training in the Management of Cystic Fibrosis: A Systematic Review. Cardiopulm Phys Ther J. 19(3): 75–83.

Sinha S, Papp LA, Gorman JM. (2000). How study of respiratory physiology aided our understanding of abnormal brain function in panic disorder. J Affect Disord. 2000 Dec;61(3):191-200.

Thomas M, Decramer M, O'Donnell DE (2013). No room to breathe: the importance of lung hyperinflation in COPD. Prim Care Respir J. 22(1):101-11.

Tiller, J., Pain, M., & Biddle, N. (1987). Anxiety disorder and perception of inspiratory resistive loads. Chest, 91, 547-51.

U.S. Department of Health and Human Services. National Institutes of Health. National Heart Lung and Blood Institute. Morbidity and Mortality: 2009 Chartbook on Cardiovascular, Lung and Blood Diseases.

Van Den Bergh O, Kempynck P, Van De Woestijne K, Baeyens F, Eelen P. (1995) Respiratory learning and somatic complaints: a conditioning approach using CO2-enriched air inhalation. Behav Res Ther 33 (5): 517-527.

Walker J.R. and Furer, P. (2008). Interoceptive exposure in the treatment of health anxiety and hypochondriasis. J. Cogn. Psychother., 22, pp. 366–378

Weston AR, Macfarlane DJ, Hopkins WG. (1989). Physical activity of asthmatic and nonasthmatic children. J Asthma. 26(5), 279-86.

Wiley, R. L., & Zechman, F. W., Jr. (1966). Perception of added airflow resistance in humans. Respir Physiol, 2, 73-87.

Zöckler N, Rief W, Kühl K, Kenn K. (2012). COPD-specific anxiety and depressive symptoms in COPD patients. Pneumologie. 66(5):290-6.

Published
2015-02-02
Section
Medical Surgical Nursing