Association of psychological flexibility with engagement in pulmonary rehabilitation following an acute exacerbation of Chronic Obstructive Pulmonary Disease

Caroline Fernandes-James, Christopher Graham, Alan Batterham, Samantha Harrison

Research output: Contribution to journalArticle

Abstract

B. Objectives: To investigate a) the association between psychological flexibility and engagement in pulmonary rehabilitation within eight weeks following hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) b) how psychological (in)flexibility presents in this context.
B. Methods: A mixed-methods study was conducted. Psychological flexibility during an AECOPD was assessed using The Acceptance and Action Questionnaire-II (AAQ-II) (n=41) and the Engaged Living Scale (ELS) (n=40). Engagement in post-AECOPD pulmonary rehabilitation was then recorded. Twenty-three patients also participated in cognitive interviews.
B. Results: Psychological flexibility was associated with a greater chance of accepting a pulmonary rehabilitation referral following an AECOPD. Small numbers prohibited analysis on attendance or completion. An AAQ-II score of 11 translated to a 60 (37 to 82)% probability of accepting a referral to pulmonary rehabilitation and an ELS score of 73 was associated with a 68 (46 to 91)% probability of accepting. Four themes were extracted from interviews: 1. family values, 2. self as abnormal, 3. ‘can’t do anything’ versus ‘I do what I can’, 4. disability, and related emotions, as barriers to action.
B. Discussion: Randomised clinical trials are needed to evaluate interventions designed to increase psychological flexibility (i.e. Acceptance and Commitment Therapy) to support acceptance of pulmonary rehabilitation post-AECOPD.

LanguageEnglish
JournalChronic Respiratory Disease
Publication statusAccepted - 10 Sep 2019

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Chronic Obstructive Pulmonary Disease
Rehabilitation
Psychology
Lung
Acceptance and Commitment Therapy
Referral and Consultation
Interviews
Emotions
Hospitalization
Randomized Controlled Trials
Surveys and Questionnaires

Cite this

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title = "Association of psychological flexibility with engagement in pulmonary rehabilitation following an acute exacerbation of Chronic Obstructive Pulmonary Disease",
abstract = "B. Objectives: To investigate a) the association between psychological flexibility and engagement in pulmonary rehabilitation within eight weeks following hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) b) how psychological (in)flexibility presents in this context. B. Methods: A mixed-methods study was conducted. Psychological flexibility during an AECOPD was assessed using The Acceptance and Action Questionnaire-II (AAQ-II) (n=41) and the Engaged Living Scale (ELS) (n=40). Engagement in post-AECOPD pulmonary rehabilitation was then recorded. Twenty-three patients also participated in cognitive interviews.B. Results: Psychological flexibility was associated with a greater chance of accepting a pulmonary rehabilitation referral following an AECOPD. Small numbers prohibited analysis on attendance or completion. An AAQ-II score of 11 translated to a 60 (37 to 82){\%} probability of accepting a referral to pulmonary rehabilitation and an ELS score of 73 was associated with a 68 (46 to 91){\%} probability of accepting. Four themes were extracted from interviews: 1. family values, 2. self as abnormal, 3. ‘can’t do anything’ versus ‘I do what I can’, 4. disability, and related emotions, as barriers to action.B. Discussion: Randomised clinical trials are needed to evaluate interventions designed to increase psychological flexibility (i.e. Acceptance and Commitment Therapy) to support acceptance of pulmonary rehabilitation post-AECOPD.",
author = "Caroline Fernandes-James and Christopher Graham and Alan Batterham and Samantha Harrison",
year = "2019",
month = "9",
day = "10",
language = "English",
journal = "Chronic Respiratory Disease",
issn = "1479-9723",
publisher = "SAGE Publications Ltd",

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TY - JOUR

T1 - Association of psychological flexibility with engagement in pulmonary rehabilitation following an acute exacerbation of Chronic Obstructive Pulmonary Disease

AU - Fernandes-James, Caroline

AU - Graham, Christopher

AU - Batterham, Alan

AU - Harrison, Samantha

PY - 2019/9/10

Y1 - 2019/9/10

N2 - B. Objectives: To investigate a) the association between psychological flexibility and engagement in pulmonary rehabilitation within eight weeks following hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) b) how psychological (in)flexibility presents in this context. B. Methods: A mixed-methods study was conducted. Psychological flexibility during an AECOPD was assessed using The Acceptance and Action Questionnaire-II (AAQ-II) (n=41) and the Engaged Living Scale (ELS) (n=40). Engagement in post-AECOPD pulmonary rehabilitation was then recorded. Twenty-three patients also participated in cognitive interviews.B. Results: Psychological flexibility was associated with a greater chance of accepting a pulmonary rehabilitation referral following an AECOPD. Small numbers prohibited analysis on attendance or completion. An AAQ-II score of 11 translated to a 60 (37 to 82)% probability of accepting a referral to pulmonary rehabilitation and an ELS score of 73 was associated with a 68 (46 to 91)% probability of accepting. Four themes were extracted from interviews: 1. family values, 2. self as abnormal, 3. ‘can’t do anything’ versus ‘I do what I can’, 4. disability, and related emotions, as barriers to action.B. Discussion: Randomised clinical trials are needed to evaluate interventions designed to increase psychological flexibility (i.e. Acceptance and Commitment Therapy) to support acceptance of pulmonary rehabilitation post-AECOPD.

AB - B. Objectives: To investigate a) the association between psychological flexibility and engagement in pulmonary rehabilitation within eight weeks following hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) b) how psychological (in)flexibility presents in this context. B. Methods: A mixed-methods study was conducted. Psychological flexibility during an AECOPD was assessed using The Acceptance and Action Questionnaire-II (AAQ-II) (n=41) and the Engaged Living Scale (ELS) (n=40). Engagement in post-AECOPD pulmonary rehabilitation was then recorded. Twenty-three patients also participated in cognitive interviews.B. Results: Psychological flexibility was associated with a greater chance of accepting a pulmonary rehabilitation referral following an AECOPD. Small numbers prohibited analysis on attendance or completion. An AAQ-II score of 11 translated to a 60 (37 to 82)% probability of accepting a referral to pulmonary rehabilitation and an ELS score of 73 was associated with a 68 (46 to 91)% probability of accepting. Four themes were extracted from interviews: 1. family values, 2. self as abnormal, 3. ‘can’t do anything’ versus ‘I do what I can’, 4. disability, and related emotions, as barriers to action.B. Discussion: Randomised clinical trials are needed to evaluate interventions designed to increase psychological flexibility (i.e. Acceptance and Commitment Therapy) to support acceptance of pulmonary rehabilitation post-AECOPD.

M3 - Article

JO - Chronic Respiratory Disease

T2 - Chronic Respiratory Disease

JF - Chronic Respiratory Disease

SN - 1479-9723

ER -