Psychological Perspectives in COPD Care

Chronic Obstructive Pulmonary Disease (COPD) is a prevalent respiratory condition that is both preventable and manageable. Common symptoms are shortness of breath, cough, and mucus production. However, the scope of symptoms actually extends beyond these respiratory manifestations. Individuals with COPD frequently face additional challenges, including psychological issues. Despite their significant influence on overall health and quality of life, these psychological aspects often go overlooked- at least by now. Could it be that the healthcare industry is starting to acknowledge the important role psychological interventions play in COPD management?

In the following, we will be focusing on the findings of a recent study that explores the implementation of psychological interventions. For the sake of completeness, we would also like to provide you with the setting of the study: The participants are not the COPD patients this time, but 20 stakeholders from various roles in the UK National Health Service, such as General Practitioners, Respiratory Specialists, and Mental Health professionals. The median healthcare tenure among these participants recruited from England and Wales was 13 years, spanning primary and secondary care, and Primary Care Mental Health. They were interviewed to explore the implementation challenges and possibilities for psychological interventions, particularly focusing on TANDEM* for individuals with COPD. The main goal that they had was to understand the factors influencing the integration of psychological care in COPD services.

We will be focusing on the four key themes that emerged in this very study, the first one being COPD and emotional distress impacting service engagement. The challenges that occur in COPD include breathlessness, reduced activity, and co-morbidities. All the mentioned aspects then cause emotional distress, which displays a negative factor in engagement due to anxiety, depression, and resistance to discussing mood. In this context, stakeholders rather emphasize the need for tailored interventions for patients with complex lives and mental health issues.

The second key theme that was revealed was resource limitations in COPD service provision. Time, which is probably the most valuable resource in all of our lives, comes across as a constraint in COPD management as well, as it poses barriers to implementing psychological interventions. As expressed by the stakeholders that participated in this study, the workload, training needs, and challenges in changing service structures still remain as concerns. However, it is possible to say that a certain optimism still exists for the integration of psychological care into routine practice.

Moving on to the third key theme, which is the importance of integrated care for patient well-being, we must start by saying that integrated care is also supported by healthcare stakeholders to reduce the number of services patients attend. The reciprocal impact of physical and psychological symptoms is recognized by their side as well, and therefore they also suggest home treatment to address barriers to attendance, emphasizing a holistic approach.

Being the last key theme that this study highlighted, we now come to the discussion whether healthcare communication is an enabler or a barrier to patient engagement. There is no doubt that effective communication is crucial for understanding psychological interventions and promoting patient engagement. It is also to be noted that communication between professionals is vital for successful provision, requiring clear explanations of services. However, it is not like this issue does not come with its concern: Let us mention a few aspects of communication which also have sides that rather create concern. Home visits for instance are valued for accessibility but face concerns about cost and viability in dispersed regions. Other than that, delivering psychological interventions empowers respiratory professionals, but not all may be willing, making supervision and competence assessments essential. Nonetheless, the fact that effective communication is crucial for patient understanding and referral processes remains true.

Overall, it can be concluded that the challenges of implementing psychological interventions in COPD care still exist, but at least the need to overcome resource constraints, integrate care, and improve communication is acknowledged by healthcare stakeholders. Recommendations include exploring so-called "COPD treatment hubs," embedding psychological approaches in healthcare training, and acknowledging challenges and opportunities in incorporating psychological support for individuals with COPD.

At Breathment, our commitment lies in enhancing the overall well-being of individuals living with COPD, addressing not only physical aspects but also placing a significant emphasis on psychological well-being. Alongside exercises prescribed by your dedicated physiotherapist through the Breathment Therapy App, we offer informative resources covering essential aspects of COPD, spanning from nutrition to mental health. Schedule an appointment with us today and let us improve your quality of life with COPD.