Pneumologie 2017; 71(12): 837-842
DOI: 10.1055/s-0043-114961
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Im Gespräch mit COPD-Patienten: patientenzentriert kommunizieren[*]

In Exchange with COPD Patients: Towards a Patient-Oriented Communication
N. M. Stenzel
1   Psychologische Hochschule Berlin
,
K. Kenn
2   Schön-Klinik Berchtesgadener Land, Deutsches Zentrum für Lungenforschung, Philipps-Universität Marburg
,
G. Steinkamp
3   Medizinisch-wissenschaftliches Publizieren, Schwerin
› Author Affiliations
Further Information

Publication History

eingereicht16 June 2017

akzeptiert26 June 2017

Publication Date:
05 October 2017 (online)

Zusammenfassung

Die Lebensqualität von COPD-Patienten ist häufig deutlich beeinträchtigt. Neben den körperlichen Limitationen der Betroffenen treten häufig psychische Komorbiditäten auf. Damit gehen häufig auch dysfunktionale Annahmen der Betroffenen in Bezug auf ihre Erkrankung und deren Behandlung einher. Diese können nicht nur die Lebensqualität der Betroffenen weiter beeinträchtigen, sondern auch Auswirkungen auf die Kommunikation zwischen Arzt und Patient sowie das Krankheitsverhalten haben. Aus diesem Grund ist es wichtig, dass Behandler sie im Dialog mit dem Patienten berücksichtigen.

Der folgende Beitrag thematisiert, welches Gewicht dysfunktionalen Krankheitsannahmen und psychischen Komorbiditäten bei COPD zukommt, und geht auf die Möglichkeiten ein, diese im Arzt-Patient-Kontakt positiv zu berücksichtigen.

Abstract

The quality of life can be severely impaired in patients with COPD. In addition to physical restraints, they often suffer from psychological comorbidities (e. g. anxiety, depression). Psychological comorbidities are often associated with dysfunctional beliefs about the illness and its treatment. Such dysfunctional beliefs, in turn, are likely to negatively affect patients’ quality of life as well as their communication with physicians and their illness behavior in general. It is therefore important for physicians to adapt their communication to account for patients’ dysfunctional beliefs.

This paper will review the role of dysfunctional beliefs and psychological comorbidities in COPD. It will also elaborate on potential ways to adjust communication between physicians and patients accordingly.

* Dieses Manuskript basiert auf einem Vortrag bei der Expertentagung „Luftschlösser“ zum Thema „Exazerbation der COPD“ am 17. Februar 2017 in Wiesbaden (Sponsor: Boehringer Ingelheim).


 
  • Literatur

  • 1 Curtis JR, Wenrich MD, Carline JD. et al. Patients' perspectives on physician skill in end-of-life care. Differences between patients with COPD, cancer, and AIDS. Chest 2002; 122: 356-362
  • 2 Stenzel N, Rief W, Kuhl K. et al. Fear of progression and end-of-life fear in COPD patients. Pneumologie 2012; 66: 111-118
  • 3 Knauft E, Nielsen EL, Engelberg RA. et al. Barriers and facilitators to end-of-life care communication for patients with COPD. Chest 2005; 127: 2188-2196
  • 4 Haugdahl HS, Storli SL, Meland B. et al. Underestimation of Patient Breathlessness by Nurses and Physicians during a Spontaneous Breathing Trial. Am J Respir Crit Care Med 2015; 192: 1440-1448
  • 5 Glattacker M, Bengel J, Jäckel WH. Die deutschsprachige Version des Illness Perception Questionnaire-revised. Psychometrische Evaluation an Patienten mit chronisch somatischen Erkrankungen. Zeitschr Gesundheitspsychol 2009; 17: 158-169
  • 6 Leventhal H, Cameron L. Behavioural theories and the problem of compliance. Patient Educ Couns 1987; 10: 117-138
  • 7 Scharloo M, Kaptein AA, Weinman JA. et al. Physical and psychological correlates of functioning in patients with chronic obstructive pulmonary disease. J Asthma 2000; 37: 17-29
  • 8 Zoeckler N, Kenn K, Kuehl K. et al. Illness perceptions predict exercise capacity and psychological well-being after pulmonary rehabilitation in COPD patients. J Psychosom Res 2014; 76: 146-151
  • 9 Mikkelsen RL, Middelboe T, Pisinger C. et al. Anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). A review. Nord J Psychiatry 2004; 58: 65-70
  • 10 Kunik ME, Roundy K, Veazey C. et al. Surprisingly high prevalence of anxiety and depression in chronic breathing disorders. Chest 2005; 127: 1205-1211
  • 11 Yohannes AM, Baldwin RC, Connolly MJ. Depression and anxiety in elderly outpatients with chronic obstructive pulmonary disease: prevalence, and validation of the BASDEC screening questionnaire. Int J Geriatr Psychiatry 2000; 15: 1090-1096
  • 12 Matte DL, Pizzichini MMM, Hoepers ATC. et al. Prevalence of depression in COPD. A systematic review and meta-analysis of controlled studies. Respir Med 2016; 117: 154-161
  • 13 Livermore N, Sharpe L, McKenzie D. Panic attacks and panic disorder in chronic obstructive pulmonary disease. A cognitive behavioral perspective. Respir Med 2010; 104: 1246-1253
  • 14 Fan VS, Ramsey SD, Giardino ND. et al. Sex, depression, and risk of hospitalization and mortality in chronic obstructive pulmonary disease. Arch Intern Med 2007; 167: 2345-2353
  • 15 Alexopoulos GS, Raue PJ, Sirey JA. et al. Developing an intervention for depressed, chronically medically ill elders. A model from COPD. Int J Geriatr Psychiatry 2008; 23: 447-453
  • 16 Fan VS, Giardino ND, Blough DK. et al. Costs of pulmonary rehabilitation and predictors of adherence in the National Emphysema Treatment Trial. COPD 2008; 5: 105-116
  • 17 Keil DC, Stenzel NM, Kuhl K. et al. The impact of chronic obstructive pulmonary disease-related fears on disease-specific disability. Chron Respir Dis 2014; 11: 31-40
  • 18 Simon NM, Weiss AM, Kradin R. et al. The relationship of anxiety disorders, anxiety sensitivity and pulmonary dysfunction with dyspnea-related distress and avoidance. J Nerv Ment Dis 2006; 194: 951-957
  • 19 Leupoldt A von, Taube K, Lehmann K. et al. The impact of anxiety and depression on outcomes of pulmonary rehabilitation in patients with COPD. Chest 2011; 140: 730-736
  • 20 Reardon JZ, Lareau SC, ZuWallack R. Functional status and quality of life in chronic obstructive pulmonary disease. Am J Med 2006; 119: 32-37
  • 21 Giardino ND, Curtis JL, Andrei A-C. et al. Anxiety is associated with diminished exercise performance and quality of life in severe emphysema. A cross-sectional study. Respir Res 2010; 11: 29
  • 22 Kampelmacher MJ, van Kestern RG, Alsbach GP. et al. Characteristics and complaints of patients prescribed long-term oxygen therapy in The Netherlands. Respir Med 1998; 92: 70-75
  • 23 Kühl K, Kenn K, Rief W. et al. Ist das peinlich!? Die Rolle von Scham bei COPD. AT 2012; 38: 333-341
  • 24 Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA 1999; 282: 1737-1744
  • 25 Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606-613
  • 26 Wittchen H-U, Zaudig M, Fydrich T. SKID. Strukturiertes Klinisches Interview für DSM-IV; Achse I und II. Göttingen: Hogrefe; 1997
  • 27 Back AL, Arnold RM, Baile WF. et al. Efficacy of communication skills training for giving bad news and discussing transitions to palliative care. Arch Intern Med 2007; 167: 453-460
  • 28 Leung JM, Udris EM, Uman J. et al. The effect of end-of-life discussions on perceived quality of care and health status among patients with COPD. Chest 2012; 142: 128-133