Examination of the contribution of mindfulness and catastrophising to the presence of anxiety and frequency of COPD related hospital admissions in COPD patients.

Abstract

Purpose: The aim of the systematic review was to explore the role that anxiety plays in hospital admissions for those with Chronic Obstructive Pulmonary Disease (COPD). The empirical study aimed to examine whether the frequency of COPD related admissions is related to psychological factors (anxiety, depression, catastrophising, and mindfulness), disease severity, perceived disability and demographic factors. It also sought to examine whether cognitive factors (mindfulness and catastrophising) may explain unique variance in predicting anxiety and COPD-related admissions when other relevant factors are controlled for. Methods: The literature was systematically searched for research related to the predictive power of anxiety in relation to COPD related hospital admissions. A postal cross-sectional survey of 54 people with COPD examined the psychological profile of those who are admitted to hospital for COPD, and if mindfulness and catastrophising can predict anxiety and COPD hospital admissions. Correlations and multiple regressions were utilised to explore these hypotheses. Results: Fourteen studies met inclusion criteria for the systematic review, demonstrating mixed results regarding whether anxiety plays a role in COPD related hospital admissions. Findings from the empirical study suggest that a significant relationship exists between disease severity and number of COPD hospital admissions and catastrophising and overall mindfulness predicted 16.3% of variance in COPD hospital admissions (non-significant). Anxiety scores were significantly correlated with breathlessness, depression, catastrophising and mindfulness with catastrophising and mindfulness predicting 22.3% of variance in anxiety (significant). Conclusions: Further research with robust measures of anxiety and hospital utilization are needed to aid our understanding of the role of anxiety in COPD related admissions. Further research is necessary to determine if mindfulness and catastrophising are useful constructs in predicting anxiety levels and hospital admissions in those with COPD. This will help to inform future psychological interventions with this population.