Marital adjustment among patients with chronic obstructive pulmonary disease who are participating in pulmonary rehabilitation.

BACKGROUND: Marital adjustment has been associated with morbidity and mortality across various chronic diseases but has been largely ignored among patients with chronic obstructive pulmonary disease (COPD). PURPOSE: This study was designed to evaluate the relationship among marital adjustment, quality of life, psychologic functioning, and functional capacity among married patients with COPD who are participating in a 5-week exercise rehabilitation program and their spouses. SAMPLE: A convenience sample of 31 patients with COPD and their partners was included. DESIGN: A prospective 1-group pretest-posttest study was conducted. RESULTS: Marital adjustment scores indicated that patients and partners were, on average, satisfied with their marriages. Patient marital adjustment was associated with patient psychologic well-being, whereas partner marital adjustment was associated with patient physical functioning. In addition, patient and partner perceptions of marital adjustment predicted change in patient functioning after exercise rehabilitation. Patients who entered the program with poor marital adjustment experienced a greater magnitude of improvement in mental health after rehabilitation than did well-adjusted patients. CONCLUSIONS: These findings suggest that marital adjustment is associated with both psychologic well-being and physical functioning among patients with COPD, and that it may predict change among patients with COPD participating in exercise rehabilitation.

Mammography pain and discomfort: a cognitive-behavioral perspective.

Although some women report having little pain or discomfort during mammography, other women find mammography to be a painful and uncomfortable experience. Cognitive and behavioral factors may influence the perception of pain and discomfort during mammography. This review critically evaluates the research on mammography pain from a cognitive-behavioral perspective. The review is in three sections. The first reviews studies measuring pain and discomfort in women who have recently had mammograms and studies investigating the relative importance of pain and discomfort in influencing women's decisions to have a mammogram. The second section presents a cognitive-behavioral model of mammography pain that is based on theories of behavior and self-regulation developed by Kanfer and Hagerman (1987). The review concludes with a discussion of the implications of the cognitive-behavioral perspective for clinical management and research on mammography pain and discomfort.

Cognitive and psychological outcomes of exercise in a 1-year follow-up study of patients with chronic obstructive pulmonary disease.

This study evaluated outcomes of self-directed exercise activity on cognitive functioning and psychological well-being among 28 adults with chronic obstructive pulmonary disease (COPD). Participants had completed an intensive 10-week program of exercise training and were given an exercise prescription to follow. One year later, participants completed comprehensive assessments of physical, cognitive, and psychological functioning. At follow-up, 39% (n=11) had continued with a regular program of moderate intensity exercise. Repeated measures analysis of variance indicated that exercise adherent participants maintained gains they had achieved in the initial exercise intervention, but nonexercise participants experienced declines in functional capacity, cognitive performance, and psychological well-being. Continued exercise among patients with COPD is associated with maintenance of physical, cognitive, and psychological functioning.