The Impact of Mental Health, Physical Health, and Illness Perceptions on Physical Activity in a COPD Population

Purpose – This body of research exists to expand the knowledge base surrounding how mental health, physical health, and illness perceptions interact with physical activity levels in individuals with COPD. Methods – The first study looked at pulmonary rehabilitation participants and consisted of measuring physical activity, anxiety, depression, and illness perceptions on entry to the program and again, after three months of participation in the program. The second and third study were both completed with data collected from Statistics Canada (Canadian Health Measures Survey). In the second study, information from across Canada was analyzed to determine correlates with physical activity for all levels of airway obstruction severity separately and together (self-reported health, mental health, quality of life, respiratory symptoms, spirometry). The third study took similar variables and compared them between those who had obstruction and those withoutas well as between each separate level of airway obstruction (mild, moderate, severe/very severe). Results – The first study found that as anxiety levels increase, health related quality of life (HRQoL) gets worse and typical dyspnea levels are elevated. As depression levels increase, both exertional and typical dyspnea increase, HRQoL decreases, and illness perceptions become more negative. These more negative illness perceptions are related to increased exertional dyspnea and lower HRQoL. The second study found that there were several common variables that helped predict all intensities of physical activities at various levels of airway obstruction: self-perceived health, mental-health, QOL, life satisfaction, simple chores make SOB, wheeze on exertion, and frequent persistent colds. The third study found that, in general, as airway obstruction increases, physical activity levels decrease along with self-perceived health, stress, and quality of life. Respiratory symptoms also increase as obstruction increases. Physical activity levels were not significantly different between those with airway obstruction and those without obstruction. Significance of Findings – Individuals with moderate to very severe obstruction had lower levels of physical activity than their healthy counterparts. These reductions in physical activity levels may be related to the sensation of dyspnea, lower levels of quality of life, poor perceived health/mental health, higher levels of anxiety and/or depression, and the presence of more negative illness perceptions