Emotional Distress and Physical Activity Engagement in U.S. Veterans With Chronic Obstructive Pulmonary Disease: A Qualitative Study

Author:

Bamonti Patricia M12ORCID,Rose Grace A1,Park Stella3,Silberbogen Amy K45,Moye Jennifer23ORCID,Moy Marilyn L67

Affiliation:

1. Research & Development Service , VA Boston Healthcare System, Boston MA , USA

2. Department of Psychiatry, Havard Medical School , Boston, MA , USA

3. New England Geriatric Research Education & Clinical Center , VA Boston Healthcare System, Boston, MA , USA

4. VA Boston Healthcare System , Boston, MA , USA

5. Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine , Boston, MA , USA

6. Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System , Boston, MA , USA

7. Department of Medicine, Harvard Medical School , Boston, MA , USA

Abstract

Abstract Background Physical activity is recommended as part of guideline-based care for managing chronic obstructive pulmonary disease (COPD) at all stages of the disease. However, physical activity interventions are less effective in individuals with co-occurring emotional distress (i.e., depression and/or anxiety symptoms). Interventions that dually promote improved physical and mental health in COPD are needed. The first step for intervention development is understanding individuals’ experience of these factors. Purpose To understand the experience of emotional distress in U.S. Veterans diagnosed with COPD and to explore how emotional distress impacts physical activity engagement. Methods Structured interviews informed by the cognitive and behavioral models of psychopathology were conducted with 29 United States Veterans with COPD (89.66% male, age 67.72 ± 6.55 years, 93.10% White) at the VA Boston Healthcare System. Interviews were audio recorded, transcribed, and underwent thematic analysis. Results Three major themes encapsulating 17 codes emerged through thematic analysis: (i) the experience of emotional distress in Veterans with COPD; (ii) the complex relationship between emotional distress, physical activity engagement, and COPD; (iii) contextual and personal factors. Conclusions Veterans’ interpretation of their COPD symptoms as unpredictable and uncontrollable and COPD-related physical limitations influenced their experience of emotional distress, while the experience of emotional distress both promoted and deterred physical activity engagement. Veterans were motivated to engage in physical activity despite experiencing emotional distress when they faced a responsibility in daily life. They identified motivational strategies and self-regulation techniques to manage emotional distress and to foster physical activity.

Funder

U.S. Department of Veterans Affairs (VA) Rehabilitation Research and Development Service Career Development Award-2

Publisher

Oxford University Press (OUP)

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