The influence of rehabilitation on behaviour modification in COPD.

Psychological and social factors are important in functioning and well-being of patients with chronic lung disease. While a rehabilitation programme of 4-10 weeks may optimise physical function, maintenance of results of rehabilitation depends for a substantial part on psychological factors such as mood, coping and lifestyle. Behavioural research suggests that modifying behavioural patterns and coping styles takes time and improvement of depressive state or symptoms may also take months. While no clear recommendations can be abstracted from the present literature concerning composition and duration of psychosocial programmes, we would suggest a duration of the programme of at least 3 months with inclusion of structured psychosocial elements aiming at behaviour modification. Regular physical and social activities in the post-rehabilitation period are necessary for relapse prevention. Evidence for this approach, however, is up to now only circumstantial. Further research should focus on maintaining results of rehabilitation and in particular on the role of psychological factors.