Schuz, N and Walters, JAE and Cameron-Tucker, H and Scott, J and Wood-Baker, R and Walters, EH, Patient anxiety and depression moderate the effects of increased self-management knowledge on physical activity: a secondary analysis of a randomised controlled trial on health-mentoring in COPD, COPD, 12, (5) pp. 502-509. ISSN 1541-2555 (2015) [Refereed Article]
Copyright 2015 Taylor & Francis
Objective: Anxiety and depression are common comorbidities in people with chronic obstructive pulmonary disease (COPD). While these comorbidities could potentially lead to a higher motivation to learn about self-management, they could also inhibit patients from translating this knowledge into appropriate self-management behaviours. This paper explores the moderating effects of anxiety and depression on a health-mentoring intervention, focusing on mechanisms of change (mediation).
Methods: 182 COPD patients participated in an RCT, with anxiety and depression assessed by the Hospital Anxiety and Depression Scale (HADS), self-management knowledge by the Partners in Health Scale, and spontaneous physical activity using accelerometers, all measured at baseline, 6 and 12 months. The moderated mediation model tested the intervention's effect on physical activity, mediated via changes in self-management knowledge, at different levels of anxiety and depression. Results. Knowledge mediated the effect of the intervention on changes in physical activity only for participants reporting low levels of anxiety or depression. Both acted as moderators: Increased knowledge led to more physical activity among participants reporting low anxiety or depression and to less activity among highly anxious or depressed participants.
Conclusion: Although health-mentoring interventions can be an effective tool to increase knowledge and physical activity among COPD patients, it is essential to take anxiety and depression into account, as increased knowledge may have detrimental effects in highly anxious or depressed participants. This suggests that patients with elevated anxiety or depression may need to be treated appropriately before engaging in chronic disease self-management interventions.
|Item Type:||Refereed Article|
|Keywords:||anxiety, self-management, COPD|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Respiratory diseases|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Schuz, N (Dr Natalie Schuez)|
|UTAS Author:||Walters, JAE (Dr Julia Walters)|
|UTAS Author:||Cameron-Tucker, H (Dr Helen Cameron-Tucker)|
|UTAS Author:||Scott, J (Professor Jenn Scott)|
|UTAS Author:||Wood-Baker, R (Professor Richard Wood-Baker)|
|UTAS Author:||Walters, EH (Professor Haydn Walters)|
|Funding Support:||National Health and Medical Research Council (490028)|
|Web of Science® Times Cited:||19|
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