Stress Coping among COPD patients

Stress coping strategies for refugee population suffering from Chronic Obstructive Pulmonary Disease (COPD).

By Aysha Siddiqui

Stress and Coping, PSYC 6748,

Walden University

Abstract

Chronic obstructive Pulmonary Disorder (COPD) is a lung disease that can make breathing difficult. COPD is a common health condition found among refugees population who are living without access to quality health care, medicines and treatment facilities. This population requires specific coping strategies for the stress induced by the COPD. This paper reviews stress coping strategies for COPD suffering patients who are refugees, effective and ineffective strategies. It suggests alternate coping strategies for ineffective coping techniques for COPD.  

Common stress coping strategy for refugees suffering from COPD

Chronic obstructive pulmonary disorder (COPD) is a lung disease that blocks the airflow making it difficult to breathe (MyoClinic.com). Yaman et al (2002) conducted a study on health problems among UN refugees center in Turkey, Ankara. The results of their study revealed that infectious diseases like COPD were the most common among this population. Due to declined health care, lack of diagnosis and past living conditions, refugee population is at very high risk for developing infectious diseases including COPD. Research shows that patients suffering from COPD can face stress and may need specific stress coping techniques to deal with this stress.

Effective coping strategies

a)      Biology focused strategy

An effective biology focused coping strategy for patients with COPD ‘oxygen therapy’. Oxygen therapy is the process of increasing the supply of oxygen to the lungs with help of a face mask, cylinder and tube that carries oxygen to the mask. This type of therapy usually helps increase activity and function better (National Institute of Health, NIH). Borak et al (1996) conducted a study on the psychological status of patients after one year of effective oxygen therapy. Results showed that before therapy patients had ‘depressed mood self-esteem with narrow interests, signs of anxiety, mental stress and depression’. There was a decline in these conditions after an year of oxygen therapy.

b)      Emotion focused strategy

Psychotherapy is an effective coping technique for patients suffering from COPD in living conditions of refugees or like refugees (which means lack of access to instant health care). Eiser et al (1997) found that anxiety is very common among patients of COPD and the effects of psycho therapy offered to these patients. After six sessions of group psycho therapy results showed improvement in tolerating physical activity without feeling anxious or worried.

c)      Problem focused strategy

Educating the patients about their condition of health and the stress related to the condition is an effective problem focused strategy. The methods would include providing printed material with simple instructions on how to handle stress and what kind of support to build around them.

Ineffective coping strategy for dealing stress faced by COPD sufferers

a)      Problem focused

Since we are considering refugee population then problem focused techniques could be challenging in taking effect. One problem focused technique that may not be effective would be treating the patients for depression and not stress. There is always a very thin line between the two and there is a close connection between depression and stress. If patients suffering from COPD are actually getting depressed maybe due to their illness or even because of the medication, then getting that under control could be hard in a refugee population. To make this technique effective it would be suggested to engage internal medicine doctors along with personality assessment specialists also.

b)      Biology focused

Biology focused coping techniques include a behavior change to reduce the physiological changes that happen when stress takes place (Laureate education, 2012). An ineffective technique in case of refugee with COPD could be altering lifestyle and eating habits. This is because the living conditions of refugees are compromised and they are usually looking at their survival. Inclusion of organizations, non-profits or other such groups could help with making this technique effective. Healthy eating and better sleep is an example of biology focused technique that could be effective as well with proper support. 

c)      Emotion focused

This may include being given psychological support by therapists who are not properly qualified to help a population who is suffering from a chronic disease as well as are refugees. Refugees are going through the stress of handling the COPD as well being uprooted from their homes. If patients have families, their age and in what conditions they left home can all play a role in the stress they are facing. To make this coping technique effective, it would be best to engage therapists or social workers who have had training in dealing with refugee population. Therapists could be given a short training course as well to handle these patients.

References

National Institute of Health (NIH), ‘What is Oxygen therapy?’

Borak, J., Sliwiński, P., Tobiasz, M., Gorecka, D., & Zieliński, J. (1996). Psychological status of COPD patients before and after one year of long-term oxygen therapy. Monaldi archives for chest disease, 51(1), 7.

Eiser, N., West, C., Evans, S., Jeffers, A., & Quirk, F. (1997). Effects of psychotherapy in moderately severe COPD: a pilot study. European Respiratory Journal, 10(7), 1581-1584.

Yaman, H., Kut, A., Yaman, A., & Ungan, M. (2002). Health problems among UN refugees at a family medical centre in Ankara, Turkey. Scandinavian journal of primary health care, 20(2), 85-87.

Data cleaning meaning 'proofreading'

Data cleaning means the ‘proofreading’ of data to eliminate errors and coding (techniques to organize raw data) inconsistencies, according to Frankfort-Nachmias & Nachmias (2009). Data cleaning, also known as data cleaning is an integral part of data processing that should take place before an analysis of the data collected. Computers perform the function of data cleaning mostly now with the development of efficient software (Frankfort-Nachmias & Nachmias, 2009). Missing data can be in many forms like response bias, careless response or no response. According to Meade & Craig (2012), internet surveys, especially in cases of ‘obligatory participation’ can result in data that’s quality can be a concern. They report that ‘careless responses’ can be controlled by using identified rather than anonymous responses.

Missing data is a common concern with multivariate studies, as reported by Little (1988) and can lead to a questions if it is data ‘missing completely at random’ (MCAR) or if it’s related to a some variables. Little (1998) suggests that if we compare the value of means for each variable between groups then we may be able to assess if it is MCAR or not. Schafer & Olsen (1998) highlight the possibility of missing data in a multivariate study as well. They further add that ‘new computational algorithms and software’ have given the ability to researchers to create proper imputations multivariate studies. Their study reports ‘multiple imputation’ technique that combine estimates with m> plausible values. Bourque & Clark (1992) write an interesting point that ‘data preparation more of an ‘art when compared to science of hypothesis testing’

One example of data cleaning is dealing with outliers (these are values or data points considered to be far outside norm of a variable) that have been defined by some researchers as values that deviate so much that they arouse suspicion (Osborne & Overbay, 2012). Outliers can have feverish effects on data analysis and can be handled by either by eliminating if evaluated as an error in data or by observing, looking at the original responses (Osborne & Overbay, 2012).

Hypothesis testing is directly connected to data analysis (Bourque & Clark, 1992). In the rush of testing the hypothesis researchers usually do an incomplete job of data analysis and then repeatedly process data to bring it into usable form. In our research study, our second hypothesis states that individuals who grow up in a cross cultural home with immigrant parents experience lesser success in life compared to their peers. To illustrate this relationship

                                                                            References

Bourque, L. B., & Clark, V. (1992). Processing data: The survey example (No. 85). Sage.

Frankfort-Nachmias, C., & Nachmias, D. (2008). Research methods in the social sciences (7th ed.). New York: Worth.

Little, R. J. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83(404), 1198-1202.

Meade, A. W., & Craig, S. B. (2012). Identifying careless responses in survey data. Psychological methods, 17(3), 437.

Osborne, J. W., & Overbay, A. (2012). Best practices in data cleaning. Sage.

Schafer, J. L., & Olsen, M. K. (1998). Multiple imputation for multivariate missing-data problems: A data analyst's perspective. Multivariate behavioral research, 33(4), 545-571.