Loss of Dignity in Severe Chronic Obstructive Pulmonary Disease.

Context: The maintenance of dignity is an important concept in palliative care, and the loss of dignity is a significant concern among patients with advanced cancer.

Objectives: The goals of this study were to examine whether loss of dignity is also a concern for patients receiving interdisciplinary rehabilitation for Stage III or IV chronic obstructive pulmonary disease. We examined the prevalence and correlates of loss of dignity and determined whether it improves with treatment.

Attachment insecurity predicts responses to an interdisciplinary chronic pain rehabilitation program.

The aim of this study was to examine the hypothesis that attachment insecurity is associated with poorer responses to interdisciplinary treatment for chronic pain. Patients (n = 235) admitted to a 4-week interdisciplinary rehabilitation program were recruited. At pre-treatment, participants completed a battery of questionnaires assessing adult attachment styles and dimensions, as well as pain intensity, disability, self-efficacy, pain catastrophizing, and depressive symptoms.

A Breathlessness Catastrophizing Scale for chronic obstructive pulmonary disease.

Objective: Catastrophizing about breathlessness may be related to disability in patients with chronic obstructive pulmonary disease (COPD), but assessment options are limited. This study reports the initial validation of a 13-item Breathlessness Catastrophizing Scale (BCS).

Method: Pulmonary rehabilitation inpatients completed spirometric, functional performance and questionnaire assessments at admission (N=242) and discharge (n=186).

Changes in perceived pain severity following interdisciplinary treatment for chronic pain.

Background: There is good support for the effectiveness of interdisciplinary chronic pain management programs in improving functional outcomes; however, relatively little is known about patients who report deterioration following participation in such programs.

Objectives: The present retrospective study investigated patients' reports of increased pain severity during participation in a cognitive-behaviourally oriented, outpatient treatment for chronic pain.

Methods: Participants (n=280) completed a four-week, group-based, interdisciplinary chronic pain self-management program at a rehabilitation hospital.

Client-Oriented Role Evaluation (CORE): the development of a clinical rehabilitation instrument to assess role change associated with disability.

This paper describes the development of an instrument, the Client-Oriented Role Evaluation (CORE), to help meet the needs of rehabilitation clients and clinicians in their joint efforts to define realistic and meaningful therapeutic goals. The CORE is based on a model that captures the relationship among identity, roles, constituent occupations, and personal and environmental determinants. The model encourages a comprehensive approach to examining role change and role loss that occurs with disability.