Examining Change in Symptoms of Depression, Anxiety, and Stress in Adults after Treatment of Chronic Cough: A Dissertation
Authors
French, Cynthia L.Faculty Advisor
Carol BovaUMass Chan Affiliations
Graduate School of NursingDocument Type
Doctoral DissertationPublication Date
2014-05-01Keywords
AnxietyAnxiety Disorders
Cough
Depression
Depressive Disorder
Quality of Life
Stress
Mental Disorders
Nursing
Psychiatry and Psychology
Respiratory Tract Diseases
Metadata
Show full item recordAbstract
Background: Chronic cough is a common health problem with variable success rates to standardized treatment. Psychologic symptoms of depression, anxiety, and stress have been reported in association with chronic cough. The purpose of this study was to examine changes in the psychologic symptoms of depression, anxiety, and stress in adults with chronic cough 3 months after management using the ACCP cough treatment guidelines. Methods: This study used a descriptive longitudinal observation design. The major tenets associated with the Theory of Unpleasant Symptoms were examined. Intervention fidelity to the study components was measured. Results: A sample of 80 consecutive patients with chronic cough of greater than 8 weeks duration was recruited from one cough specialty clinic. Mean age of subjects was 58.54 years; 68.7% were female; 98.7% were white, and 97.5% were non-smokers. Mean cough duration was 85.99 months and mean cough severity was 6.11 (possible 0 –10; higher scores equal greater cough severity). Cough severity improved post treatment (n=65, M=2.32, (SE =.291), t (64) =7.98, p=.000); cough-specific quality-of-life also improved (n=65, M=9.17, (SE=1.30), t (64) =7.02, p=.000). Physiologic (urge-to-cough r=.360, ability to speak r=.469) and psychologic factors (depression r=.512, anxiety r=.507, stress r=.484) were significantly related to cough-specific quality-of-life and to cough severity (urge-to-cough r=.643, ability to speak r=.674 and depression r=.356, anxiety r=.419, stress r=.323) (all r, p=.01); social support and number of diagnoses were not related to either variable. Those experiencing greater financial strain had worse cough severity. Women, those experiencing financial strain, and those taking self-prescribed therapy had worse cough-specific quality-of-life. Intervention fidelity to the study plan was rated as high according to observation, participant receipt, and patient/physician concordance. Qualitative review identified potential areas of variability with intervention fidelity. Conclusions: By measuring the factors related to the major tenets of the Theory of Unpleasant Symptoms, this theory has helped to explain why those with chronic cough may have symptoms of depression, anxiety, and stress and why these symptoms improve as cough severity and cough-specific quality-of-life improve. Moreover, by measuring intervention fidelity, it may be possible to determine why cough guidelines may not be yielding consistently favorable results.DOI
10.13028/dsb8-s310Permanent Link to this Item
http://hdl.handle.net/20.500.14038/34377Notes
Correction: On page 75, the sentence "Of the initial 80 subjects, 53 (66.3%) reported taking antidepressant medications and 6 (7.5%) reported taking an anxiolytic drug" should read instead: "Of the initial 80 subjects, 22 (27.5%) reported taking antidepressant medications and 6 (7.5%) reported taking an anxiolytic drug."
Signature approval page dated April 11, 2014.
Related Resources
Published article related to this dissertation: French CL, Crawford SL, Bova C, Irwin RS. Change in Psychological, Physiological, and Situational Factors in Adults After Treatment of Chronic Cough. Chest. 2017 Sep;152(3):547-562. doi: 10.1016/j.chest.2017.06.024. Epub 2017 Jul 3. PMID: 28684289.Rights
Copyright by Cynthia L. French 2014.Distribution License
https://creativecommons.org/licenses/by/4.0/ae974a485f413a2113503eed53cd6c53
10.13028/dsb8-s310
Scopus Count
Except where otherwise noted, this item's license is described as Copyright by Cynthia L. French 2014.