Evolution of Physical Self-Esteem During Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary...

Background/Objectives: Patients with COPD have altered self-esteem, and good self-esteem promotes personal, health, and social success. Improving self-esteem could be a method for encouraging the maintenance of physical activity. Only one study has evaluated the effects of pulmonary rehabilitation (PR) on self-esteem in moderate COPD patients. The objective was to assess the evolution of self-esteem in COPD patients of all stages of severity during PR. Methods: COPD patients undergoing PR were included in this prospective observational study. Patients were evaluated before and after the 4-week PR program. The objectives were to (1) assess the evolution of self-esteem using the Physical Self Inventory-6 questionnaire (PSI-6), (2) assess the evolution in each sub-score of PSI-6, (3) examine the correlations between the evolution of self-esteem and the evolution of parameters usually used during PR, and (4) determine an MID for self-esteem. Results: In total, 76 patients were included. We found that there was a significant increase in the total score in PSI-6 (9.29, p < 0.001), CI 95% [6.74; 11.83], and in the sub-scores of PSI-6. The evolution of the PSI-6 score was moderately correlated with changes in exercise capacity using STST1 (r = 0.352, p = 0.002) and quality of life (r = -0.361, p = 0.001) and weakly correlated to changes in dyspnea (r = -0.245, p = 0.03), anxiety (r = -0.248, p = 0.03), and depression (r = -0.290, p = 0.01). Using a distribution-based analysis, we found an MID between 5.2 and 5.6. Conclusions: We showed a significant increase in global score and in each sub-score of self-esteem using PSI-6 in COPD patients undergoing a PR program. We propose an MID of 5.6.