Date of Award


Degree Name

Doctor of Philosophy



First Advisor

Dr. C. Richard Spates

Second Advisor

Dr. Malcolm Robertson

Third Advisor

Dr. Lester Wright

Fourth Advisor

Dr. Anne Eshelman


This descriptive study examined coping strategies and social support among thirty-three patients with moderate to severe Chronic Obstructive Pulmonary Disease (COPD) to assess relationships to psychological and functional status, and health care utilization. More specifically, the qualitative and quantitative differences in coping strategies and social support were examined in relation to anxiety, depression, activity level, and use of emergency and inpatient medical services. Subjects participated in a one-session screening that included a brief clinical interview, battery of questionnaires and exercise tolerance test. Health care utilization data were obtained from subjects’ medical records. Subjects' primary support persons also provided collateral data on psychological well being, coping strategies, and social support. Data were analyzed using descriptive statistics, Pearson r correlations, and linear and stepwise multiple regression analyses.

Results indicated that 25% and 15% of the sample met criteria for clinical anxiety and depression, respectively. Subjects also had significant impairment in physical, emotional, and social functioning. However, the majority of subjects had not been admitted to the emergency room or hospital for respiratory-related problems in the last year. Subjects were found to use a large number of coping strategies in effort to adjust to their COPD. Problem-focused strategies were used more often than emotion-focused or maladaptive strategies. Nevertheless, 50% of subjects used at least one maladaptive coping strategy. Subjects reported a high rate of social support, and perceived the quality o f their support to be quite good. Instrumental social support was slightly more prevalent than emotional support for this sample.

Maladaptive coping strategies and pain were the best predictors of psychological well being in this sample. Mental disengagement and negative social support significantly predicted subjects' physical functioning. Additionally, negative social support significantly predicted respiratory-related hospitalizations. The number of emotion-focused coping strategies used by subjects best predicted the length of hospitalization. Collateral-reported social support also predicted the number of inpatient visits for subjects.

Access Setting

Dissertation-Open Access