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Study Emphasizes Need for Positive Coping Styles Among COPD Caregivers


A new study offers insight into ways to decrease the burden on caregivers for patients with chronic obstructive pulmonary disease (COPD) in China and around the world.

A multicenter cross-sectional study published in the International Journal of Chronic Obstructive Pulmonary Disease has delivered a unique set of findings on the well-being of caregivers for those with chronic obstructive pulmonary disease (COPD) in mainland China. 

Prominently, the study found a correlation between caregiving burden and negative coping styles. A decrease in resources and stress relief formed a negative feedback loop, leading to lower qualities of life. 

As a result, the authors suggest that medical personnel might help caregivers cope with hardship by teaching skills, recommending avenues of social support, and conducting interventions with caregivers who may need more rapid improvement in their coping styles.

The information was gathered by researchers from several universities in China including Shandong University and Shanghai Normal University. They conducted polls of 201 caregivers at 4 large regional hospitals in Shandong Province from December 2019 to June 2020. Of these 201 caregivers, 65.7% were the children of parents with COPD, 62.2% were women, and 78.1% had attained less than a college education.

Presently, an estimated 99.9 million adults have COPD in China, which has become the third leading cause of death due to its low awareness rates and high morbidity that can be compounded by other underlying chronic diseases. The caregivers of these patients in general have a lack of research dedicated to their own well-being, dynamics of social support, and overall quality of life during the length of aid, something the investgiators hoped to help rectify by collecting these data.

The majority of other studies focusing on COPD caregivers have focused just on quality of life. With this in mind, this study emphasized exploring how the variables of social support and negative coping styles of caregivers might interact using a chain-mediated model. 

To participate in the study, the sampled COPD caregivers had to meet multiple criteria, including not receiving remuneration for their effort and having been caring for patients over 3 months cumulatively. They could not also have a serious physical illness of their own. The Perceived Social Support Scale (PSSS) was used to measure 12 items on a Likert 7-point scale ranging from strongly disagree to strongly agree.

Pearson correlation analysis revealed that caregiving burden was negatively correlated with quality of life (r = –0.330; P < .01) and social support (r = −0.218; P < .01) and positively correlated with negative coping style (r = 0.394; P < .01). There was a negative correlation between quality of life and negative coping (r = –0.263; P < .01).

Intriguingly, the study also notes that traditional Chinese culture reinforces a strong focus on familial ties, which may distinguish different levels of personal resolve in Chinese caregivers compared with caregivers in Western countries. 

A cultural attitude emphasizing “acceptance of destiny” seems to make many Chinese caregivers and patients with COPD feel that one’s ultimate health history is predetermined and cannot be changed. The authors believe a sense of fulfilling obligations to the family through caregiving in spite of negative hardship was a statistically significant result of this attitude.

“This important finding will help us understand the powerful role that family-centered social support and emotion regulation systems play in the daily lives of Chinese people,” they wrote.

Several limitations were present in the study. As the study’s results were cross-sectional, its findings did not imply a causal effect of caregiving burden on quality of life. Caregiver competence, role conflict, and illness perception were also not measured. 

Additionally, patients attending the hospitals had the disease in moderate and severe stages, which limits how these findings can be applied to caregivers across all levels of COPD severity.

In response, the authors recommend more longitudinal studies be conducted to find how these different variables interact.

Considering the negative correlation found, the authors hope their study might offer more theoretical ground to expand on in order to improve outcomes. A wider body of data can be especially useful to aid caregivers of patients with COPD undergoing recurring symptoms, a prolonged duration of COPD, and progressive exacerbation.


Yi M, Jiang D, Jia Y, Xu W, et al. Impact of caregiving burden on quality of life of caregivers of COPD patients: the chain mediating role of social support and negative coping styles. Int J Chron Obstruct Pulmon Dis. 2021;16:2245-2255. https://doi.org/10.2147/COPD.S311772

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