Personality traits and health-related quality of life in pulmonary rehabilitation
The MONTREHAL scientific study, conducted in patients with chronic respiratory diseases, explores the role of personality traits in responses to pulmonary rehabilitation and quality of life impacts.
Defining non-response to pulmonary rehabilitation by threshold scores for personality traits: a population-based study
ERJ Open Research
What is it?
In pulmonary rehabilitation (PR), nearly a third of patients do not achieve a clinically significant improvement in their quality of life at the end of the programme. These patients are referred to as “non-responders”.
The study, conducted in three Inicea Breath Clinics (La Vallonie, La Solane and Les Clarines), explored the role that personality traits play in non-response risk. The researchers also sought to determine whether it was possible to identify a personality threshold to identify at-risk patients, in the manner of a diagnostic tool.
Study population
A total of 719 patients with chronic respiratory diseases and who were enrolled in a four-week pulmonary rehabilitation programme were included in the study.
Personality traits were assessed at admission using the “Big Five” model (openness, conscientiousness, extraversion, agreeableness and neuroticism). Several clinical parameters were also measured before and after the programme, including quality of life, exercise capacity and shortness of breath.
Non-response was defined as insufficient improvement between programme entry and exit, below the minimum clinically important difference (MCID).
Key findings
The study shows that certain personality traits influence the response to pulmonary rehabilitation.
Neuroticism (tendency to emotional instability, anxiety and stress) increases the risk of non-response. Conversely, agreeableness (tendencies towards cooperation, benevolence and trust in others) seems to play a protective role.
The most striking result, however, is the impossibility of determining a personality threshold that is sufficiently reliable to clearly identify “at-risk” patients. Although certain traits influence the response to the programme, they alone do not accurately predict patients’ progress.
In summary
- Personality influences the response to the programme. Neuroticism increases the risk of non-response in terms of quality of life. However, its effect remains progressive, with no threshold to clearly identify patients at risk.
- Agreeableness seems to lead to commitment to receiving care. More agreeable patients achieve better outcomes, probably due to a better therapeutic alliance and stronger involvement in the programme.
- More personalised approaches should be explored. The results highlight the benefit of further tailoring support to patients’ psychological profiles to optimise the benefits of pulmonary rehabilitation.
Authors
- Sébastien Kuss (1, 2)
- Nelly Héraud (2)
- Espérance Moine (2)
- François Alexandre (2)
- Virginie Molinier (2)
- Brice Canada (1)
1 L-VIS – Laboratoire sur les Vulnérabilités et l’Innovation dans le Sport, Université de Lyon
2 DRIS – Direction de la recherche et de l’innovation en santé, Clariane