The physical and social configuration of hospitals implies the possibility of introducing inpatients to adverse psychological effects. These effects have been described and analyzed by different authors over the past few years[1–4]. Volicer et al. identified hospital experiences related to routine attention that are perceived as stressful during hospitalization, like: difficulties to obtain data concerning their own therapeutic processes, ignorance of the consequences of the disease, dangers that test involves, reduction of intimate space in the room, use of medical language, restriction of visits of own family’s members and friends, etc. Based on these observations the authors drew up the 40 items questionnaire called Hospital Stress Rating Scale. This scale was validated and translated in Spanish by Kendall. Between 1977 and 1978 other studies on stress during hospitalization incorporated the importance of cardiovascular and socio-demographic factors during hospitalization[7–9], coping strategies and psychological impact[10, 11] and severity of the disease, and presence of pain as important variables, affirming that some of them can predict stress level during hospitalization in acute patients. During the 80s, authors focused their interest on factors related to the patients’ difficulties of adjustment to hospital[13–15]. Researches carried out over the two last decades have extended the study of the iatrogenic effects of hospitalization to different pathologies[16, 17] or stress perception differences between patients and health care staff[11, 18, 19].
Chronic Obstructive Pulmonary Disease (COPD) is one of the most prevalent respiratory diseases with a frequent need for hospitalization; these patients suffer acute exacerbations during the year and hospitalization is an important part of patient care. The illness severity and a progressive loss of quality of life and physical mobility deteriorate patients’social and family support. Nevertheless, although poor relations between pulmonary function and quality of life and social support have been reported in the literature, recent studies have shown that improving physical activity (specific rehabilitation programs) can reduce symptoms and associated psychological dysfunctions and increase well-being and quality of life in these patients[23, 24].
Currently, a bibliographic review of databases does not show scientific studies concerning stress or the psychological effects of hospitalization in patients with COPD or in patients with chronic diseases who need frequent hospitalization. Andenaes et al observed high levels of stress in hospitalized COPD patients, concluding that 58.7% of them showed different levels of stress in comparison to non-hospitalized COPD patients. Then, in their follow up study, Andenaes et al observed a decrease in stress levels nine months after hospitalization; so the authors deduced that this had clearly been caused by hospitalization.
In a previous study, we can observe that patients with COPD suffer low stress levels during hospitalization but it is not clear the role of Health Related Quality of Life (HRQOL) and Social Support. For this reason, the aim of this study is to determine stress levels during hospitalization in patients with a chronic disease such as COPD. After that, we want to relate these parameters to the previous level of quality of life and patients’ social support. We have hypothesized that these last two parameters can contribute to diminishing stress levels in COPD patients.