The Impact of Psychosocial Interventions in Patients with COPD

Primary outcomes

1. Multidimensional Scale of Perceinved Social Support (MSPSS)

   Time frame: Through study completion, an average of a year and a half (1.5 years).

   To assess patients perceived social support, the Multidimensional Scale of Perceived Social Support (MSPSS) (Zimet et al., 1988), translated and weighted in Greek (Theofilou, 2015), will be used.The MSPSS includes 12 questions in 3 domains of perceived social support (family, friends, significant others) with 4 items in each subscale, ranging from 1-7 (likert-type) with a total score of minimum 12 and maximum 84. Higher scores indicate greater social support. Scores 12-35 indicate low perceived social support, scores 36-60 indicate moderate perceived social support, and scores 61-84 indicate high perceived social support.

2. Patient Health Questionnaire (PHQ-4)

   Time frame: Through study completion, an average of a year and a half (1.5 years).

   To assess the mental state of the patients (anxiety and depression), the Patient Health Questionnaire (PHQ-4) (Löwe et al., 2010), translated and weighted in Greek (Christodoulaki et al., 2022), will be used. The PHQ-4 is a brief assessment of anxiety and depression including 4 questions. Questions 1 and 2 are subscales of the anxiety assessment of the GAD-2 exploratory instrument, while questions 3 and. 4 are subscales of the depression assessment of the PHQ-2 exploratory instrument. The PHQ-4 includes 4 questions in the range 0-3 (likert-type) with a total score of 0 to 12. The higher the score the less anxiety/depression. A score above 3 on either indicates that further assessment with the PHQ-9 Patient Health Questionnaire or the GAD-7 Generalized Anxiety Disorder Scale should be done.

3. Financial Ability Scale (FAS)

   Time frame: Through study completion, an average of a year and a half (1.5 years).

   The Financial Ability Scale (FAS) questionnaire, translated into Greek (Koutsimpou et al., 2020), will be used to assess the financial status of the patients. The FAS includes 12 likert-type questions (ranging from no, little, moderate, good, very good).

4. Test of the Adherence to Inhalers (TAI)

   Time frame: Through study completion, an average of a year and a half (1.5 years).

   To assess patients adherence to treatment, the Test of the Adherence to Inhalers (TAI) questionnaire (Plaza et al., 2016), translated and weighted in Greek (Ierodiakonou et al., 2020), will be used.The TAI includes 12 questions ranging from 1-5 (likert type) with a total score of minimum 10 and maximum 50, which classifies patients adherence to treatment and indicates specific behavioural patterns (voluntary, involuntary, etc.) of adherence.

5. Sort Form (SF-12)

   Time frame: Through study completion, an average of a year and a half (1.5 years).

   The Sort Form (SF-12) questionnaire (Ware and Sherbourne, 1992), often used as a quality of life assessment questionnaire, translated and weighted in Greek (Kontodimopoulos et al., 2007), will be used to assess the patients health overview.The SF-12 is a short form of the SF-36 questionnaire and studies 4 domains of the patients health: physical role, physical functioning, emotional role, mental health. Each dimension is rated on a scale from 0 to 100, with 0 points representing worse health-related quality of life, and 100 points representing better health-related quality of life.

6. Clinical COPD Questionnaire (CCQ)

   Time frame: Through study completion, an average of a year and a half (1.5 years).

   For the assessment of the patients quality of life, the Clinical COPD Questionnaire (CCQ) (van der Molen et al., 2003), translated and weighted in Greek (Tsiligianni et al., 2012), (Papadopoulos et al., 2011), will be used. The CCQ includes 10 questions ranging from 0-6 (likert-type), where patients are asked to recall their experiences in the last 24 hours. The higher the score, the worse the patients health status.