Psychosocial issues in chronic obstructive pulmonary disease.

Chronic illnesses such as COPD require both comprehensive evaluations and multisystem treatment approaches with integration of biological, behavioral, psychological, and social systems. People function as biopsychosocial units, with complex interplay between themselves and their environments determining the degree of their illness. Illness, as distinct from disease, is a person's subjective response to the state of disease or organ pathology. Recognition and identification of the psychosocial components of a person's illness allows for far more effective therapeutic intervention. Treatment objectives include better acceptance of life changes and the development of new attitudes and goals through an increase in self-confidence and control over emotional, physical, and respiratory functioning. These rehabilitation goals can be fulfilled by the use of supportive therapies (individual, family, or marital and group) and educational behavioral techniques based upon a solid working alliance with the patient.