Cognitive Behavior Therapy for Anxiety and Depression Secondary to COPD among Korean-Americans in Honolulu: A Feasibility Study

Abstract

Purpose: 1) To test the feasibility of a culturally tailored cognitive behavior therapy (CTCBT) for Korean Americans (KAs) who suffer anxiety or depression secondary to chronic obstructive pulmonary disease (COPD); 2) To determine recruitment and retention feasibility for the CTCBT. Method: A descriptive study without a control group was designed to test the feasibility of CTCBT for KAs. A literature review of interventional studies for KAs was performed to find necessary cultural consideration in developing CTCBT for KAs. The Mind Well-Being Program as a CTCBT was developed and tested with eight patients with COPD residing in Honolulu, Hawaii. The program consisted of six one-hour-long weekly group sessions. Outcomes were measured with the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), the Saint George Respiratory Questionnaire (SGRQ), and a patient satisfaction questionnaire before and after the program and at six weeks after the program's completion. Findings: Eight out of twenty-nine potential patients volunteered to participate in the study. The attendance rate for the sessions was one hundred percent. Cultural considerations recommended for studies with KAs were: providing intervention in the Korean language, assessing Korean health beliefs and social norms for targeted conditions, using collectivism and navigation services, and protecting participants from the stigma of mental illness. In this descriptive study, average scores for the BAI and BDI decreased from 17.13 to 9 and from 19 to 10.75 respectively by the end of the therapy, and the results were sustained for 6 weeks. SGRQ scores also showed a decrease in all three areas of the measurement: symptoms, impact, and activity. Participant satisfaction with the program was 3.75 out of 4. Conclusion: The CTCBT-KAs achieved a meaningful decrease in anxiety and depression and an improvement in respiratory-related quality of life. Although there were limitations, the present study demonstrated the feasibility of using CTCBT for KAs.