This study was designed to determine the effect of pulmonary rehabilitation on anxiety, medical orientation, social introversion, attitude toward work, and engagement in vocational activities in patiens with chronic obstructive pulmonary diseases (COPD). An experimental situation was designed in which 45 matched patients with COPD were studied at NYU-Bellevue Medical Centre. Baseline testing consisted of pulmonary function tests, blood gas studies, energy-cost studies, Minnesota Multiphasic Personality Inventory, medical orientation scale, and Livingston work attitude scale. The subjects were assigned randomly to one of three groups on the basis of treatment: the experimental group, pulmonary rehabilitation; the first control group, psychotherapy exclusively; and the second control group, no treatment at all. Upon completion, the results were compared, and all subjects received guidance and counselling regarding vocational activities. Five to six weeks later a follow-up study determined whether the subjects were thus engaged. Hypothesis 1 stating that patients of the rehabilitation program would improve on the variables, was partially confirmed. Hypothesis 2 stating that more patients in the program would engage in vocational activities, was fully confirmed. Conclusions were (1) COPD patients lacked knowledge of their medical condition. They were highly anxious, socially isolated, lonely and afraid to commit themselves to vocational activities. (2) Patients receiving psychotherapy improved psychologically but not vocationally. Where breathing was facilitated, vocational engagement resulted. (3) A program combining rehabilitation and psychotherapy is a sine qua non for the COPD patient.

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