Methodologic limitations
The methodologic strength of the present study, relative to other studies of coping in patients with COPD, is that it has examined the associations among specific situational appraisals, coping strategies, and psychological distress, during acute exacerbations of COPD, instead of attempting an assessment of coping with COPD in general. However, the coping literature refers to a variety of coping questionnaires, with different populations in different settings, making comparisons between studies
difficult. Nevertheless, findings must be tempered in view of the methodologic limitations of the study. These include the applicability of the WOC questionnaire
in relation to an acute exacerbation of COPD. The WOC items are designed to describe coping in a variety of situations across different populations. However, the data from the interviews showed that the item “Tried to make myself feel better by eating, drinking, smoking, using drugs, or medication” is ambiguous, because it may signify the need for medication as well as for misuse. Other items seemed to have minor relevance to Norwegians, indicated by the fact that they were not endorsed. For example, no respondents reported use
of the strategy “finding a new faith,” probably because
of Norwegian cultural norms.