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KOAH Tedaviye Uyum Bozukluğu, Siberkondri ve Sağlık Anksiyetesi Birbirleriyle İlişkili midir?

Yıl 2026, Cilt: 8 Sayı: 1, 85 - 94, 28.02.2026
https://doi.org/10.52827/hititmedj.1779122
https://izlik.org/JA22HJ52NJ

Öz

Amaç: Kronik obstrüktif akciğer hastalığı (KOAH) olan hastalar sıklıkla anksiyete gibi psikolojik sorunlar yaşamakta, bu da tedaviye uyumu bozarak prognozu kötüleştirebilmektedir. Sağlık bilgisi için internet kullanımının artmasıyla birlikte, siberkondri sağlıkla ilişkili anksiyeteyi etkileyebilecek potansiyel bir faktör olarak ortaya çıkmıştır. Bu çalışmanın amacı, KOAH hastalarında sağlık anksiyetesi ile siberkondri arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntem: Bu kesitsel çalışmaya, göğüs hastalıkları polikliniğinde takip için başvuran, 18–65 yaş arası stabil 52 KOAH hastası dahil edildi. Sosyodemografik ve klinik veriler kaydedildi, tedaviye uyum hastane kayıtları, eczane verileri ve ulusal sağlık veri tabanı (e-Nabız) üzerinden doğrulandı. Sağlık anksiyetesi, Sağlık Anksiyetesi Envanteri ile; siberkondri ise Siberkondri Şiddet Ölçeği ile değerlendirildi.
Bulgular: Hastaların yaş ortalaması 57,9±10,6 yıl olup %38,5’i kadındı. Ortalama sağlık anksiyetesi skoru 21,3±10,0; ortalama siberkondri skoru ise 28,3±10,0 bulundu. Sağlık anksiyetesi ile siberkondri arasında anlamlı pozitif korelasyon saptandı (r=0,382, p=0,005). Regresyon analizinde, daha yüksek siberkondri skorları (B=0,360, p=0,014) ve tedaviye uyumsuzluk (B=–8,625, p=0,002) bağımsız olarak yüksek sağlık anksiyetesi ile ilişkiliydi. Yaş, eğitim, gelir düzeyi ve hastalık süresi gibi demografik değişkenler anlamlı ilişki göstermedi. Kentsel bölgelerde yaşayan hastaların siberkondri skorları, kırsal bölgelerde yaşayanlara göre anlamlı derecede yüksekti (31,8±9,4 vs. 22,8±8,4, p=0,001).
Sonuç: KOAH hastalarında sağlık anksiyetesi, demografik faktörlerden ziyade siberkondri ve tedavi uyumundan güçlü şekilde etkilenmektedir. Bu bulgular, rutin KOAH yönetimine dijital sağlık okuryazarlığının değerlendirilmesi ve çevrim içi sağlık bilgisi kullanımına yönelik müdahalelerin entegre edilmesinin önemini vurgulamaktadır.

Etik Beyan

Bu çalışma, Hitit Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (Tarih: 15 Mart 2024; Karar No: 2024/52).

Destekleyen Kurum

Bu çalışma için herhangi bir kurum veya kuruluştan mali destek alınmamıştır.

Teşekkür

Yoktur.

Kaynakça

  • Global Initiative for Chronic Obstructive Lung Disease. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2025 Report: Global Strategy for the Diagnosis, Management, and Prevention of COPD. GOLD; 2025 ([https://goldcopd.org/2025-gold-report](https://goldcopd.org/2025-gold-report)) Accessed Date: 01.01.2025.
  • Russell S, Ogunbayo OJ, Newham JJ, et al. Qualitative systematic review of barriers and facilitators to self-management of chronic obstructive pulmonary disease: views of patients and healthcare professionals. NPJ Primary Care Respiratory Medicine 2018;28(1):2.
  • Willgoss TG, Yohannes AM. Anxiety Disorders in Patients With COPD: A Systematic Review. Respiratory Care 2012;58(5):858-866.
  • Zhao X, Liu G, Liu D, et al. Clinical and economic burden of anxiety/depression among older adult COPD patients: evidence from the COPD-AD China Registry study. Frontiers in Psychiatry 2023;14:1221767.
  • Mayo Clinic. Illness Anxiety Disorder. ([https://www.mayoclinic.org/diseases-conditions/illness-anxiety-disorder/symptoms-causes/syc-20373782](https://www.mayoclinic.org/diseases-conditions/illness-anxiety-disorder/symptoms-causes/syc-20373782)) Accessed Date: 01.01.2025.
  • Pumar MI, Gray CR, Walsh JR, Yang IA, Rolls TA, Ward DL. Anxiety and depression—Important psychological comorbidities of COPD. J Thorac Dis 2014;6(11):1615-1631.
  • Livermore N, Sharpe L, McKenzie D. Fear and catastrophizing in persistent dyspnea: development and validation of the Dyspnea Catastrophizing Scale. Chest 2010;138(2):408-415.
  • Willgoss TG, Yohannes AM. Anxiety disorders in patients with COPD: a systematic review. Respiratory Care 2013;58(5):858-866.
  • Atlantis E, Fahey P, Cochrane B, Smith S. Bidirectional associations between clinically relevant depression or anxiety and COPD: a systematic review and meta-analysis. Chest 2013;144(3):766-777.
  • Yohannes AM, Baldwin RC, Connolly MJ. Depression and anxiety in elderly patients with chronic obstructive pulmonary disease. Age and Ageing 2006;35(5):457-459.
  • de Voogd JN, Sanderman R, Postema K, van Sonderen E, Ranchor AV. Relationship between anxiety and perceived dyspnea in patients with chronic obstructive pulmonary disease. Psychosomatic Medicine 2009;71(7):870-876.
  • Starcevic V, Berle D, Arnáez S. Recent insights into cyberchondria. Curr Psychiatry Rep 2020;22(11):56.
  • Abramowitz JS, Olatunji BO, Deacon BJ. Health anxiety, hypochondriasis, and the anxiety disorders. Behaviour Therapy 2007;38(1):86-94.
  • Muse K, McManus F, Leung C, Meghreblian B, Williams JMG. Cyberchondriasis: fact or fiction? A preliminary examination of the relationship between health anxiety and searching for health information on the Internet. Journal of Anxiety Disorders 2012;26(1):189-196.
  • Etkin A, Egner T, Kalisch R. Emotional processing in anterior cingulate and medial prefrontal cortex. Trends in Cognitive Sciences 2011;15(2):85-93.
  • Paulus MP, Stein MB. Interoception in anxiety and depression. Brain Structure and Function 2010;214(5-6):451-463.
  • Schienle A, Schäfer A, Stark R, Vaitl D. Long-term effects of cognitive-behavioral therapy on brain activation in hypochondriasis. Psychotherapy and Psychosomatics 2009;78(1):28-37.
  • McMullan RD, Berle D, Arnáez S, Starcevic V. The relationships between health anxiety, online health information seeking, and cyberchondria: systematic review and meta-analysis. J Affect Disord 2019;245:270-278.
  • Sansakorn P, Mushtaque I, Awais EYM, Dost MKB. The relationship between cyberchondria and health anxiety and the moderating role of health literacy among the Pakistani public. Int J Environ Res Public Health 2024;21(9).
  • Schenkel SK, Jungmann SM, Gropalis M, Witthöft M. Conceptualizations of cyberchondria and relations to the anxiety spectrum: systematic review and meta-analysis. J Med Internet Res 2021;23(11):e27835.
  • Salkovskis PM, Rimes KA, Warwick HM, Clark DM. The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychol Med 2002;32(5):843-853.
  • Aydemir Ö, Kirpinar I, Sati T, Uykur B, Cengisiz C. Reliability and validity of the Turkish version of the Health Anxiety Inventory. Noropsikiyatri Arsivi 2013;50(4):325-331.
  • McElroy E, Shevlin M. The development and initial validation of the Cyberchondria Severity Scale (CSS). Journal of Anxiety Disorders 2014;28(2):259-265.
  • Selvi Y, Turan SG, Sayin AA, Boysan M, Kandeger A. The Cyberchondria Severity Scale (CSS): validity and reliability study of the Turkish version. Sleep and Hypnosis 2018;20(4):241-246.
  • Özyıldız KH, Alkan A. Akademisyenlerin Sağlık Anksiyeteleri ile Siberkondri Düzeyleri Arasındaki İlişkinin İncelenmesine Yönelik Bir Araştırma. Süleyman Demirel Üniversitesi Vizyoner Dergisi 2022;13(33):309-324.
  • Christiansen CF, Løkke A, Bregnballe V, Prior TS, Farver-Vestergaard I. COPD-related anxiety: a systematic review of patient perspectives. Int J Chron Obstruct Pulmon Dis 2023;18:1031-1046.
  • Durak B, Erdoğan Kaya A. Correlating cyberchondria and health anxiety: demographic insights from stable asthma patients. European Journal of Therapeutics 2024;30:502-509.
  • Aslantaş AHB, Altuntaş M. Cyberchondria’s possible relationship with problematic internet use and eHealth literacy. Journal of Academic Research in Medicine 2023;13(1):63-70.
  • Ayers JW, Poliak A, Dredze M, Leas EC, Zhu Z, Kelley JB, et al. Comparing physician and artificial intelligence chatbot responses to patient questions posted to a public social media forum. JAMA Internal Medicine 2023;183:589-596.
  • Doherty-Torstrick ER, Walton KE, Fallon BA. Cyberchondria: parsing health anxiety from online behavior. Psychosomatics 2016;57(4):390-400.
  • Kooij L, Vos PJE, Dijkstra A, van Harten WH. Effectiveness of a mobile health and self-management app for high-risk patients with chronic obstructive pulmonary disease in daily clinical practice: mixed methods evaluation study. JMIR Mhealth Uhealth 2021;9(2):e21977.
  • Park S, Cho HY, Park JY, Chung K, Jhung K. Development and evaluation of a mindfulness-based mobile intervention for perinatal mental health: randomized controlled trial. JMIR Mental Health 2025;12:e56601.
  • Russell S, Ogunbayo OJ, Newham JJ, et al. Qualitative systematic review of barriers and facilitators to self-management of chronic obstructive pulmonary disease: views of patients and healthcare professionals. NPJ Primary Care Respiratory Medicine 2018;28(1):2.
  • Zhao X, Liu G, Liu D, et al. Clinical and economic burden of anxiety/depression among older adult COPD patients: evidence from the COPD-AD China Registry study. Frontiers in Psychiatry 2023;14:1221767.
  • Er OS. The effect of cyberchondria on surgical readiness: status, severity, and the role of doctor–patient interaction. Psychiatric and Health Dimensions (PHD) 2024;15(1):41-49.
  • Lin C, Lin H. Impact of mobile internet use on health-seeking behaviors: evidence from China. Frontiers in Public Health 2024;12:1403877.
  • Chen X, Orom H, Hay JL, et al. Differences in rural and urban health information access and use. J Rural Health 2019;35(3):405-417.
  • Graves JM, Abshire DA, Amiri S, Mackelprang JL. Disparities in technology and broadband internet access across rurality: implications for health and education. Fam Community Health 2021;44(4):257-265.
  • Lin Y, Xu R. Assessing cyberchondria and eHealth literacy differences in urban and rural China. European Journal of Public Health 2024;34(Supplement_3):ckae144.1698.
  • Karsaneh O, Anber A, Al Shboul S, et al. Impact of anxiety and depression on the level of asthma control among Jordanian adults with asthma. Journal of Asthma and Allergy 2024;17:463-476.
  • Wu D, Long B, Huang B, et al. Exploring the relationship between education, living environment, and anxiety/depression among stable patients: insights from the COPD-AD China Registry Study. International Journal of Chronic Obstructive Pulmonary Disease 2024;19:2063-2071.
  • Yohannes AM, Casaburi R, Dryden S, Hanania NA. Sex differences and determinants of anxiety symptoms in patients with COPD initiating pulmonary rehabilitation. Respir Med 2024;227:107633.
  • Cleland JA, Lee AJ, Hall S. Associations of depression and anxiety with gender, age, health-related quality of life and symptoms in primary care COPD patients. Fam Pract 2007;24(3):217-223.

Are Non-Adherence to COPD Treatment, Cyberchondria, and Health Anxiety Interrelated?

Yıl 2026, Cilt: 8 Sayı: 1, 85 - 94, 28.02.2026
https://doi.org/10.52827/hititmedj.1779122
https://izlik.org/JA22HJ52NJ

Öz

Objective: Patients with chronic obstructive pulmonary disease (COPD) commonly experience psychological problems such as anxiety, which may impair treatment adherence and worsen prognosis. With the increasing use of the Internet for health information, cyberchondria has emerged as a potential factor influencing health-related anxiety. This study aimed to investigate the relationship between health anxiety and cyberchondria in COPD patients.
Material and Method: This cross-sectional study included 52 stable COPD patients aged 18–65 years who presented for follow-up at the pulmonary outpatient clinic. Sociodemographic and clinical data were obtained, and treatment adherence was verified through hospital records, pharmacy data, and the national health database (e-Nabız). Health anxiety was evaluated using the Health Anxiety Inventory, while cyberchondria was assessed with the Cyberchondria Severity Scale.
Results: The mean age of the patients was 57.9±10.6 years, and 38.5% were female. The mean health anxiety score was 21.3±10.0, while the mean cyberchondria score was 28.3±10.0. A significant positive correlation was observed between health anxiety and cyberchondria (r=0.382, p=0.005). Regression analysis showed that higher cyberchondria scores (B=0.360, p=0.014) and non-adherence to treatment (B=–8.625, p=0.002) were independent predictors of elevated health anxiety. Demographic variables such as age, education, income, and disease duration were not significantly associated. Patients living in urban areas had significantly higher cyberchondria scores compared to those in rural areas (31.8±9.4 vs. 22.8±8.4, p=0.001).
Conclusion: Health anxiety in COPD patients is strongly influenced by cyberchondria and treatment adherence rather than demographic factors. These findings highlight the importance of integrating digital health literacy assessment and interventions targeting online health information use into routine COPD management.

Etik Beyan

This study was approved by the Clinical Research Ethics Committee of Hitit University Faculty of Medicine (Date: March 15, 2024; Decision No: 2024/52).

Destekleyen Kurum

The authors received no financial support from any institution or organization for this study.

Teşekkür

None.

Kaynakça

  • Global Initiative for Chronic Obstructive Lung Disease. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2025 Report: Global Strategy for the Diagnosis, Management, and Prevention of COPD. GOLD; 2025 ([https://goldcopd.org/2025-gold-report](https://goldcopd.org/2025-gold-report)) Accessed Date: 01.01.2025.
  • Russell S, Ogunbayo OJ, Newham JJ, et al. Qualitative systematic review of barriers and facilitators to self-management of chronic obstructive pulmonary disease: views of patients and healthcare professionals. NPJ Primary Care Respiratory Medicine 2018;28(1):2.
  • Willgoss TG, Yohannes AM. Anxiety Disorders in Patients With COPD: A Systematic Review. Respiratory Care 2012;58(5):858-866.
  • Zhao X, Liu G, Liu D, et al. Clinical and economic burden of anxiety/depression among older adult COPD patients: evidence from the COPD-AD China Registry study. Frontiers in Psychiatry 2023;14:1221767.
  • Mayo Clinic. Illness Anxiety Disorder. ([https://www.mayoclinic.org/diseases-conditions/illness-anxiety-disorder/symptoms-causes/syc-20373782](https://www.mayoclinic.org/diseases-conditions/illness-anxiety-disorder/symptoms-causes/syc-20373782)) Accessed Date: 01.01.2025.
  • Pumar MI, Gray CR, Walsh JR, Yang IA, Rolls TA, Ward DL. Anxiety and depression—Important psychological comorbidities of COPD. J Thorac Dis 2014;6(11):1615-1631.
  • Livermore N, Sharpe L, McKenzie D. Fear and catastrophizing in persistent dyspnea: development and validation of the Dyspnea Catastrophizing Scale. Chest 2010;138(2):408-415.
  • Willgoss TG, Yohannes AM. Anxiety disorders in patients with COPD: a systematic review. Respiratory Care 2013;58(5):858-866.
  • Atlantis E, Fahey P, Cochrane B, Smith S. Bidirectional associations between clinically relevant depression or anxiety and COPD: a systematic review and meta-analysis. Chest 2013;144(3):766-777.
  • Yohannes AM, Baldwin RC, Connolly MJ. Depression and anxiety in elderly patients with chronic obstructive pulmonary disease. Age and Ageing 2006;35(5):457-459.
  • de Voogd JN, Sanderman R, Postema K, van Sonderen E, Ranchor AV. Relationship between anxiety and perceived dyspnea in patients with chronic obstructive pulmonary disease. Psychosomatic Medicine 2009;71(7):870-876.
  • Starcevic V, Berle D, Arnáez S. Recent insights into cyberchondria. Curr Psychiatry Rep 2020;22(11):56.
  • Abramowitz JS, Olatunji BO, Deacon BJ. Health anxiety, hypochondriasis, and the anxiety disorders. Behaviour Therapy 2007;38(1):86-94.
  • Muse K, McManus F, Leung C, Meghreblian B, Williams JMG. Cyberchondriasis: fact or fiction? A preliminary examination of the relationship between health anxiety and searching for health information on the Internet. Journal of Anxiety Disorders 2012;26(1):189-196.
  • Etkin A, Egner T, Kalisch R. Emotional processing in anterior cingulate and medial prefrontal cortex. Trends in Cognitive Sciences 2011;15(2):85-93.
  • Paulus MP, Stein MB. Interoception in anxiety and depression. Brain Structure and Function 2010;214(5-6):451-463.
  • Schienle A, Schäfer A, Stark R, Vaitl D. Long-term effects of cognitive-behavioral therapy on brain activation in hypochondriasis. Psychotherapy and Psychosomatics 2009;78(1):28-37.
  • McMullan RD, Berle D, Arnáez S, Starcevic V. The relationships between health anxiety, online health information seeking, and cyberchondria: systematic review and meta-analysis. J Affect Disord 2019;245:270-278.
  • Sansakorn P, Mushtaque I, Awais EYM, Dost MKB. The relationship between cyberchondria and health anxiety and the moderating role of health literacy among the Pakistani public. Int J Environ Res Public Health 2024;21(9).
  • Schenkel SK, Jungmann SM, Gropalis M, Witthöft M. Conceptualizations of cyberchondria and relations to the anxiety spectrum: systematic review and meta-analysis. J Med Internet Res 2021;23(11):e27835.
  • Salkovskis PM, Rimes KA, Warwick HM, Clark DM. The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychol Med 2002;32(5):843-853.
  • Aydemir Ö, Kirpinar I, Sati T, Uykur B, Cengisiz C. Reliability and validity of the Turkish version of the Health Anxiety Inventory. Noropsikiyatri Arsivi 2013;50(4):325-331.
  • McElroy E, Shevlin M. The development and initial validation of the Cyberchondria Severity Scale (CSS). Journal of Anxiety Disorders 2014;28(2):259-265.
  • Selvi Y, Turan SG, Sayin AA, Boysan M, Kandeger A. The Cyberchondria Severity Scale (CSS): validity and reliability study of the Turkish version. Sleep and Hypnosis 2018;20(4):241-246.
  • Özyıldız KH, Alkan A. Akademisyenlerin Sağlık Anksiyeteleri ile Siberkondri Düzeyleri Arasındaki İlişkinin İncelenmesine Yönelik Bir Araştırma. Süleyman Demirel Üniversitesi Vizyoner Dergisi 2022;13(33):309-324.
  • Christiansen CF, Løkke A, Bregnballe V, Prior TS, Farver-Vestergaard I. COPD-related anxiety: a systematic review of patient perspectives. Int J Chron Obstruct Pulmon Dis 2023;18:1031-1046.
  • Durak B, Erdoğan Kaya A. Correlating cyberchondria and health anxiety: demographic insights from stable asthma patients. European Journal of Therapeutics 2024;30:502-509.
  • Aslantaş AHB, Altuntaş M. Cyberchondria’s possible relationship with problematic internet use and eHealth literacy. Journal of Academic Research in Medicine 2023;13(1):63-70.
  • Ayers JW, Poliak A, Dredze M, Leas EC, Zhu Z, Kelley JB, et al. Comparing physician and artificial intelligence chatbot responses to patient questions posted to a public social media forum. JAMA Internal Medicine 2023;183:589-596.
  • Doherty-Torstrick ER, Walton KE, Fallon BA. Cyberchondria: parsing health anxiety from online behavior. Psychosomatics 2016;57(4):390-400.
  • Kooij L, Vos PJE, Dijkstra A, van Harten WH. Effectiveness of a mobile health and self-management app for high-risk patients with chronic obstructive pulmonary disease in daily clinical practice: mixed methods evaluation study. JMIR Mhealth Uhealth 2021;9(2):e21977.
  • Park S, Cho HY, Park JY, Chung K, Jhung K. Development and evaluation of a mindfulness-based mobile intervention for perinatal mental health: randomized controlled trial. JMIR Mental Health 2025;12:e56601.
  • Russell S, Ogunbayo OJ, Newham JJ, et al. Qualitative systematic review of barriers and facilitators to self-management of chronic obstructive pulmonary disease: views of patients and healthcare professionals. NPJ Primary Care Respiratory Medicine 2018;28(1):2.
  • Zhao X, Liu G, Liu D, et al. Clinical and economic burden of anxiety/depression among older adult COPD patients: evidence from the COPD-AD China Registry study. Frontiers in Psychiatry 2023;14:1221767.
  • Er OS. The effect of cyberchondria on surgical readiness: status, severity, and the role of doctor–patient interaction. Psychiatric and Health Dimensions (PHD) 2024;15(1):41-49.
  • Lin C, Lin H. Impact of mobile internet use on health-seeking behaviors: evidence from China. Frontiers in Public Health 2024;12:1403877.
  • Chen X, Orom H, Hay JL, et al. Differences in rural and urban health information access and use. J Rural Health 2019;35(3):405-417.
  • Graves JM, Abshire DA, Amiri S, Mackelprang JL. Disparities in technology and broadband internet access across rurality: implications for health and education. Fam Community Health 2021;44(4):257-265.
  • Lin Y, Xu R. Assessing cyberchondria and eHealth literacy differences in urban and rural China. European Journal of Public Health 2024;34(Supplement_3):ckae144.1698.
  • Karsaneh O, Anber A, Al Shboul S, et al. Impact of anxiety and depression on the level of asthma control among Jordanian adults with asthma. Journal of Asthma and Allergy 2024;17:463-476.
  • Wu D, Long B, Huang B, et al. Exploring the relationship between education, living environment, and anxiety/depression among stable patients: insights from the COPD-AD China Registry Study. International Journal of Chronic Obstructive Pulmonary Disease 2024;19:2063-2071.
  • Yohannes AM, Casaburi R, Dryden S, Hanania NA. Sex differences and determinants of anxiety symptoms in patients with COPD initiating pulmonary rehabilitation. Respir Med 2024;227:107633.
  • Cleland JA, Lee AJ, Hall S. Associations of depression and anxiety with gender, age, health-related quality of life and symptoms in primary care COPD patients. Fam Pract 2007;24(3):217-223.
Toplam 43 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Göğüs Hastalıkları, Psikiyatri
Bölüm Araştırma Makalesi
Yazarlar

Büşra Durak 0000-0002-2638-1513

Ayşe Erdoğan Kaya 0000-0002-6780-9301

Gönderilme Tarihi 7 Eylül 2025
Kabul Tarihi 21 Kasım 2025
Yayımlanma Tarihi 28 Şubat 2026
DOI https://doi.org/10.52827/hititmedj.1779122
IZ https://izlik.org/JA22HJ52NJ
Yayımlandığı Sayı Yıl 2026 Cilt: 8 Sayı: 1

Kaynak Göster

AMA 1.Durak B, Erdoğan Kaya A. Are Non-Adherence to COPD Treatment, Cyberchondria, and Health Anxiety Interrelated? Hitit Medical Journal. 2026;8(1):85-94. doi:10.52827/hititmedj.1779122