A combined sample (n = 132) of asthma (70%, n = 92) and chronic obstructive pulmonary disease (COPD) (30%, n = 40) patients was assessed for short-term and longitudinal changes in perceived health status (HS), quality of life (QoL), and trait anxiety after a 4-week inpatient pulmonary rehabilitation program (PRP). The total sample improved on HS (P = 0.009, effect size (ES) = 0.12) and QoL (P = 0.011, ES = 0.16) immediately after rehabilitation but improvements diminished at 6 months follow-up. Trait anxiety scores changed very little. The COPD group improved on HS immediately after the rehabilitation program (P = 0.005, ES = 0.16) but scores had deteriorated at follow-up. The asthma group had only a small and non-significant HS improvement immediately after the program but got better during the follow-up period and improved significantly on HS (P = 0.040, ES = 0.21) from before rehabilitation to follow-up 6 months after the program. Within both diagnosis groups, patients who were living alone had the largest improvements in QoL scores. PRP may have different longitudinal effects for patients with asthma and COPD. After-care procedures are probably important in rehabilitation of patients with COPD. Chronic Respiratory Disease 2008; 5: 69-73
Because quality of life (QoL) and health status (HS) scales contain different kinds of items and are shown not to be equivalent, there is a recommendation to use both types of scales. We investigated the relationship between either type of scale but focusing on the subscales of HS measures. A sample of chronic obstructive pulmonary disease (COPD) patients completed two QoL scales and two HS scales (BPQ and SGRQ), neuroticism, six-minute walk test and FEV1. Factor analysis revealed a two-factor structure (consistent with previous research), and showed that one type of HS subscale is different from QoL but another is equivalent to QoL. If total HS scores are used then it is valuable to include a QoL measure, but if HS subscales are reported, then these cover both latent variables, with the BPQ providing a clearer separation of the latent variables than the SGRQ.
Chronic obstructive pulmonary disease (COPD) limits the ability to perform activities of daily living (ADL). The Pulmonary Functional Status and Dyspnoea Questionnaire (PFSDQ) measures general dyspnoea, dyspnoea during ADL (dyspnoea score) and loss of functional performance (activity score) for a large number of activities commonly performed by adults. The questionnaire is only validated for male patients. The aim of our study was therefore to validate the PFSDQ for women with COPD. We then wanted to investigate possible gender differences in responses to the PFSDQ and whether associations between the PFSDQ and pulmonary function, exercise capacity, health related quality of life (HRQoL) and general quality of life (QoL) were influenced by gender. This cross-sectional, observational study included 110 COPD patients. Sixty-five men and 45 women, referred to pulmonary rehabilitation participated. Pulmonary function and six-minute walking distance (6MWD) were measured. Patients completed PFSDQ, St George's Respiratory Questionnaire (SGRQ, HRQoL) and Perceived Quality of Life Scale (PQoL, QoL). No gender differences were found in pulmonary function (% of predicted), 6MWD, SGRQ or PQoL. Most items in the PFSDQ were found relevant by both women and men. Activity Scores were only different for men and women for items concerning home management; women had changed their functional performance the most, particularly for the heaviest chores. No gender differences were found in dyspnoea scores. Moderate correlations were found between PFSDQ and 6MWD, SGRQ and PQoL. Multiple linear regression analyses showed that these relations were not influenced by gender. We consider PFSDQ as applicable to women as to men as a comprehensive measure of functional performance and dyspnoea. The questionnaire gives information complementary to measures of exercise capacity, HRQOL and QOL. The larger loss of functional performance in home management among women should be taken into account in the treatment of COPD patients.
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