Impact of Chronic Obstructive Pulmonary Disease (COPD) on Patient’s Life and His Family

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common chronic diseases of adults and is a major cause of chronic morbidity and mortality throughout the world. It is the cause of physical and mental suffering for the patient, significantly impairs quality of life, reduces the vital activity and affects the patient’s life in its various aspects. In 2012, the nationwide survey was conducted in COPD outpatients with a history of smoking exploring the various factors of the disease and its effects on the health and life of the patient. The purpose of the analysis presented here is to assess the impact of COPD and tobacco smoking on the patient’s health and life. Material and Methods: Data were collected from patients by their physicians during routine visit with usage of specifically prepared questionnaire for this study. Patients over 35 years of age, with diagnosed COPD, current or past smokers were recruited from outpatients settings. The study involved 10,365 patients with COPD. Representative sample of 2967 questionnaires were randomly drawn for the statistical analysis. Results: The mean age of responders was 61.15 ± 10.25 years, 33.98% of participants were women, 56.73% were current smokers and 43.37% declared smoking in the past. The largest number of patients had COPD in a moderate degree (II—acc. to GOLD 2010)—55.38%, sequentially mild (I)—21.40%, and severe (III)—19.96%, the smallest group were people with very severe degree of disease (IV)—3.27%. Using the new classification of the COPD severity (acc. to GOLD 2013), the largest group of patients were less symptomatic (mMRC ) subjects who had a low risk (A)—52.67%, but in fact a second group of patients were subjects with severe symptoms and a high risk (D)—20.45% , sequentially—patients with low severity of symptoms, but a high risk (C)—16.16% , and severe symptoms and a low risk—10.72% (B). Patients most often reported that COPD affects their activity in sport (83.45% of respondents), than in living activity (82.78%) and family life (79.3%). COPD had significant (moderate or severe) effect on sport (60.85%) and life activity (38.44%), as well as on work (34.9%), but the greatest impact, leading up to the resignation of the activity: on sport practice (21.75%), sexual intercourse (12.6%) and hobbies (11.49%). The disease severity (GOLD 2013 C/D) was the independent factor which reduced all forms of activity. In patients’ opinion smoking had negative impact on their health (52,65%) and the family budget (41.83%). The negative impact of smoking on family relations was declared by 16.38% of respondents. Among the factors which favor effective quit from addiction were: age ≥ 65 years and more seere degree of obturation (III/IV GOLD 2010). Conclusions: The results of the study confirmed the significant impact of the disease and addiction to smoking not only on patients’ life but also on their families.

Informal caregivers of patients with COPD: Home Sweet Home?

“…For example, 16% of couples declared that smoking had a negative impact on their relationship and 42% stated that smoking had a negative impact on the family budget [30]. Furthermore, for some caregivers the coughing caused feelings of disgust, leading to difficulties in kissing their loved one [26].…”

“…Furthermore, for some caregivers the coughing caused feelings of disgust, leading to difficulties in kissing their loved one [26]. This, together with the fact that sexual intercourse was considered too strenuous for the patient, changed the intimate relationship [26,30,35]. Although almost all caregivers felt that the patient needed their support [26], some caregivers persevered because of a sense of duty described in terms of marriage vows and societal expectations [31].…”

“…Patients often report that COPD affects their family life [30]. In this context, shared activities and familiar ways of being together as a couple could change [26] or completely disappear [31].…”

Impact of changing GOLD guidelines (2007–2011–2017) on assignment of a COPD patient to disease severity category

“…Our study found that according to GOLD 2007 classification, among the 2597 COPD patients under the care of a primary care physician, more than half of the subjects (56.7%) presented severe COPD. Those proportions differ from some observed in outpatient specialist care and GP's, where 47-55% of patients had moderate COPD severity stage [7][8][9]. In cross-sectional studies, the proportion of patients presenting a particular severity stage of the disease depended on the study population as well as the study protocol.…”

POLASTMA—The Polish National Programme of Early Diagnosis and Therapy of Asthma

“…Similarly, in the COPD cohort 57% of patients admitted current smoking and 43% declared smoking in the past. The negative impact of smoking on family relations was declared by 16.4% of respondents [16].…”