Impact of Dyspnea and Physiologic Function on General Health Status in Patients with Chronic Obstructive Pulmonary Disease

Mahler, Donald A.; Faryniarz, Kathy; Tomlinson, Donald; Colice, Gene; Robins, Arthur; Olmstead, Elaine M.; O’Connor, Gerald T.

doi:10.1378/chest.102.2.395

Cited by 155 publications

(104 citation statements)

References 19 publications

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“…For example, disease severity in COPD patients based on spirometric classification is related to health status, utilization of health-care resources, development of exacerbations, and mortality. 3,26,27 Although cross-sectional studies 8,16,28,29 show modest correlations between measures of lung function and dyspnea ratings, previous investigators 27, 30 -32 have not shown significant differences in MRC dyspnea scores with different stages of COPD. Our results are the first to demonstrate that patient-reported dyspnea ratings on three different instruments are significantly related to the stage of disease severity based on percent predicted FEV 1 in patients with COPD.…”

Section: Discussionmentioning

confidence: 94%

Patient-Reported Dyspnea in COPD Reliability and Association With Stage of Disease

Mahler

Ward

Waterman

et al. 2009

Chest

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Background: Although questionnaires are used frequently with patients to self-report the severity of dyspnea as related to activities of daily living, the reliability of these instruments has not been established. The two purposes of this study were to examine the test-retest reliability of three widely used dyspnea instruments and to compare dyspnea scores at different stages of disease. Methods: At paired baseline visits, 101 stable patients with COPD were tested; at paired follow-up visits at 3 months, 89 of these patients were tested. At each visit, patients rated dyspnea with three instruments presented in random order and then performed post-bronchodilator therapy lung function tests. Conclusions: Test-retest reliability was acceptable for patient-reported dyspnea scores using three clinical instruments at baseline and at the 3-month follow-up. Our results demonstrate for the first time that patient-reported dyspnea ratings are related to the stage of disease severity.

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Section: Discussionmentioning

confidence: 94%

Patient-Reported Dyspnea in COPD Reliability and Association With Stage of Disease

Mahler

Ward

Waterman

et al. 2009

Chest

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“…[2][3][4][5][6][7][8] In particular, dyspnea in relationship to physical function is commonly reported in the setting of advanced lung cancer. 38 As reported in other studies, 2-5 QOL ratings did not always correlate with the severity of pulmonary functional impairment or even the severity of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Impact of Respiratory Symptoms and Pulmonary Function on Quality of Life of Long-term Survivors of Non-Small Cell Lung Cancer

Sarna

Evangelista

Tashkin

et al. 2004

Chest

208

153

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Purpose: To describe respiratory symptoms and pulmonary function among long-term survivors of non-small cell lung cancer (NSCLC), and their relationship to quality of life (QOL). Methods: Cross-sectional survey of disease-free, 5-year minimum survivors of NSCLC (n ‫؍‬ 142; 54% women; average age, 71 years); the majority (74%) had received a lobectomy. Analysis included frequency of self-reported respiratory symptoms (cough, phlegm, wheezing, breathlessness) as measured by the American Thoracic Society questionnaire, pulmonary function findings from hand-held spirometry, and QOL (Short Form-36). Results: Two thirds of survivors reported at least one respiratory symptom (mean, 1.3; SD, 1.2): 25% cough, 28% phlegm, 31% wheezing, and 39% dyspnea. Twenty-one percent reported that they spent most of the day in bed in the past 12 months because of respiratory symptoms. Average FEV 1 percentage predicted was 68% (SD, 23); 21% had < 50% predicted FEV 1 . Based on spirometry results, 36% had a moderate/severe obstructive and/or restrictive ventilatory disorder. Survivors exposed to second-hand smoke (28%) were more than three times as likely to report respiratory symptoms. Respiratory symptom burden contributed to diminished QOL in several domains. Conclusions: The majority of these survivors experienced respiratory symptoms, and more than one third reported dyspnea, including one of five patients with seriously diminished pulmonary function. Symptom burden, rather than ventilatory impairment, contributed to diminished QOL. Further study is needed to determine the patterns and effective management of posttreatment respiratory symptoms on survivors of lung cancer. (CHEST 2004; 125:439 -445)Key words: cancer survivors; chronic lung disease; lung neoplasms; pulmonary function; quality of life; respiratory symptoms; tobacco, smoking Abbreviations: ATS ϭ American Thoracic Society; df ϭ degrees of freedom; FEF 25-75% ϭ maximum expiratory flow rate; NSCLC ϭ non-small cell lung cancer; QOL ϭ quality of life; SF-36 ϭ Short Form-36 T he long-term consequences of the curative treatment for non-small cell lung cancer (NSCLC) on pulmonary status, the frequency of respiratory symptoms, and the impact of these pulmonary consequences on the quality of life (QOL) of such survivors have not been previously reported. Respiratory distress, even among the 14% of patients with NSCLC who are disease-free survivors, 1 may negatively affect QOL. Dyspnea and other respiratory symptoms have been reported to negatively impact QOL in those with COPD and other chronic lung conditions, 2-8 but little information is available about the impact on people with cancer. 9 One study 10 suggests that patients with NSCLC may actually have better QOL than those with severe COPD.*From the School of Nursing (Drs. Sarna and Evangelista),

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“…The poor correlation between the physical state and anxiety or depression is consistent with other reports, and validates that the HADscale is not influenced by physical impairment. Mahler et al (3) reported that the mood disturbance evaluated by MOS(Medical Outcome Study) survey (25) in patients with COPDwas poorly correlated with FEVL0.Light et al (21) reported that neither depression nor anxiety correlated with FEVL0, PaO2 or PaCO2. Thus, the independence of mooddisturbance from the physical state may be commonin COPDpatients regardless of LTOT.…”

Section: Discussionmentioning

confidence: 99%

“…Dyspneais a common complaint of patients with chronic pulmonary obstructive disease (COPD)and an important determinant of their quality of life (1)(2)(3). It has been recognized that the intensity of dyspnea for a given degree of functional impairment is variable among COPDpatients (4).…”

Section: Introductionmentioning

confidence: 99%

Relationship between Dyspnea in Daily Life and Psycho-physiologic State in Patients with Chronic Obstructive Pulmonary Disease during Long-Term Domiciliary Oxygen Therapy.

et al. 1996

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Impact of Dyspnea and Physiologic Function on General Health Status in Patients with Chronic Obstructive Pulmonary Disease

Cited by 155 publications

References 19 publications

Patient-Reported Dyspnea in COPD Reliability and Association With Stage of Disease

Patient-Reported Dyspnea in COPD Reliability and Association With Stage of Disease

Impact of Respiratory Symptoms and Pulmonary Function on Quality of Life of Long-term Survivors of Non-Small Cell Lung Cancer

Relationship between Dyspnea in Daily Life and Psycho-physiologic State in Patients with Chronic Obstructive Pulmonary Disease during Long-Term Domiciliary Oxygen Therapy.

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