Chen Yi-Wen, Camp Pat G, Coxson Harvey O, Road Jeremy D, Guenette Jordan A, Hunt Michael A, Reid W Darlene
a Department of Physical Therapy , University of British Columbia , Vancouver , BC Canada.
b Department of Physical Therapy, and Centre for Heart Lung Innovation , University of British Columbia , Vancouver , BC Canada.
COPD. 2018 Feb;15(1):65-72. doi: 10.1080/15412555.2017.1401990. Epub 2017 Dec 11.
In addition to dyspnea and fatigue, pain is a prevalent symptom in chronic obstructive pulmonary disease (COPD). Understanding the relative prevalence, magnitude, and interference with aspects of daily living of these symptoms can improve COPD management. Therefore, the purposes of this study were to: (1) compare the prevalence and magnitude of dyspnea, fatigue, and pain and how each limits aspects of daily living; (2) determine the association between pain and the other two symptoms; and (3) assess the impact of these symptoms on quality of life in COPD. Participants were recruited from pulmonary rehabilitation programs. Pain, dyspnea, and fatigue were measured using the Brief Pain Inventory (BPI), Brief Fatigue Inventory (BFI), and Dyspnea Inventory (DI), respectively. Quality of life was measured using the Clinical COPD Questionnaire (CCQ). The prevalence of dyspnea, fatigue, and pain were 93%, 77%, and 74%, respectively. Individuals with COPD reported similar severity scores of the three symptoms. Dyspnea interfered with general activity more than pain (F = 3.1, p < 0.05), whilst pain interfered with mood (F = 3.6, p < 0.05) and sleep (F = 7.4, p < 0.01) more than dyspnea and fatigue. These three symptoms were moderately-to-highly correlated with each other (ρ = 0.49-0.78, p < 0.01) and all individually impacted quality of life. In summary, pain is a common symptom in addition to dyspnea and fatigue in COPD; all three interfere similarly among aspects of daily living with some exceptions. Accordingly, management of COPD should include a multifaceted approach that addresses pain as well as dyspnea and fatigue.
除了呼吸困难和疲劳外，疼痛是慢性阻塞性肺疾病（COPD）中一种普遍存在的症状。了解这些症状的相对患病率、严重程度以及对日常生活方面的干扰，有助于改善慢性阻塞性肺疾病的管理。因此，本研究的目的是：（1）比较呼吸困难、疲劳和疼痛的患病率及严重程度，以及它们如何限制日常生活的各个方面；（2）确定疼痛与其他两种症状之间的关联；（3）评估这些症状对慢性阻塞性肺疾病患者生活质量的影响。研究对象从肺康复项目中招募。分别使用简明疼痛评估量表（BPI）、简明疲劳量表（BFI）和呼吸困难量表（DI）来测量疼痛、呼吸困难和疲劳。使用慢性阻塞性肺疾病临床问卷（CCQ）来测量生活质量。呼吸困难、疲劳和疼痛的患病率分别为93%、77%和74%。慢性阻塞性肺疾病患者报告的这三种症状的严重程度得分相似。呼吸困难对日常活动的干扰比疼痛更大（F = 3.1，p < 0.05），而疼痛对情绪（F = 3.6，p < 0.05）和睡眠（F = 7.4，p < 0.01）的干扰比呼吸困难和疲劳更大。这三种症状之间呈中度至高度相关（ρ = 0.49 - 0.78，p < 0.01），且均对生活质量有单独影响。总之，除了呼吸困难和疲劳外，疼痛是慢性阻塞性肺疾病中一种常见症状；在日常生活的某些方面，这三种症状的干扰情况相似，但也有一些例外。因此，慢性阻塞性肺疾病的管理应包括一种多方面的方法，既要解决呼吸困难和疲劳问题，也要解决疼痛问题。
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