Crisan Alexandru Florian, Pescaru Camelia Corina, Maritescu Adelina, Stoicescu Emil Robert, Carunta Vlad, Oancea Cristian
Research Center for Assessment of Human Motion, Functionality, and Disability, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania.
Pulmonary Rehabilitation Center, Clinical Hospital of Infectious Diseases and Pulmonology, "Victor Babes", Gheorghe Adam Street 13, 300310 Timisoara, Romania.
J Clin Med. 2025 Mar 10;14(6):1865. doi: 10.3390/jcm14061865.
Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by significant physical and psychological burdens. However, the influence of the disease's severity on psychological factors and functional outcomes remains unclear. This study aimed to investigate the impact of disease severity on psychological factors and functional outcomes in patients with moderate and severe COPD. This cross-sectional study included 98 patients with moderate ( = 44) or severe ( = 54) COPD. Anxiety and depression, guilt and shame, self-compassion, self-efficacy (PRAISE), and fear of negative evaluation were assessed. Functional capacity was evaluated with the six minute walk test (6MWT), and disease impact was assessed via the COPD assessment test (CAT). Lung function was measured through post-bronchodilator spirometry. : Compared with those with moderate COPD, those with severe COPD presented significantly greater levels of guilt (12 vs. 10; < 0.01), anxiety (10 vs. 6.5; < 0.01), and depression (7.5 vs. 6; = 0.06). Self-compassion was significantly lower in the severe group (3.16 vs. 3.41; < 0.01), whereas shame and fear of negative evaluation scores were similar between the groups. The functional capacity was significantly reduced in patients with severe COPD (217.04 ± 70.16 m vs. 286.46 ± 77.92 m; < 0.01). Disease impact and dyspnea (CAT, mMRC) were worse in severe cases ( < 0.01). Patients with severe COPD presented significantly greater levels of guilt, anxiety, and depression, alongside lower self-compassion, worse functional outcomes, and poorer health-related quality of life, compared to those with moderate COPD.
慢性阻塞性肺疾病（COPD）是一种进行性肺部疾病，具有显著的身心负担。然而，该疾病严重程度对心理因素和功能结局的影响仍不清楚。本研究旨在调查疾病严重程度对中度和重度COPD患者心理因素和功能结局的影响。这项横断面研究纳入了98例中度（n = 44）或重度（n = 54）COPD患者。评估了焦虑和抑郁、内疚和羞耻、自我同情、自我效能感（PRAISE）以及对负面评价的恐惧。通过六分钟步行试验（6MWT）评估功能能力，并通过慢性阻塞性肺疾病评估测试（CAT）评估疾病影响。通过支气管扩张剂后肺量计测量肺功能。结果显示：与中度COPD患者相比，重度COPD患者的内疚感（12 vs. 10；P < 0.01）、焦虑（10 vs. 6.5；P < 0.01）和抑郁（7.5 vs. 6；P = 0.06）水平显著更高。重度组的自我同情显著更低（3.16 vs. 3.41；P < 0.01），而两组之间的羞耻感和对负面评价的恐惧得分相似。重度COPD患者的功能能力显著降低（217.04 ± 70.16米 vs. 286.46 ± 77.92米；P < 0.01）。严重病例的疾病影响和呼吸困难（CAT，mMRC）更严重（P < 0.01）。与中度COPD患者相比，重度COPD患者的内疚、焦虑和抑郁水平显著更高，同时自我同情更低，功能结局更差，与健康相关的生活质量更差。
