Ketelaars C A, Schlösser M A, Mostert R, Huyer Abu-Saad H, Halfens R J, Wouters E F
Department of Nursing Science, University of Limburg, Netherlands.
Thorax. 1996 Jan;51(1):39-43. doi: 10.1136/thx.51.1.39.
The consequences of chronic obstructive pulmonary disease (COPD) on daily life, encapsulated by the term "health-related quality of life" (HRQL), are important in determining appropriate home care. There is a need to understand the relative contribution of respiratory impairment, physical disability, coping, age, and socioeconomic variables on HRQL.
Patients with COPD were recruited on admission to a pulmonary rehabilitation centre. Respiratory impairment was assessed by lung function tests and physical disability was evaluated by a 12 minute walking test. HRQL was assessed by means of the St George's Respiratory Questionnaire (SGRQ) measuring "symptoms", "activity", and "impact". Because the SGRQ does not include a measure of "well being", this was taken from the medical psychological questionnaire for lung diseases. The COPD coping questionnaire and a questionnaire covering basic socioeconomic variables were also used.
One hundred and twenty six patients of mean (SD) age 65 (9) years and mean (SD) forced expiratory volume in one second (FEV1) 39 (9)% predicted were included. The scores on the SGRQ indicated severe impairment. Correlations were found between lung function parameters, 12 minute walking test, and the HRQL "activity" and "impact" components. Coping strategies were correlated with the "activity", "impact", and "well being" components. No correlations were found between age, socioeconomic variables, and HRQL. FEV1, 12 minute walking test, and the coping strategies "avoidance" and "emotional reaction" were the best predictors of HRQL.
In patients with COPD methods of improving physical performance and teaching adequate coping strategies should be considered in order to improve HRQL.
慢性阻塞性肺疾病（COPD）对日常生活的影响，用“健康相关生活质量”（HRQL）这一术语概括，在确定合适的家庭护理方面很重要。有必要了解呼吸功能损害、身体残疾、应对方式、年龄和社会经济变量对健康相关生活质量的相对影响。
慢性阻塞性肺疾病患者在进入肺康复中心时被招募。通过肺功能测试评估呼吸功能损害，通过12分钟步行测试评估身体残疾。通过圣乔治呼吸问卷（SGRQ）评估健康相关生活质量，该问卷测量“症状”、“活动”和“影响”。由于圣乔治呼吸问卷不包括“幸福感”的测量，这一指标取自肺部疾病医学心理问卷。还使用了慢性阻塞性肺疾病应对问卷和一份涵盖基本社会经济变量的问卷。
纳入了126例患者，平均（标准差）年龄为65（9）岁，一秒用力呼气量（FEV1）平均（标准差）为预计值的39（9）%。圣乔治呼吸问卷的得分表明存在严重损害。在肺功能参数、12分钟步行测试与健康相关生活质量的“活动”和“影响”部分之间发现了相关性。应对策略与“活动”、“影响”和“幸福感”部分相关。未发现年龄、社会经济变量与健康相关生活质量之间存在相关性。FEV1、12分钟步行测试以及应对策略“回避”和“情绪反应”是健康相关生活质量的最佳预测因素。
对于慢性阻塞性肺疾病患者，应考虑改善身体机能的方法并教授适当的应对策略，以提高健康相关生活质量。
