Engström C P, Persson L O, Larsson S, Rydén A, Sullivan M
Department of Pulmonary Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
Thorax. 1996 Aug;51(8):825-30. doi: 10.1136/thx.51.8.825.
Self-assessment questionnaires which measure the functional and affective consequences of chronic obstructive pulmonary disease (COPD) give valuable information about the effects of the disease and may serve as important tools with which to evaluate treatment.
A cross sectional comparative study was performed between patients with COPD (n = 68), stratified according to pulmonary function, and a healthy control group (n = 89). A battery of well established clinical and quality of life measures (the Sickness Impact Profile (SIP), Mood Adjective Check List (MACL), and Hospital Anxiety and Depression scale (HAD)) was used to examine in which functional and affective aspects the patient group differed from the control group and how these measures related to pulmonary function and smoking habits.
Compared with the controls, COPD affected functional status in most areas, not just those requiring physical activity. Forty six patients with forced expiratory volume in one second (FEV1) below 50% predicted showed particularly high levels of dysfunction in ambulation, eating, home management, and recreation/ pastimes (SIP). Despite this, their level of psychosocial functioning and mood status was little different from that of the healthy controls. Among the patients, a subgroup reported substantial psychological distress, but mood status was only weakly, or not at all, related to pulmonary function. Smoking habits did not affect functional status or well being.
Quality of life is not significantly affected in patients with mild to moderate loss of pulmonary function, possibly due to coping and/or pulmonary reserve capacity. This suggests that generic self-assessment questionnaires are of limited value for detecting the early consequences of COPD. However, in later stages of the disease they are sensitive enough to discriminate between patients with different levels of pulmonary dysfunction. The low correlations between the indices of pulmonary function and the indices of affective status suggest that well being depends, to a large extent, on factors outside the clinical domain.
用于评估慢性阻塞性肺疾病（COPD）功能和情感后果的自我评估问卷能提供有关该疾病影响的有价值信息，可作为评估治疗的重要工具。
对根据肺功能分层的慢性阻塞性肺疾病患者（n = 68）和健康对照组（n = 89）进行了一项横断面比较研究。使用一系列成熟的临床和生活质量测量工具（疾病影响量表（SIP）、情绪形容词检查表（MACL）和医院焦虑抑郁量表（HAD））来检查患者组在哪些功能和情感方面与对照组不同，以及这些测量工具与肺功能和吸烟习惯的关系。
与对照组相比，慢性阻塞性肺疾病影响了大多数领域的功能状态，而不仅仅是那些需要体力活动的领域。46例一秒用力呼气容积（FEV1）低于预计值50%的患者在行走、进食、家庭管理和娱乐/消遣（SIP）方面表现出特别高的功能障碍水平。尽管如此，他们的心理社会功能水平和情绪状态与健康对照组差异不大。在患者中，有一个亚组报告有严重的心理困扰，但情绪状态与肺功能仅呈弱相关或无相关性。吸烟习惯不影响功能状态或幸福感。
轻度至中度肺功能丧失的患者生活质量未受到显著影响，这可能归因于应对能力和/或肺储备能力。这表明通用的自我评估问卷在检测慢性阻塞性肺疾病的早期后果方面价值有限。然而，在疾病的后期阶段，它们足够敏感，能够区分不同肺功能障碍水平的患者。肺功能指标与情感状态指标之间的低相关性表明，幸福感在很大程度上取决于临床领域之外的因素。
