• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of thoraxThoraxInstructions for authorsInstructions for authors
Thorax. Aug 1996; 51(8): 825–830.
PMCID: PMC472558

Functional status and well being in chronic obstructive pulmonary disease with regard to clinical parameters and smoking: a descriptive and comparative study.


BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Mahler DA, Harver A. A factor analysis of dyspnea ratings, respiratory muscle strength, and lung function in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis. 1992 Feb;145(2 Pt 1):467–470. [PubMed]
  • Wegner RE, Jörres RA, Kirsten DK, Magnussen H. Factor analysis of exercise capacity, dyspnoea ratings and lung function in patients with severe COPD. Eur Respir J. 1994 Apr;7(4):725–729. [PubMed]
  • Mahler DA, Faryniarz K, Tomlinson D, Colice GL, Robins AG, Olmstead EM, O'Connor GT. Impact of dyspnea and physiologic function on general health status in patients with chronic obstructive pulmonary disease. Chest. 1992 Aug;102(2):395–401. [PubMed]
  • Jones PW, Baveystock CM, Littlejohns P. Relationships between general health measured with the sickness impact profile and respiratory symptoms, physiological measures, and mood in patients with chronic airflow limitation. Am Rev Respir Dis. 1989 Dec;140(6):1538–1543. [PubMed]
  • Fishman AP. Pulmonary rehabilitation research. Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):825–833. [PubMed]
  • Curtis JR, Deyo RA, Hudson LD. Pulmonary rehabilitation in chronic respiratory insufficiency. 7. Health-related quality of life among patients with chronic obstructive pulmonary disease. Thorax. 1994 Feb;49(2):162–170. [PMC free article] [PubMed]
  • Ware JE., Jr Standards for validating health measures: definition and content. J Chronic Dis. 1987;40(6):473–480. [PubMed]
  • Anderson RT, Aaronson NK, Wilkin D. Critical review of the international assessments of health-related quality of life. Qual Life Res. 1993 Dec;2(6):369–395. [PubMed]
  • McSweeny AJ, Grant I, Heaton RK, Adams KM, Timms RM. Life quality of patients with chronic obstructive pulmonary disease. Arch Intern Med. 1982 Mar;142(3):473–478. [PubMed]
  • Prigatano GP, Wright EC, Levin D. Quality of life and its predictors in patients with mild hypoxemia and chronic obstructive pulmonary disease. Arch Intern Med. 1984 Aug;144(8):1613–1619. [PubMed]
  • Kaptein AA, Brand PL, Dekker FW, Kerstjens HA, Postma DS, Sluiter HJ. Quality-of-life in a long-term multicentre trial in chronic nonspecific lung disease: assessment at baseline. The Dutch CNSLD Study Group. Eur Respir J. 1993 Nov;6(10):1479–1484. [PubMed]
  • Williams SJ, Bury MR. Impairment, disability and handicap in chronic respiratory illness. Soc Sci Med. 1989;29(5):609–616. [PubMed]
  • BERGLUND E, BIRATH G, BJURE J, GRIMBY G, KJELLMER I, SANDQVIST L, SODERHOLM B. Spirometric studies in normal subjects. I. Forced expirograms in subjects between 7 and 70 years of age. Acta Med Scand. 1963 Feb;173:185–192. [PubMed]
  • Sullivan M, Ahlmén M, Archenholtz B, Svensson G. Measuring health in rheumatic disorders by means of a Swedish version of the sickness impact profile. Results from a population study. Scand J Rheumatol. 1986;15(2):193–200. [PubMed]
  • Bergner M, Bobbitt RA, Carter WB, Gilson BS. The Sickness Impact Profile: development and final revision of a health status measure. Med Care. 1981 Aug;19(8):787–805. [PubMed]
  • Lundqvist C, Siösteen A, Blomstrand C, Lind B, Sullivan M. Spinal cord injuries. Clinical, functional, and emotional status. Spine (Phila Pa 1976) 1991 Jan;16(1):78–83. [PubMed]
  • Sullivan M, Karlsson J, Sjöström L, Backman L, Bengtsson C, Bouchard C, Dahlgren S, Jonsson E, Larsson B, Lindstedt S, et al. Swedish obese subjects (SOS)--an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int J Obes Relat Metab Disord. 1993 Sep;17(9):503–512. [PubMed]
  • Sjöberg L, Svensson E, Persson LO. The measurement of mood. Scand J Psychol. 1979;20(1):1–18. [PubMed]
  • Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361–370. [PubMed]
  • Wilson DO, Rogers RM, Wright EC, Anthonisen NR. Body weight in chronic obstructive pulmonary disease. The National Institutes of Health Intermittent Positive-Pressure Breathing Trial. Am Rev Respir Dis. 1989 Jun;139(6):1435–1438. [PubMed]
  • Pehrsson K, Olofson J, Larsson S, Sullivan M. Quality of life of patients treated by home mechanical ventilation due to restrictive ventilatory disorders. Respir Med. 1994 Jan;88(1):21–26. [PubMed]
  • Hopwood P, Howell A, Maguire P. Screening for psychiatric morbidity in patients with advanced breast cancer: validation of two self-report questionnaires. Br J Cancer. 1991 Aug;64(2):353–356. [PMC free article] [PubMed]
  • Hopwood P, Howell A, Maguire P. Screening for psychiatric morbidity in patients with advanced breast cancer: validation of two self-report questionnaires. Br J Cancer. 1991 Aug;64(2):353–356. [PMC free article] [PubMed]
  • Aylard PR, Gooding JH, McKenna PJ, Snaith RP. A validation study of three anxiety and depression self-assessment scales. J Psychosom Res. 1987;31(2):261–268. [PubMed]
  • Ahlmén EM, Bengtsson CB, Sullivan BM, Bjelle A. A comparison of overall health between patients with rheumatoid arthritis and a population with and without rheumatoid arthritis. Scand J Rheumatol. 1990;19(6):413–421. [PubMed]
  • Sullivan M, Ahlmén M, Bjelle A. Health status assessment in rheumatoid arthritis. I. Further work on the validity of the sickness impact profile. J Rheumatol. 1990 Apr;17(4):439–447. [PubMed]
  • Lazarus RS. Coping theory and research: past, present, and future. Psychosom Med. 1993 May-Jun;55(3):234–247. [PubMed]

Articles from Thorax are provided here courtesy of BMJ Group


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...