DETERMINANTS OF HEALTH-RELATED QUALITY-OF-LIFE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

Background - The consequences of chronic obstructive pulmonary disease (COPD) on daily life, encapsulated by the term ''health-related quali ty of life'' (HRQL), are important in determining appropriate home car e. There is a need to understand the relative contribution of respirat ory impairment, physical disability, coping, age, and socioeconomic va riables on HRQL. Methods - Patients with COPD were recruited on admiss ion to a pulmonary rehabilitation centre. Respiratory impairment was a ssessed by lung function tests and physical disability was evaluated b y a 12 minute walking test. HRQL was assessed by means of the St Georg e's Respiratory Questionnaire (SGRQ) measuring ''symptoms'', ''activit y'', and ''impact''. Because the SGRQ does not include a measure of '' well being'', this was taken from the medical psychological questionna ire for lung diseases. The COPD coping questionnaire and a questionnai re covering basic socioeconomic variables were also used. Results - On e hundred and twenty six patients of mean (SD) age 65 (9) years and me an (SD) forced expiratory volume in one second (FEV(1)) 39 (9)% predic ted were included. The scores on the SGRQ indicated severe impairment. Correlations were found between lung function parameters, 12 minute w alking test, and the HRQL ''activity'' and ''impact'' components. Copi ng strategies were correlated with the ''activity'', ''impact'', and ' 'well being'' components. No correlations were found between age, soci oeconomic variables, and HRQL. FEV(1), 12 minute walking test, and the coping strategies ''avoidance'' and ''emotional reaction'' were the b est predictors of HRQL. Conclusion - In patients with COPD methods of improving physical performance and teaching adequate coping strategies should be considered in order to improve HRQL.