PREDICTORS OF FUNCTIONING OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

Objective: To determine the extent to which mood, symptoms, lung funct ion, and social support of patients with chronic obstructive pulmonary disease (COPD) predicted their level of functioning over a 30-month p eriod. Design: Prospective, longitudinal. Setting: The homes of patien ts living in or adjacent to metropolitan Toronto. Subjects: Seventy-on e patients (48 men and 23 women) with COPD who had a forced expiratory volume in 1 second less than 50% of predicted (FEV(1) <50%) and who s poke English. They ranged in age from 43 to 81 years (mean 66.37 years ). Outcome Measures: The patients' level of functioning at the final d ata collection visit, 30 months after the initial measure. Instruments : At both data collection visits patients completed measures of mood ( negative mood scales of the Profile of Mood States), symptoms (Bronchi tis-Emphysema Symptom Checklist), social support (Personal Resource Qu estionnaire), and functioning (Sickness Impact Profile). Results: Data were analyzed by use of multiple regression analysis. From measures t aken at the initial visit (Tl),the best predictors of patients' functi oning at 30 months (T2) were their functioning at T1, symptoms, FEV(1) , and age, Together these accounted for 70% of the variance in the fin al functioning scores, with initial functioning scores accounting for 51% of the variance. The most prevalent symptoms were dyspnea and fati gue, and both were highly correlated with functioning scores 30 months later. Conclusions: In this study, symptoms, FEV(1), and age are pred ictive of functioning in patients with COPD over a 30-month time frame . However, only 50% of the 143 patients recruited into the study compl eted it. Therefore caution needs to be exercised when the results are applied to other patients with COPD.