THE DISABLEMENT PROCESS IN PATIENTS WITH PULMONARY-DISEASE

Background and Purpose. The purposes of this study were (1) to describ e the disabilities of patients with pulmonary disease and (2) to exami ne the relationships among impairments, functional limitations, and di sability, as described by the disablement process model. Subjects. Sub jects were 154 patients with chronic pulmonary disease (64% female, 36 % male; mean age=59 years, SD=14, range=24-86). Methods. Information w as abstracted from physical therapy records, including measurements of pulmonary impairment, 6-minute walk distance (6MWD), and Functional S tatus Questionnaire (FSQ) scores. Multivariate analyses were used to e xamine tile relationships among measurements of impairment, 6MWD, and FSQ scores. Results. Mean FSQ scores ranged from 52.6 for instrumental activities of daily living to 83.3 for basic activities of daily livi ng, where 100 represents the highest level of ability. Fifty percent o f patients were not working because of health problems. Percentage of predicted 1-second forced expiratory volume (FEV(1)), oxyhemoglobin sa turation, and the ratio of FEV(1) to forced vital capacity were relate d to 6MWD but not to FSQ scores. The 6MWD was associated with scales o f the FSQ, including basic activities of daily living (R(2)=.24), inst rumental activities of daily living (R(2)=.35), and social activity (R (2)=.26). Conclusion and Discussion. Patients entering a pulmonary reh abilitation program have clinically important disabilities. The result s support the use of the disablement process model and suggest that di fferent and important information is obtained from measurements of imp airment, functional limitation, and disability in patients with pulmon ary disease.