PHYSIOLOGICAL AND PSYCHOLOGICAL FACTORS RELATED TO DYSPNEA IN SUBJECTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE.
Contributors: University of Maryland at Baltimore.
Published: 1984
Number of pages: 142
Subjects: Health Sciences, Nursing.
Description: This study investigated psychological and physiological correlates of dyspnea in patients with advanced chronic obstructive pulmonary disease (COPD). Thirty-two subjects were interviewed to determine their perceived causes for changes in dyspnea magnitude, mechanisms used to avoid increases in dyspnea and strategies used for coping with such increases. The responses to these questions are described. Of these patients, seventeen male and three female patients, ages 53 to 83 years, were each observed on at least three occasions while in a chronic care institution. Each observation included a brief examination, interview, measurement of peak expiratory flow rate (PEFR) using a Wright Peak Flow Meter, and notation of environmental conditions and treatments being used. Anxiety was assessed using the Spielberger State Anxiety Inventory and the anxiety scale of the Brief Symptom Inventory (BSI) whereas depression was assessed using the Beck Depression Inventory and the depression scale of the BSI. Dyspnea level was measured using a vertical visual analogue scale.

Dyspnea levels for each patient were divided into high, medium and low categories based on criteria developed in the prior testing of the scale, and the relationship of these three levels of dyspnea to the other variables was examined by repeated measures analysis of variance. As expected, anxiety measured by both the Spielberger and BSI scales, was greater at high dyspnea levels than at low dyspnea levels and greater at medium than at low dyspnea. In addition, high dyspnea was associated with reports of somatic complaints, symptom distress, loss of appetite and observed use of accessory muscles of respiration. Dyspnea levels were not related to PEFR, respiratory rate, depth of respiration, level of depression or other scales on the BSI. There were no differences in environmental conditions or treatments being used at the three dyspnea levels.

It appears that anxiety level, somatic complaints and symptom distress levels of patients with advanced COPD may be more closely related to the perception of dyspnea magnitude than are physiological indices of airway obstruction. It would be useful to determine the value of psychotherapeutic interventions for the relief of dyspnea in such patients.
Notes: Source: Dissertation Abstracts International, Volume: 45-12, Section: B, page: 3771.

Thesis (PH.D.)--UNIVERSITY OF MARYLAND AT BALTIMORE, 1984.

School code: 0373.