Abstract
A path analysis model examined interrelationships among variables significantly associated with chronic dyspnea in chronic bronchitis and emphysema (CBE) and the relative influence of these variables on each other and on functional status and quality of life. Results from the 45 adults (mean age, 61) with moderate CBE disease severity showed that dyspnea severity has a sizable effect on functional status and quality of life. Disease severity was more strongly related to functional status than to quality of life. Depression and mastery had the strongest total effects on quality of life. Dyspnea severity had strong but separate effects on functional status and quality of life. From these preliminary results, it is suggested that a direct focus on psychologic interventions to ameliorate depression and improve mastery is likely to improve quality of life with some resultant positive effect on functional status.
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American Thoracic Society, Medical Section of the American Lung Association (1987). Standardization of spirometry—1987 update.Am. Rev. Resp. Dis. 136: 1285–1298.
Asher, H. (1983).Causal modeling. Sage, Beverly Hills.
Brown, M. (1985). Selecting an instrument to measure dyspnea.Oncol. Nurs. Forum 12: 98–100.
Burns, B., and Howell, J. (1969). Disproportionately severe breathlessness in chronic bronchitis.Q. J. Med. 38: 277–294.
Carrieri, V. K., and Janson-Bjerklie, S. (1986). Strategies patients use to manage the sensation of dyspnea.West. J. Nurs. Res. 8: 284–305.
Cohen, J. (1977).Statistical Power Analysis for the Behavioral Sciences, Academic Press, New York.
Costa, P., and McCrae, R. (1985a). Hypochondriasis, neuroticism, and aging: When are somatic complaints unfounded?Am. Psychol. 40: 19–28.
Costa, P., and McCrae, R. (1985b).The NEO Personality Inventory Manual, Psychological Assessment Resources, Odessa, FL.
Davis, J. A. (1985).The Logic of Causal Order, Sage, Beverly Hills, CA.
Dirks, J. F., Kinsman, R. A., Horton, D. J., Fross, K. H., and Jones, N. F. (1978). Panic-fear in asthma: Rehospitalization following intensive long term treatment.Psychosom. Med. 40: 5–13.
Dudley, D. L., Martin, C. J., and Holmes, T. H. (1968). Dyspnea: Psychologic and physiologic observations.J. Psychosom. Res. 11: 325–339.
Gift, A. (1987). Dyspnea: A clinical perspective.Scholar. Inquiry Nurs. Pract. 1: 73–85.
Gift, A. G., Plaut, M., and Jacox, A. (1986). Psychologic and physiologic factors related to dyspnea in subjects with chronic pulmonary disease.Heart Lung 15: 595–601.
Guyatt, G., Bombardier, C., and Tugwell, P. (1986). Measuring disease-specific quality of life in clinical trials.Can. Med. Assoc. J. 134: 889–895.
Guyatt, G., Walter, S., and Geoff, N. (1987). Measuring change over time: Assessing the usefulness of evaluative instruments.J. Chron. Dis. 40: 171–178.
Guyton, A. (1986).Textbook of Medical Physiology, W. B. Saunders, Philadelphia.
Janson-Bjerklie, S., Ruma, S., Stulbarg, M., and Carrieri, V. (1987). Predictors of dyspnea intensity in asthma.Nurs. Res. 36: 179–183.
Hanuschek, E. A., and Jackson, J. E. (1977).Statistical Methods for Social Scientists, Academic Press, New York.
Kinsman, R. A., Yaroush, R. A., Fernandez, E., Dirks, J. F., Schocket, M., and Fukuhara, J. (1983). Symptoms and experiences in chronic bronchitis and emphysema.Chest 83: 755–761.
Liang, M., Larson, M., Cullen, K., and Schwartz, J. (1985). Comparative measurement efficiency and sensitivity of five health status instruments for arthritis research.Arth. Rheum. 28: 542–547.
Marascuilo, L. A., and Levin, J. R. (1983).Multivariate Statistics in the Social Sciences, Brooks and Cole, Monterey, CA.
McCrae, J., Costa, P., and Busch, C. (1986). Evaluating comprehensiveness in personality systems: The California Q-Set and the five-factor model.J. Personal. 54: 430–446.
Moody, L. (1988).An Instrument to Measure Psychophysiologic Response Variables in Chronic Bronchitis and Emphysema, Final Grant Report to University of Florida Division of Sponsored Research, College of Nursing, Gainesville.
Shandu, H. (1986). Psychosocial issues in chronic obstructive pulmonary disease.Clin. Chest Med. 7: 629–642.
Spitzer, W. O., Dobson, J. H., Chesterman, E., Levi, J., Shepherd, R., Battista, R., and Catchlove, B. (1981). Measuring the quality of life of cancer patients.J. Chron. Dis. 34: 585–597.
Stein, M. (1978). Dyspnea. In Tashkin, D., and Cassan, S. (eds.),Guide to Pulmonary Medicine, Grune & Stratton, New York.
Task Force on Health Risk Assessment (U.S. Department of Health and Human Services) (1986).Determining Risks to Health, Auburn House, Dover, MA.
Waltz, C., Strickland, O., and Lenz, E. (1984).Measurement in Nursing Research, F. A. Davis, Philadelphia.
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This study was supported by the National Institute on Aging and the University of Florida, Division of Sponsored Research.
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Moody, L., McCormick, K. & Williams, A. Disease and symptom severity, functional status, and quality of life in chronic bronchitis and emphysema (CBE). J Behav Med 13, 297–306 (1990). https://doi.org/10.1007/BF00846836
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DOI: https://doi.org/10.1007/BF00846836