The purpose of this observational study was to determine the relationships between symptoms experienced during episodes of dyspnea, the use of coping strategies, and functional incapacity in patients with chronic obstructive pulmonary disease (COPD). We used a convenience sample of 70 adults enrolled in a pulmonary rehabilitation program in a large, private, Midwestern hospital; 51 (73%) subjects were recruited. The 26 men and 25 women ranged in age from 53 to 83 years. Three standardized self-report instruments, the Bronchitis-Emphysema Symptoms Checklist (BESC), the Revised Jalowiec Coping Scale (Part A), and the Functional Incapacitation Scale, were used in participants’ homes to collect data. Pulmonary function status (forced expiratory volume in 1 second [FEV1%]) was determined from chart records; FEV1% predicted ranged from 17% to 91% with a mean of 39.5%. All subjects reported that their most frequently occurring symptoms during episodes of dyspnea were physiological (shortness of breath, fatigue, and sleep difficulties). The most frequently reported psychological symptoms were helplessness/hopelessness, anxiety, and irritability. Coping styles used most frequently during dyspnea episodes included being optimistic, confrontive, and self-reliant. The correlation between frequency of symptoms and use of coping strategies was highly significant, r = .354, p = .005. The correlation between frequency of BESC physiologic symptoms and functional status was also highly significant, r = .419, p = .001, as was the correlation between BESC psychological symptoms and functional status, r = .438, p = .001. Nursing interventions are needed to help people with COPD learn strategies for symptom management during episodes of dyspnea.
1 Ohio Hospital Association in Columbus, OH
School of Nursing, PO Box 26172, University of North Carolina at Greensboro, Greensboro, NC 27402-6172
Carol F. Baker is an Assistant Professor at the University of North Carolina at Greensboro, School of Nursing. Her program of research is centered on the health of women and adolescents who have pulmonary disease, with an emphasis on exercise rehabilitation
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