An exploration of dyspnoea and determinants in patients with COPD

Abstract

Background: Dyspnoea is a major symptom in COPD and has arising awareness of being a multidimensional symptom consisting of physical and affective experiences. As patients with COPD find coping with dyspnoea challenging, more knowledge is needed in order to better understand and support patients.

Aim: The aim of this study was to examine how physical and affective dimensions of dyspnoea were associated, and whether multiple variables, as for example lung function and comorbidities, could explain the variation in dyspnoea severity in patients with COPD.

Methods: 203 patients with COPD (49% female) attending a 4-week inpatient pulmonary rehabilitation program were included. The study was a cross-sectional study including background characteristics and the questionnaires Dyspnoea-12 (D12) and Hospital Anxiety and Depression Scale (HADS). Correlation and regression analyzes were performed.

Results: FEV1 was 42,1 (18,5)% pred, DLCO 47,7 (18,8)% pred and RV/TLC 162,4 (32,5)% pred. Score on the D12 was 18,0 (8,6) and there were a significant association between the physical (10,8 (5,2)) and affective (7,2 (4,5)) dimensions of D12 (r .57, p = 0.01). HADS-anxiety (HADS-A) was 7.1 (4.5) and HADS-depression (HADS-D) 6.2 (3.8). Patients with greater dyspnoea severity reported higher degree of anxiety (HADS-A (B:0.97, p < 0.001)) and depression (HADS-D (B:0.55, p = 0.002)). None of the other independents variables, as age, gender, lung function and comorbidities, significantly explained the variation in D12 score.

Conclusion: We found a moderate and significant association between physical and affective dyspnoea. Anxiety and depression were the only significant variables to explain the variation in dyspnoea severity.