Showing papers by "Donald A. Mahler published in 1995"

Changes in dyspnea, health status, and lung function in chronic airway disease.

Abstract: The purpose of this study was to examine longitudinal changes in clinical parameters in patients with chronic obstructive pulmonary disease (COPD). We postulated that progressive dyspnea and decline in lung function over time would influence or impact patient's health status. Clinical ratings of dyspnea, general health status, and physiologic lung function were measured every 6 mo over a 2-yr period in an original group of 110 male patients with stable but symptomatic COPD and no significant comorbidity. At enrollment, age was 67 +/- 8 yr (mean +/- SD), forced expiratory volume in one second (FEV1) was 1.28 +/- 0.59 I (44 +/- 17% of predicted), and forced vital capacity (FVC) was 2.84 +/- 0.84 I (68 +/- 18% of predicted). A total of 34 patients "dropped out" because of death (n = 20), relocation (n = 7), and other reasons (n = 7). Dyspnea was measured using the transition dyspnea index (TDI), which represented changes from the baseline state; general health status was measured using the Medical Outcomes Study (MOS) 20-item short-form survey; physiologic lung function was assessed by spirometry (FVC and FEV1) and inspiratory muscle strength (PImax). Statistical analyses were performed using all available data for each patient, including results until the time at which patients died or were lost to follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of the Short-Form 36-item Questionnaire to Measure Health-Related Quality of Life in Patients with COPD

Abstract: Study objective To evaluate the short-form 36-item questionnaire (SF-36) as an instrument for measuring health-related quality of life (HRQL) in patients with symptomatic COPD. Design Observational data at a single point in time. Setting Outpatient pulmonary clinic. Patients Fifty male patients with COPD and no significant comorbidity. Measurements and results HRQL was assessed with the SF-36, which consists of 36 questions that cover nine health domains. Clinical ratings of dyspnea were measured by the multidimensional baseline dyspnea index (BDI). Pulmonary function tests included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1 ), and maximal inspiratory mouth pressure (PImax). The mean (± SD) age of the patients was 72 ± 8 years. The BDI focal score was 5.6 ± 2.3, FEV 1 was 1.32 ± 0.60 L (48 ± 22% pred), and PImax was 62 ± 23 cm H 2 O. The BDI focal score was significantly correlated with seven of nine components of the SF-36 (range of r, 0.42 to 0.91; p 1 percent of predicted and PImax were significantly correlated with five of nine health components (range of r, 0.30 to 0.65 and 0.31 to 0.61, respectively). Using linear regression model analysis with the different SF-36 components as the dependent variable and BDI, FVC, FEV 1 , and PImax as independent variables, the BDI score was the only significant predictor of social and physical functioning, role-physical, vitality, pain, health perceptions, and health transition (p Conclusions The SF-36 is a valid instrument to measure HRQL in patients with COPD. The severity of dyspnea but not respiratory function was a significant predictor of various components of HRQL.