Chest
Volume 83, Issue 5, May 1983, Pages 755-761
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Symptoms and Experiences in Chronic Bronchitis and Emphysema

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A heterogeneous group of 146 patients with chronic bronchitis and emphysema were asked to rate the frequency with which 89 symptoms and experiences occurred during their breathing difficulties. Normative values and the reported frequency of occurrence for the 11 symptom categories are presented. As expected, symptoms of dyspnea were the most frequently reported during breathing difficulties. In decreasing order, symptoms of dyspnea were followed by symptoms of fatigue, sleep disturbance, congestion, irritability, anxiety, decathexis, helplessness-hopelessness, poor memory, alienation. Separation of the patients into subgroups revealed that women reported more anxiety and helplessness-hopelessness than men. Younger patients reported more irritability and anxiety than older patients. Patients with mixed disease reported more dyspnea than those with chronic bronchitis or emphysema, although patients with emphysema reported more loss of interest in life than patients with chronic bronchitis. Self-ratings of functional incapacitation were clearly related to the symptom reports. Relationships among the symptom categories were discussed, as was the potential usefulness of symptom patterns in exploring coping styles in respiratory disease.

Section snippets

Checklist Development

Symptom items were originally derived from individual interviews with 29 adult patients with chronic bronchitis or emphysema. Each patient was asked to describe his breathing difficulties and to cite all symptoms and experiences which typically occurred. These interviews produced 89 symptom and experience items. Each of these 89 items was then placed in random order next to a five-point scale of frequency of occurrence (1 = never; 5 = always). This arrangement allowed a patient to rate the

DISCUSSION

The psychometric derivation and meaning of the symptom categories for chronic bronchitis and emphysema have been discussed in considerable detail in our earlier report.6 As in any illness, the target symptoms of chronic bronchitis and emphysema (dyspnea and congestion) are embedded within a context of other, more collateral symptoms and experiences. Among other reports, this context includes affective states related to anxiety and depression, and thereby reflects the person’s unique way of

ACKNOWLEDGMENTS

We thank Ms. Peggy Harris for assistance in data collection and analyses, and France Johnson-Behm for preparation of the manuscript.

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Supported in part by grants AI-15392 and HL-22065 from the National Institutes of Health.

Manuscript revision accepted November 4.

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