Quality of life in patients with chronic airflow limitation

One hundred patients with chronic airflow limitation (CAL) randomly selected from over 600 such patients seen in the previous 2 years at a respiratory referral centre were asked about the ways in which their lives were adversely effected by their lung problems. Major problem areas included dyspnoea on day-to-day activities, fatigue and certain areas of emotional function including embarrassment, depression, anxiety and frustration. Severity of airflow limitation was only weakly related to patients' problems. Patients did not volunteer items easily, and most problems were elicited by specific probes. In 36 subjects, relatives were asked about the patients' problems. Relatives tended to identify fewer items, but items identified were judged more important; there was a limited relation between spouses' and patients' assessment of CAL-related problems (Pearson's r = 0.42-0.60). These results suggest that physicians cannot rely on severity of airflow limitation as an indicator of the impact of CAL on patients' lives. Patients should be specifically asked about problem areas, especially emotional difficulties, and spouses' view of the problems should be obtained.