Symptom Distress, Symptom Management, and Functional Status Among Individuals with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study
Janjira Sukkueng, Sirinapha JittimaneeIntroduction
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) can cause life-threatening symptoms that impede individuals’ ability to perform their daily activities. Identifying factors associated with functional status may help inform interventions to improve functional status among individuals with AECOPD.
Objectives
This study assessed the extent and patterns of functional status among individuals with AECOPD and identified its associated factors.
Methods
This cross-sectional study included 132 individuals aged 40 years or older with post-bronchodilator FEV1/FVC < 0.70 who experienced acute exacerbations within the past six months. The study was conducted at three tertiary hospitals in the central region of Thailand with high AECOPD caseload. Functional status was assessed using the Short-Form Pulmonary Functional Status Scale (PFSS-11 © ). Data were collected in outpatient departments during scheduled clinical appointments using questionnaires and medical chart reviews. Multiple linear regression was used to evaluate the associations. Findings are reported according to the STROBE checklist.
Results
Functional status during acute exacerbations was moderately impaired (Mean = 3.45, SD = 1.03). Physical and emotional functioning were also moderately impaired (Mean 3.42, SD 1.03; Mean 3.54, SD 1.02, respectively). The multiple regression model was statistically significant (F= 68.682, p < .001) and explained 76.7% of the variance in functional status (R 2 = .767, Adjusted R 2 = .756). Symptom distress (β = −.380, p < .001), age (β = −.203, p < .001), social support (β = .189, p < .001), three or more episodes of exacerbation (β = −.179, p = .006), symptom management attempts (β = −.153, p = .025), and two episodes of exacerbation (β = −.150, p = .004) were significantly associated with functional status.
Conclusion
AECOPD moderately impaired functional status. Interventions properly addressing symptom distress, age, social support, symptom management attempts, and exacerbation frequency may help support functional status.