Health-Related Quality of Life and Related Factors in Thais with Stable COPD



This cross-sectional descriptive study aimed to describe the health-related quality of life (HRQL) and related factors of the southern Thai patients with stable COPD. The sample consisted of 126 patients with stable COPD attending the out-patient pulmonary clinic of Thasala hospital. The patients were assessed for HRQL by the Saint George's Respiratory Questionnaire (SGRQ), age, BMI, depression, dyspnea by the Modified Medical Research Council (mMRC), exercise capacity by the 6 min walk distance (6MWD), and admission. The results found that 84 % of patients were male, with a mean age of 69.6 years, FEV1 70 (9.6) % predicted, BMI 21.9 (4.4) and 6MWD 259.8 (97.9). The HRQL indicated mild impairment: symptoms 47.1 (22.4), activity 49.7 (30.3), impact 41.9 (21.2) and total scores of 45.1 (21.7). The regression analysis showed that HRQL was significantly associated with exercise capacity, depression, and MRC dyspnea respectively (R2 = 0.492, p < 0.01). Therefore, stable COPD patients should be assessed and motivated to pulmonary rehabilitation for promoting clinical outcomes and also improving their HRQL.


COPD, stable, quality of life, related factors

Full Text:



The Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017. Available at:, accessed March 2017.

S Burapadaja, P Konkaew, P Tuntipathananandh and J Sanguansermsri. Effect of clinical practice guideline on therapeutic outcomes and treatment expenditures of COPD patients. Chiang Mai Univ. J. Nat. Sci. 2006; 5, 77-84.

N Noonil, S Sindhu, S Hanucharurnkul and N Suwonnaroop. An integrated approach to coordination of community resources improves health outcomes and satisfaction in care of Thai patients with COPD. Thai J. Nurs. 2007; 11, 118-31.

PW Jones. Activity limitation and quality of life in COPD. J. Chron. Obstruct. Pulmon. Dis. 2007; 4, 273-8.

JB Gruenberger, J Vietri, DL Keininger and DA Mahler. Greater dyspnea is associated with lower health-related quality of life among European patients with COPD. Int. J. Chron. Obstruct .Pulmon. Dis. 2017; 12, 937-44.

SW Weldam, MJ Schuurmans, R Liu and JW Lammers. Evaluation of quality of life instruments for use in COPD care and research: A systematic review. Int. J. Nurs. Stud. 2017; 50. 688-707.

JZ Reardon, SC Lareau and R ZuWallack. Functional status and quality of life in chronic obstructive pulmonary disease. Am. J. Med. 2006; 119, S32-7.

A Yorgancioglu, Y Havlucu, P Celik, G Dinc and A Saka. Relation between quality of life and morbidity and mortality in COPD patients: Two-year follow-up study. J. Chron. Obstruct. Pulmon. Dis. 2010; 7, 248-53.

I Henoch, S Strang, CG Lofdahl and A Ekberg-Jansson. Health-related quality of life in a nationwide cohort of patients with COPD related to other characteristics. Eur. Respir. J. 2016; 3, 1-8.

JM Marin, CG Cote, O Diaz, C Lisboa, C Casanova, MV Lopez, SJ Carrizo, V Pin-Plata, LJ Dordelly, H Nekach and BR Celli. Prognostic assessment in COPD: Health related quality of life and the BODE index. Respir. Med. 2011; 105, 916-21.

PW Jones, FH Quirk, CM Baveystock and P Littlejohns. A self-complete measure of health status for chronic airflow limitation: The St. George's Respiratory Questionnaire. Am. Rev. Respir. Dis. 1992; 145, 1321-7.

SK Sarkar, S Basuthakur, SK Das, A Das, S Das, S Choudhury and S Datta. Evaluation of correlation of BODE index with health-related quality of life among patients with stable COPD attending a tertiary care hospital. Lung India 2015; 32, 24-8.

JP Allinson, GC Donaldson, B Kowlessar, AJ Mackay, R Singh, SE Brill and JA Wedzicha. The independent effect of chronic bronchitis on Health-related quality of life In COPD. Am. J. Respir. Crit. Care Med. 2014; 189, A5929.

A Blakemore, C Dickens, E Guthrie, P Bower, E Kontopantelis, C Afzal and PA Coventry. Depression and anxiety predict health-related quality of life in chronic obstructive pulmonary disease: systemic review and meta-analysis. Int. J. Chron. Obstruct. Pulmon. Dis. 2014; 9, 501-12.

EA Regan, D Curran-Everett, KF Hoth, GR Washko, J Black-Shinn, CE McEvoy, NA Hanania, CA Meldrum, AM Boriek and JW Ramsdell. Worsening quality of life in COPD is associated with increasing dyspnea, reduced walking distance and baseline expiratory gas trapping. Am. J. Respir. Crit. Care Med. 2015; 191, A2839.

SR Agrawal, R Joshi and A Jain. Correlation of severity of chronic obstructive pulmonary disease with health-related quality of life and six-minute walk test in a rural hospital of central India. Lung India 2015; 32, 233-40.

C Bunnag, R Fuangtong, C Pothirat and P Punyaratabandhu. A Comparative study of patients’ preferences and sensory perceptions of three forms of inhalers among Thai asthma and COPD patients. Asian Pac. J. Allergy Immunol. 2007; 25, 99-109.

GL Biscione, L Mugnaini, F Pasqua, G Crigna, L Ferri, V Cardaci, M Fini, R Gargano and P Granone. A Cesario BODE index and pulmonary rehabilitation in chronic respiratory failure. Eur. Respir J. 2006; 27, 1320-26.

JP de Torres, E Cordoba-Lanus and C Lopez-Aguilar. C-reaction protein levels and clinically important predictive outcomes in stable COPD patients. Eur. Respir. J. 2006; 27, 902-7.

J Cohen. A power Primer. Psychol. Bull. 1992; 112, 155-9.

National Institutes of Health, National Heart Lung and Blood Institute Obesity Education Initiative Expert Panel on the Identification, Evaluation, and Treatment of Obesity in Adults. Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch. Intern. Med. 1998; 158, 1855-67.

BR Celli, CG Cote, JM Marin, C Casanova, MDO Montes, RA Mendez, VP Pinto and HJ Cabral. The body-mass index, airflow obstruction, dyspnea and exercise capacity index in COPD. New Eng. J. Med. 2004; 350, 1005-12.

JC Bestall, EA Paul, R Garrod, R Garnham, PW Jones and JA Wedzicha. Usefulness of the Medical Research Council (MRC) dyspnea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999; 54, 581-6.

PW Jones, L Adamek, G Nadeau and N Nanik. Comparisons of health status scores with MRC grades in COPD: implications for the GOLD 2011 classification. Eur. Respir. J. 2013; 42, 647-54.

JM Marin, CG Cote, O Diaz, C Lisboa, C Casanova, MV Lopez, SJ Carrizo, V Pin-Plata, LJ Dordelly, H Nekach and BR Celli. Prognostic assessment in COPD: Health related quality of life and the BODE index. Respir. Med. 2011; 105, 916-21.

SJ Singh, MA Puhan, V Andrianopoulos, NA Hernandes, KE Mitchell, CJ Hill, AL Lee, CA Camillo, T Troosters, MA Spruit, BW Carlin, J Wanger, V Peplin, D Saet, DA Kaminsky, MC McCormack, N Maclntyre, BH Culver, FC Sciurba, SM Revill, V Delafosse and AE Holland. An official review of the European Respiratory Society/American Thoracic Society: Measurement properties of field walking tests in chronic respiratory disease. Eur. Respir. J. 2014; 44, 1447-78.

M Lotrakul, S Sumrithe and R Saipanish. Reliability and validity of the Thai version of the PHQ-9. BMC Psychiatr. 2008; 8, 46-52.

AS Moriarty, S Gilbody, D McMillan and L Manea. Screening and case finding for major depressive disorder using the Patient Health Questionnaire (PHQ-9): A meta-analysis. Gen. Hosp. Psychiatr. 2015; 37, 567-76.

SA Antoniu. Descriptors of dyspnea in obstructive lung disease. Mul. Respir. Med. 2010; 5, 216-9.

M Justine, F Tahirah and V Mohan. Health-related quality of life, lung function and dyspnea rating in COPD patients. Monaldi. Arch. Chest Dis. 2013; 79, 116-20.

A Ekici, E Bulcun, T Karakoc, E Senturk and M Ekici. Factors associated with quality of life in subjects with stable COPD. Respir. Care 2015; 60, 1585-91.

S Jogesh and K Gitumoni. Impact of psychosocial factors on health-related quality of life in chronic obstructive pulmonary disease patients. J. Psychiatr. Allied Sci. 2015; 6, 20-7.

N Zoeckler, K Kenn, K Kuehl, N Stenzel and W Rief. Illness perceptions predict exercise capacity and psychological well-being after pulmonary rehabilitation in COPD patients. J. Psycho. Res. 2014; 76, 146-51.

MH Jung, SH Ihm, DH Lee, HW Park, Y Choi, WB Chung, HO Jung and HJ Youn. Factors determining exercise capacity in community-dwelling apparently healthy subjects. J. Hypertens. 2016; 34, e482.

LB Cooper, RJ Mentz, JL Sun, PJ Schulte, JL Fleg, LS Cooper, IL Pina, ES Leifer, WE Kraus, DJ Whellan, SJ Keteyian and CM O’Connor. Psychological factors, Exercise adherence, and Outcomes in Heart Failure Patients. Circ. Heart Fail. 2015; 8, 1044-51.

YS Lee, S Park, YM Oh, SD Lee, SW Park, YS Kim, KH In, BH Jung, KH Lee, SW Ra, YI Hwang, YB Park and KS Jung. Chronic obstructive disease assessment test can predict depression: a prospective multi-center study. J. Korean Med. Sci. 2013; 28, 1048-54.

H Negi, M Sarkar, A Raval, K Pandey and P Das. Presence of depression & its risk factors in patients with chronic obstructive pulmonary disease. Indian J. Med. Res. 2014; 139, 402-8.

TS Wong, YT Xiang, J Tsoh, GS Ungvari, FW Ko, DS Hui and HF Chiu. Depressive disorders in older patients with chronic obstructive pulmonary disease (COPD) in Hong Kong: A controlled study. Aging Ment. Health. 2014; 18, 588-92.

A Baraniak and D Sheffield. The efficacy of psychologically based interventions to improve anxiety, depression and quality of life in COPD: A systematic review and meta-analysis. Patient Educ. Couns. 2011; 83, 29-36.

G Gudmundsson, T Gislason, C Janson, E Linberg, R Hallin, CS Ulrik, E Brondum, MM Nieminen, T Aine and P Bakke. Risk factors for rehospitalisation in COPD: Role of health status, anxiety and depression. Eur. Respir. J. 2005; 26, 414-9.

P Almagro, B Barreiro, EA Ochoa, S Quintana, CM Rodriguez, JL Heredia and J Garau. Risk factors for hospital readmission in patients with chronic obstructive pulmonary disease. Respiration 2006; 73, 311-7.

PA Coventry, I Gemmell and CJ Todd. Psychosocial risk factors for hospital readmission in COPD patients on early discharge services: A cohort study. BMC Pulmon. Med. 2011; 11, 49-58.


  • There are currently no refbacks.

Online ISSN: 2228-835X

Last updated: 12 August 2019