Assessment of Physical Health Status, Depression and Activities of Daily Living Among Chronic Obstructive Pulmonary Disease Patients in Tertiary Care Hospitals in Mangalore, India

Background: Chronic Obstructive Pulmonary Disease (COPD) manifests with dyspnoea which causes restriction in movement, loss of independence and social isolation. Objectives: To assess physical health status, depression, activities of daily living (ADL) and its determinants among COPD patients. Methods: This cross-sectional study was done among out and in-patients at a government and private tertiary care hospital. All confirmed cases of COPD were interviewed using a semi-structured interview schedule. Results: The mean age of the 76 patients was 60.9 ± 13.3 years. The majority were males 61(80.3%) and were from urban area 48(63.2%). Duration of COPD was between 1 to 5 years among 43(56.6%) patients. Among the participants, 49(64.5%) were smokers and among them 17(34.7%) were current smokers. Physical health status was good among 23(30.3%), average among 49(64.4%) and poor among 4(5.3%) patients. Level of depression was nil, mild, moderate, moderately severe and severe among 30(39.5%), 18(23.7%), 20(26.3%), 6(7.9%) and 2(2.6%) participants respectively. ADL was poor, average and good among 4(5.3%), 17(22.3%) and 55(72.4%) participants respectively. Pack-years of smoking more than 5 years among current smokers (n=17) was significantly associated with poor to average physical health status (P=0.0063). Duration of COPD more than 5 years was associated each with poor to average ADL (P=0.05) and with the presence of depression (P=0.022) among participants. The correlation between physical health status scores and Barthel index scores was found to be significant (r = – 0.359, P=0.001). Conclusion: The study identified the number of patients having an impairment with physical health, ADL and the presence of depression. Therefore these parameters need to be screened periodically during the course of management. Further interventions such as smoking cessation measures, monitoring COPD symptom burden and tailoring treatment accordingly would help to improve the quality of life of the affected.