title: Chronic obstructive pulmonary disease patient well-being and its relationship with clinical and patient-reported outcomes: a real-life observational study.
abstract: BACKGROUND
  Quality of life is an umbrella concept that refers to all aspects of a person's life, including health status and well-being. While health status measure focuses on the impact of the disease on physical functioning, well-being represents the self-representation of the emotional states related to the disease itself.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the psychological well-being and its determining factors in a real-life chronic obstructive pulmonary disease (COPD) population and to evaluate if patients with a different well-being differ in illness perception, health status and alexithymia.
  
  
  METHODS
  Psychological well-being (Psychological General Well-Being Index), health status (SF-36), illness perception (Illness Perception Questionnaire), alexithymia (Toronto Alexithymia Scale), as well as clinical parameters were assessed in COPD out-patients.
  
  
  RESULTS
  One hundred and sixty-four patients, with a mean forced expiratory volume in 1 s of 58.5%, were recruited. Forty percent of them had a moderately/severely impaired well-being, not correlated with forced expiratory volume in 1 s and the Charlson index value but significantly with the Medical Research Council score (p = 0.0001) that appeared to be the dominant factor. Patients with impaired well-being showed a different illness perception in terms of correct identification of symptoms, disease consequences, emotional representation and confidence in treatment compared with those having a positive well-being. The latter presented a lower alexithymia prevalence and a better health status.
  
  
  CONCLUSIONS
  In order to minimize the disease-negative effects on patients' lives, assessment of well-being and its determining factors, as well as planning specific behavioural, educational and therapeutic interventions seem to be relevant and useful.
authors.affiliation: Allergy and Respiratory Diseases Clinic, Department of Internal Medicine, University of Genoa, Genoa, Italy. fulvio.braido@unige.it
authors.forename: Fulvio
authors.initials: F
authors.lastname: Braido
authors.forename: Ilaria
authors.initials: I
authors.lastname: Baiardini
authors.forename: Sara
authors.initials: S
authors.lastname: Balestracci
authors.forename: Stefania
authors.initials: S
authors.lastname: Menoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Balbi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Ferraioli
authors.forename: Sara
authors.initials: S
authors.lastname: Bocchibianchi
authors.forename: Giorgio Walter
authors.initials: GW
authors.lastname: Canonica
mesh_terms: D000342:Affective Symptoms / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D006304:Health Status; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires