title: Daily activities and health-related quality of life in patients with chronic obstructive pulmonary disease: psychological determinants: a cross-sectional study.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) patients are confronted with reduced daily activities (DA) and reduced health-related quality of life (HRQoL) caused by dyspnea and systemic effects such as skeletal muscle dysfunction and co-morbidities. To understand the complexity of living with COPD, it is important to understand which factors, in addition to physical functioning, are associated with DA and HRQoL. In this study, we explored the extent to which the combination of illness perceptions, proactive coping, and depressive symptoms contribute to DA and HRQoL in COPD patients.
  
  
  METHODS
  In a cross-sectional study in primary care, 90 COPD patients (GOLD I-III) completed questionnaires: the Brief Illness Perception Questionnaire, the Utrecht Proactive Coping Competence scale, the Centers for Epidemiologic Studies Depression scale, the Medical Research Council dyspnea scale, the Functional Performance Inventory (FPI), and the Clinical COPD Questionnaire (CCQ). The analyses were performed with multiple linear regression analyses.
  
  
  RESULTS
  More adequate and positive illness perceptions (β = .61, p < .001) and less depressive symptoms (β = .21, p = .010) were associated with better HRQoL (CCQ). Significant relations between psychological factors and DA were not found.
  
  
  CONCLUSIONS
  The results of this study demonstrate that psychological factors are related to HRQoL, but not to DA. These results contribute to understanding the complexity of living with COPD and provide starting points for the development of interventions focusing on psychological factors to support COPD patients in disease management.
authors.affiliation: Department of Respiratory Diseases, Division Heart & Lungs, University Medical Center Utrecht, HP E03,511, PO Box 85500, Utrecht 3508 GA, the Netherlands. S.Weldam@umcutrecht.nl.
authors.forename: Saskia W M
authors.initials: SW
authors.lastname: Weldam
authors.forename: Jan-Willem J
authors.initials: JW
authors.lastname: Lammers
authors.forename: Rogier L
authors.initials: RL
authors.lastname: Decates
authors.forename: Marieke J
authors.initials: MJ
authors.lastname: Schuurmans
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008173:Lung Diseases, Obstructive / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires