title: Symptoms and impact of symptoms on function and health in patients with chronic obstructive pulmonary disease and chronic heart failure in primary health care.
abstract: BACKGROUND
  Patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) seem to have several symptoms in common that impact health. However, methodological differences make this difficult to compare.
  
  
  OBJECTIVE
  Comparisons of symptoms, impact of symptoms on function and health between patients with COPD and CHF in primary health care (PHC).
  
  
  METHODS
  The study is cross sectional, including patients with COPD (n=437) and CHF (n=388), registered in the patient administrative systems of PHC. The patients received specific questionnaires--the Memorial Symptom Assessment Scale, the Medical Research Council dyspnea scale, and the Fatigue Impact Scale--by mail and additional questions about psychological and physical health.
  
  
  RESULTS
  The mean age was 70 ± 10 years and 78 ± 10 years for patients with COPD and CHF respectively (P=0.001). Patients with COPD (n=273) experienced more symptoms (11 ± 7.5) than the CHF patients (n=211) (10 ± 7.6). The most prevalent symptoms for patients with COPD were dyspnea, cough, and lack of energy. For patients with CHF, the most prevalent symptoms were dyspnea, lack of energy, and difficulty sleeping. Experience of dyspnea, cough, dry mouth, feeling irritable, worrying, and problems with sexual interest or activity were more common in patients with COPD while the experience of swelling of arms or legs was more common among patients with CHF. When controlling for background characteristics, there were no differences regarding feeling irritable, worrying, and sexual problems. There were no differences in impact of symptoms or health.
  
  
  CONCLUSIONS
  Patients with COPD and CHF seem to experience similar symptoms. There were no differences in how the patients perceived their functioning according to their cardinal symptoms; dyspnea and fatigue, and health. An intervention for both groups of patients to optimize the management of symptoms and improve function is probably more relevant in PHC than focusing on separate diagnosis groups.
authors: Department of Nursing, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden ; Primary Care Research Unit, County Council of Värmland, Karlstad, Sweden.
authors: Kersti
authors: K
authors: Theander
authors: Primary Care Research Unit, County Council of Värmland, Karlstad, Sweden ; Department of Medicine, Örebro University, Örebro, Sweden.
authors: Mikael
authors: M
authors: Hasselgren
authors: Family Medicine Research Centre, Örebro County Council, Örebro, Sweden.
authors: Kristina
authors: K
authors: Luhr
authors: Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors: Jeanette
authors: J
authors: Eckerblad
authors: Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors: Mitra
authors: M
authors: Unosson
authors: Department of Nursing, Faculty of Health Science and Technology, Karlstad University, Karlstad, Sweden.
authors: Ingela
authors: I
authors: Karlsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000453:epidemiology; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: chronic heart failure; chronic obstructive pulmonary disease; function; health; symptom