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Valeria Gatti,1 Paolo Banfi,2 Stefano Centanni,3 Salvatore D’Antonio,4 Saffi Giustini,5 Alessio Piraino,6 Marco Zibellini,1 Maria Giulia Marini1 1Health Care Area, Fondazione ISTUD, Milan, Italy; 2Fondazione Don Carlo Gnocchi IRCCS, Milan, Italy; 3Respiratory Unit, ASST San Paolo e San Carlo, Department of Health Sciences, University of Milan, Milan, Italy; 4Italian Patient’s Association “BPCO ONLUS”, Rome, Italy; 5Italian General Practitioners’ Association “SIMG”, Florence, Local Health Unit of Montale, Pistoia, Italy; 6Chiesi Farmaceutici S.p.A, Parma, Italy Purpose: The primary aim of this research was to raise awareness for COPD through real narratives of patients, caregivers, and pulmonologists. The second objective includes providing clinicians new means of caring for and treating patients with COPD.Methods: Using narrative medicine, testimonies from patients, their caregivers, and clinicians were collected through an online questionnaire enriched by a narrative plot. Narrations were analyzed throughout descriptive statistics and an elaboration of recurring words and expressions.Results: Throughout the project, 350 narratives were collected from 235 patients, 55 caregivers, and 60 physicians. Though a generally neutral reaction had been observed upon diagnosis, COPD had been found to have a high impact on the patients’ and caregivers’ lives. Metaphors utilized by patients and caregivers were suggestive of fear and panic unlike those utilized by clinicians who usually had a more technical approach. Smoking was a significant concern for not only patients and caregivers but also clinicians.Conclusion: Physicians are therefore challenged to find new ways of communicating COPD to raise awareness on this pathology and encourage corrective habits. An important social objective should be the implementation of a health system that is able to optimize patients’ and caregivers’ lives.Keywords: COPD, quality of life, narrative medicine, communication

The World Health Organization Disability Assessment Schedule II (WHO-DAS II) is a non-disease-specific International Classification of Functioning, Disability, and Health-based disability assessment instrument developed to measure activity limitations and restrictions to participation. The aim of this pilot study is to evaluate WHO-DAS II responsiveness in detecting short-time changes following the provision of an Assistive Technology,which is important to define its utility in performing daily activities. Adult inpatients with a diagnosis of Disease of the Nervous System (included in Chapter VI of the ICD-10),who were prescribed an Assistive Technology to be used in the household settings, were enrolled. The WHO-DAS II was administered in individual interview at baseline and at a 2 months follow-up: in this period patients were transitioning from the hospital to home. Changes in disability profiles were detected by calculating the effect size (ES) for each WHO-DAS II domain. Ten patients with different neurological diseases were enrolled. Few longitudinal changes in disability level are reported: mild improvement is observed in the household activities (ES0.28), whereas mild worsening is reported in self-care and participation in society domains (ES – 0.27 and – 0.26,respectively). Our study shows that the WHO-DAS II is responsive in detecting domain-specific changes over a short-term period and provides preliminary encouraging evidence for the utility of its utilization in clinical settings.However, changes in setting between baseline and follow up could have an impact on the findings and interpretation of this study.