Physical, symptomatic and psychological improvement in patients receiving comprehensive care for chronic airway obstruction

Thirty chronic bronchitis and emphysema patients were assessed both upon entry into a comprehensive care program and after one year on the program. The following were evaluated: (a) objective signs of ventilation impairment (e.g. MVV and PaCO2); (b) symptoms of airway obstruction (e.g. experienced difficulty breathing) and (c) psychological adjustment, including affective distress, dependency behavior and selected types of psychopathology. In a comparison between the clinical status of the study group upon entering the care program and 1 yr later, the group showed some absolute improvement in objective signs and affective distress; some relative improvement in symptoms; and no changes in dependency behavior or psychopathology. In an analysis of relationships among patient changes on the different variables over the first year of the program, it was found that from both the patients' and the staff's point of view, improvement in objective signs, symptoms and psychological adjustment were all positively associated.