Symptoms and Symptom Clusters in Persons with Chronic Obstructive Pulmonary Disease (COPD)

Wednesday, 24 July 2013: 8:50 AM

Julaluk Baramee, PhD
Nursing, Burapha University, Chonburi, Thailand
Supaporn Duangpaeng, DNS
Faculty of Nursing, Burapha University, Muang Chonburi, Thailand

Learning Objective 1: The learner will be able to identify symptoms and symptom clusters often occurring in COPD patients.

Learning Objective 2: The learner will be able to describe the importance of assessing symptoms and relationships among symptoms in COPD patients


Chronic obstructive pulmonary disease (COPD) is a highly prevalent disease globally. People with COPD often experience a variety of concurrent symptoms. This study aimed to examine prevalence of symptoms and to identify symptom clusters in persons with COPD.


 The sample of this cross-sectional, correlational study was 180 outpatients with COPD multi-stage randomly selected from four hospitals in the eastern region of Thailand. Dyspnea, fatigue and insomnia were measured by the Thai-version Modified Memorial Symptom Assessment Scale (MSAS). Anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics, Pearson’s correlational coefficients and exploratory factor analysis using Principle Axis Factoring were used to analyze the data.


 Most of the sample was male (90%) with mean age 70.3 years. The majority (75.6%) was diagnosed COPD for less than 10 years in which 31.7% were stage 1 and 33.9% were stage 2. A large proportion of the sample experienced symptoms at a moderate to severe level for dyspnea (72%), fatigue (45%), insomnia (51%), anxiety (25%) and depression (26%).  Almost half (44%) had two or more symptoms at a moderate to severe level, and 16% had four symptoms at a moderate to severe level. All five symptoms were positively related at moderate to high level (r ranged from .423 to .814). From an exploratory factor analysis, two symptom clusters were generated: physical symptom cluster including dyspnea, fatigue and insomnia; and, psychological symptom cluster including anxiety and depression.


With the majority of sample reported a moderate to severe level of many symptoms, a comprehensive assessment of symptom and symptom cluster is critical for improving the quality of care provided to COPD patients.