The consequences of chronic respiratory illness : a sociological study.
The Study upon which this thesis is based attempts to offer
a sociological perspective on the consequences of chronic
Using the International Classification of Impairments,
Disabilities and Handicaps [WHO 1980] as a framework, 92
patients suffering from chronic obstructive airways disease
(CO.AD: chronic obstructive bronchitis, emphysema and chronic
asthma) were interviewed in order to assess the extent of
impairment (functional limitation), disability (activity
restriction) and handicap (social disadvantage) experienced.
A smaller sub-sample of twenty-four of these patients - and
where possible their carers - were subsequently followed-up
using qualitative, open-ended, interviews, in order to cover
in greater detail some of the issues raised within the
first-stage of the study.
Chapter 1 provides a critical review of the existing
psychosocial literature on COAD, chapter 2 discusses of some
of the main methodological problems of assessing the
consequences of CO.AD, whilst chapter 3 outlines the methods
used within the study and the basic sample characteristics.
The thesis then goes on to discuss the experience of living
and coping with COAD and its symptomatology (chapter 4);
medical care and the problems of medical regimens (chapter
5); practical problems of daily life (chapter 6); problems
of work and income (chapters 7 & 8), and finally; the more
diffuse social consequences of COAD (chapter 9).
Patients were found to experience quite severe problems
spanning a broad range of areas including: breathlessness
and associated COAD symptomatology, psychological distress,
disability, practical problems of daily life, problems of
work and income, and problems concerning social and family
life. Moreover, physiological measures of lung function
proved to be fairly poor predictors of disability/quality of
life (e.g. - 0.38 p < .001), whilst much higher correlations
were found to exist between breathlessness and such measures
(e.g.-0.90 p < .001).
The thesis concludes by discussing some of the policy
implications of the study: particualarly the extent to which
a reduction in handicap could bring about a considerable
improvement in sufferers quality of life. The need for a
more integrated approach to the care and rehabilitation of
such patients and their families is also discussed.