Life values in patients with COPD: relations with pulmonary functioning and health related quality of life

Theories of coping and response shift have suggested that emotional adaptation is related to value changes, e.g. a deemphasized importance of lost life values and an enlargement of the scope of values. Perceived attainment and importance of 82 life values were examined in 65 patients with chronic obstructive pulmonary disease (COPD) and related to clinical and Health-Related Quality of Life (HRQL) measures. The life values covered 10 dimensions--harmony, positive relations, involvement, mobility, communication, knowledge, responsibility, comfort, religion and health. Forty-six of the patients were followed up after 1 year. The patients with COPD were compared with a healthy control group, a group of neurologically impaired and a non-disabled group representing the general population. Significant congruence was found between importance and attainment ratings in all groups (correlations from 0.44 to 0.53), suggesting that both impaired and healthy persons tend to perceive that they have what they find important in life. Congruence was significantly related to mood (correlations from 0.28 to 0.40), but not to functional status or clinical data. Compared to the healthy responders, the patients with COPD had significantly lower attainment ratings in health, mobility, involvement, but no differences were found for importance ratings. No evidence was found that they had replaced unattainable values with new available values, and no changes over time of perceived values were found. This suggests that patients with COPD do not seem to adapt by means of changing their value orientation.