Assessing the consequences of chronic respiratory disease: a critical review

This paper offers an overview of problems involved in assessing respiratory disablement. Health status and quality of life research have become of increasing importance but critical gaps remain, especially in relation to the multidimensional consequences of chronic obstructive airways disease (COAD). It is argued that much existing psychosocial research has been long on the 'psycho' and short on the wider social consequences and dimensions of respiratory disablement. Many general measures of quality of life and disability are not well suited to assessment of these problems. There is a need to supplement general instruments with more disease-specific measures--many for breathlessness, the most disabling symptom of COAD, have been crude and insensitive. There is also a need to augment predominantly quantitative techniques with qualitative data derived from patients' and carers' perspectives. Wider implications of disability assessment at the welfare policy level are discussed, and the paper concludes by suggesting future research areas on respiratory disablement.