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UBC Theses and Dissertations

The experience, contributors, and etiology of pain in people with chronic obstructive pulmonary disease Chen, Yi-Wen


Pain is a common symptom in patients with chronic obstructive pulmonary disease (COPD). This symptom can negatively affect physical activity levels, quality of life, and health outcomes. It has been shown that systemic inflammation, comorbidities, and symptoms (e.g., dyspnea or fatigue) may cause pain. Although previous research has determined the association between pain and the presence of comorbidities, the specific comorbidities that cause pain and other etiologic factors of pain are still unknown. Also, the interrelationships among pain, dyspnea, and fatigue and whether the presence of one symptom accentuates another remain to be examined. The overall purpose of this dissertation was to investigate the etiology of pain by exploring the pain experience, the contributors to pain, the interrelationships between pain and other symptoms, and the associations between pain and thoracic abnormalities in patients with COPD. Studies I and II established the reliability and validity of the Brief Pain Inventory (BPI), Dyspnea Inventory (DI), and Brief Fatigue Inventory (BFI) in patients with COPD. Study III determined comorbidities that caused pain as well as compared pain, fatigue, and dyspnea symptomology in patients with COPD. This study utilized a cross-sectional survey design that included the BPI, DI, BFI, General Self-efficacy Scale, Clinical COPD Questionnaire, and Comorbidities/Medication Questionnaire. Study IV investigated chest computed tomography images of patients with COPD and current/ex-smokers to examine the associations between trunk pain and thoracic vertebral deformity and arthropathy. The findings showed that the BPI, DI, and BFI were reliable and valid questionnaires to evaluate symptoms in COPD. Similar to dyspnea and fatigue, pain was also a significant symptom in patients with COPD and these three symptoms were correlated with each other. Further, the most common comorbidities that caused pain were musculoskeletal diseases. Trunk pain in patients with COPD was associated with thoracic vertebral deformities, arthropathy of thoracic joints, and hyperkyphosis. In summary, pain in COPD is associated with musculoskeletal comorbidities and there are interactions between pain and other symptoms. This dissertation provides insight into the causes of pain in patients with COPD, which can facilitate the development of pain management strategies in COPD.

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