# The Hidden Burden: Perceived Stress Levels Among Chronic Obstructive Pulmonary Disease Patients and Its Correlation With Pulmonary Function

## TL;DR

This study finds that COPD patients experience significant stress, with women showing higher stress levels and stress correlating with worse lung function.

## Contribution

The study highlights gender-based stress disparities in COPD patients and links stress levels to pulmonary function decline.

## Key findings

- 74% of COPD patients experienced moderate-to-severe stress based on PSS-10 scores.
- Female patients had significantly higher stress scores compared to male patients (p=0.04).
- Stress levels showed inverse correlations with pulmonary function measurements like vital capacity.

## Abstract

Background: Respiratory conditions such as chronic obstructive pulmonary disease (COPD) extend beyond physical symptoms to affect mental health. Current medical literature lacks a thorough exploration of psychological burdens in COPD, particularly regarding variations across different demographic populations.

Objective: This study sought to determine stress prevalence in individuals diagnosed with COPD and the relationship of perceived stress with the pulmonary function of the patients.

Methods: From December 2021 to May 2022, a cross-sectional study was conducted at Rawalpindi Teaching Hospital. A total of 100 clinically stable COPD patients were included in the study using a purposive sampling technique. Subjects' socio-demographic data were recorded, and asked to complete the standardized Perceived Stress Scale-10 (PSS-10) questionnaire. Data underwent descriptive statistics, including frequencies and mean calculations and correlation calculations for relationship assessment.

Results: The mean Perceived Stress Scale score was 18.38 ± 7.41 across all subjects (predominantly male, 89 (89%), mean age 53.88 ± 10.77). Among 100 COPD subjects, 26 (26%) were experiencing minimal stress (PSS 0-13), 59 (59%) moderate stress (PSS 14-26), and 15 (15%) severe stress (PSS 27-40). Most notably, female subjects demonstrated markedly elevated stress (22.64 ± 5.36) compared to their male counterparts (17.85 ± 7.46), reaching statistical significance (p=0.04). Inverse relationships emerged between pulmonary function measurements and stress intensity (vital capacity r=-0.19; forced vital capacity r=-0.16).

Conclusion: Our study identifies a substantial psychological burden among COPD patients, with nearly three-quarters experiencing moderate-to-severe stress and significant gender-based disparities. The findings of our study suggest that comprehensive COPD management should incorporate routine psychological evaluation with particular attention given to female patients.