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Humaj-Grysztar M, Rachel M, Bonior J. Polish Cystic Fibrosis Patients' Health-Related Quality of Life and Its Influencing Factors: A Cross-Sectional, Single-Centre Study. Healthcare (Basel) 2024; 12:1183. [PMID: 38921297 PMCID: PMC11204049 DOI: 10.3390/healthcare12121183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 06/27/2024] Open
Abstract
Cystic fibrosis (CF) is a disease characterized by long-term and troublesome symptoms that affect the patient's life. This study aimed to assess and compare the health-related quality of life (HRQoL) of Polish CF patients and identify factors influencing it. The study group consisted of 79 patients (6 to 42 years old), who filled in an age-appropriate Cystic Fibrosis Questionnaire-Revised. Medical data were collected from each patient's medical records. The domains with the highest HRQoL median were eating problems (88.89), digestive symptoms (77.78) and physical functioning (75.00). The lowest-rated domain was social functioning (61.90). Age negatively correlated with eight domains, and most strongly with treatment burden (rho = -0.474). Physical functioning positively correlated with all spirometry parameters, and most strongly with FEV1% (rho = 0.588). Treatment burden, body image and respiratory symptoms were positively correlated with all spirometry parameters except PEF%. Present exacerbations reduced scores in almost all domains, and in the MANCOVA model they were a significant factor differentiating patients' HRQoL. The univariate analysis of MANCOVA showed the significant effects of both health condition (F = 8.32, p = 0.005) and the COVID-19 pandemic (F = 5.89, p = 0.018) on social functioning domain, and of the place of residence on body image (F = 5.60, p = 0.21). A decreasing HRQoL with increasing age and during exacerbations indicates that it is important to focus on these aspects of patients' lives and ensure they received the necessary support from their healthcare providers.
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Affiliation(s)
- Magdalena Humaj-Grysztar
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland;
| | - Marta Rachel
- Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland;
- Allergology Outpatient Department, Provincial Hospital No 2, 35-301 Rzeszow, Poland
| | - Joanna Bonior
- Department of Medical Physiology, Chair of Biomedical Sciences, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland
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Walicka-Serzysko K, Postek M, Borawska-Kowalczyk U, Milczewska J, Sands D. Pulmonary Function Tests in the Evaluation of Early Lung Disease in Cystic Fibrosis. J Clin Med 2023; 12:4735. [PMID: 37510850 PMCID: PMC10380830 DOI: 10.3390/jcm12144735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/10/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Properly evaluating respiratory system dysfunction is essential in children with cystic fibrosis (CF). This prospective study aimed to assess the course of early lung disease based on multiple breath nitrogen washout (MBNW), impulse oscillometry (IOS), and conventional techniques, such as spirometry and body plethysmography. METHODS Over a 2 year recruitment period, subjects with CF aged 7-18 performed pulmonary function tests (PFTs). Moreover, the nutritional and microbiological status, frequency of pulmonary exacerbations (PExs), and patients' health-related quality of life (HRQoL) were assessed. RESULTS The mean age of the children (n = 69) was 14.09 ± 3.26 years; F/M 37/32. Spirometry-based diagnoses of normal lung function (forced expiratory volume in 1 s, FEV1 ≥ 90%pred), mild (FEV1 70-89%pred) and moderate (FEV1 40-69%pred) lung diseases were established in 34 (49.3%), 25 (36.2%), and 10 (14.5%) patients, respectively. An elevated lung clearance index (LCI > 6.98) was observed in 85% of the subjects with normal FEV1. The presence of Pseudomonas aeruginosa infection (n = 16) and the number of PExs treated with IV antibiotics were associated with significantly worse PFT results. CONCLUSIONS MBNW and IOS are more helpful tools than conventional techniques in assessing early lung disease in CF. LCI is a more useful parameter for detecting functional abnormalities than FEV1 in school-age children.
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Affiliation(s)
- Katarzyna Walicka-Serzysko
- Cystic Fibrosis Department, Institute of Mother and Child, 01-211 Warsaw, Poland
- Cystic Fibrosis Centre, Paediatric Hospital, Dziekanow Lesny, 05-092 Łomianki, Poland
| | - Magdalena Postek
- Cystic Fibrosis Department, Institute of Mother and Child, 01-211 Warsaw, Poland
- Cystic Fibrosis Centre, Paediatric Hospital, Dziekanow Lesny, 05-092 Łomianki, Poland
| | - Urszula Borawska-Kowalczyk
- Cystic Fibrosis Department, Institute of Mother and Child, 01-211 Warsaw, Poland
- Cystic Fibrosis Centre, Paediatric Hospital, Dziekanow Lesny, 05-092 Łomianki, Poland
| | - Justyna Milczewska
- Cystic Fibrosis Department, Institute of Mother and Child, 01-211 Warsaw, Poland
- Cystic Fibrosis Centre, Paediatric Hospital, Dziekanow Lesny, 05-092 Łomianki, Poland
| | - Dorota Sands
- Cystic Fibrosis Department, Institute of Mother and Child, 01-211 Warsaw, Poland
- Cystic Fibrosis Centre, Paediatric Hospital, Dziekanow Lesny, 05-092 Łomianki, Poland
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Nesser W, Grace Yi EH, Wotring AJ, Hutchins MD, Snyder S. A Partial Picture, Without a Frame: Measuring Quality of Life in Cystic Fibrosis Caregivers. AMERICAN JOURNAL OF HEALTH EDUCATION 2023. [DOI: 10.1080/19325037.2023.2186984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Perrem L, Stanojevic S, Shaw M, Pornillos M, Guido J, Sanders DB, Solomon M, Grasemann H, Sweezey N, Waters V, Davis SD, Ratjen F. Comparative analysis of respiratory symptom scores to detect acute respiratory events in children with cystic fibrosis. J Cyst Fibros 2022; 22:296-305. [PMID: 35753986 DOI: 10.1016/j.jcf.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Patient-reported outcomes (PROs) are important outcome measures in research and clinical practice. This study describes the longitudinal variability the Cystic Fibrosis Questionnaire-Revised (CFQ-R) Respiratory score and the Chronic Respiratory Infection Symptom Score (CRISS), as well as their ability to identify acute respiratory events in children with CF. METHODS In this prospective observational study, the parent-proxy (6 -13 years) and self-reported (6-18 years) CFQ-R Respiratory score and CRISS (6-18 years) were measured every 3 months over 2 years. The lung clearance index (LCI) and FEV1 were also measured. We compared the diagnostic accuracy of the PROs in distinguishing acute respiratory events and clinically stable visits, using the minimal important difference of each PRO as the threshold. RESULTS A total of 98 children with CF were included. On average, the symptom scores did not change between clinically stable visits. The positive predictive value (PPV) and negative predictive value (NPV) of a ≥8.5-point worsening in the parent-proxy CFQ-R score to identify acute respiratory events (n=119) (PPV 70.2% and NPV 87.0%) were higher than for the self-reported CFQ-R score (PPV 58.9% and NPV 72.2%). The PPV and NPV of an ≥11-point change in the CRISS for acute respiratory events (n=137) was 56.5% and 79.6%, respectively. The PPV and NPV of all PROs were increased when combined with the LCI and/or FEV1pp. CONCLUSION Symptoms scores differ in their ability to identify acute respiratory events in children with CF; PPV and NPV of all PROs were improved when combined with lung function outcomes.
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Affiliation(s)
- Lucy Perrem
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Canada; Department of Paediatrics, University of Toronto, Canada; Translational Medicine Program, SickKids Research Institute, Toronto, Canada; Royal College of Surgeons in Ireland, Dublin, Ireland; National Children's Research Centre, Children's Health Ireland, Dublin 5, Ireland.
| | - Sanja Stanojevic
- Institute of Health Policy Management and Evaluation, University of Toronto, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Michelle Shaw
- Translational Medicine Program, SickKids Research Institute, Toronto, Canada
| | - Maryjess Pornillos
- Translational Medicine Program, SickKids Research Institute, Toronto, Canada
| | - Julia Guido
- Translational Medicine Program, SickKids Research Institute, Toronto, Canada
| | - Don B Sanders
- Division of Pediatric Pulmonology, Allergy and Sleep Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Melinda Solomon
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Canada; Department of Paediatrics, University of Toronto, Canada
| | - Hartmut Grasemann
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Canada; Department of Paediatrics, University of Toronto, Canada; Translational Medicine Program, SickKids Research Institute, Toronto, Canada
| | - Neil Sweezey
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Canada; Department of Paediatrics, University of Toronto, Canada; Translational Medicine Program, SickKids Research Institute, Toronto, Canada
| | - Valerie Waters
- Department of Paediatrics, University of Toronto, Canada; Translational Medicine Program, SickKids Research Institute, Toronto, Canada; Division of Infectious Diseases, The Hospital for Sick Children, Toronto, Canada
| | - Stephanie D Davis
- Division of Pediatric Pulmonology, Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Felix Ratjen
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, Canada; Department of Paediatrics, University of Toronto, Canada; Translational Medicine Program, SickKids Research Institute, Toronto, Canada
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