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Kotsiou OS, Barkas GI, Kokkinidou K, Siachpazidou DI, Gourgoulianis KI, Daniil Z. Psychopathology in asthma patients: analysis of demographic and clinical associations. J Asthma 2024:1-13. [PMID: 39230207 DOI: 10.1080/02770903.2024.2400601] [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: 04/03/2024] [Revised: 08/29/2024] [Accepted: 08/30/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Asthma, a chronic inflammatory condition affecting the airways, significantly impacts both respiratory function and quality of life. Recent studies have highlighted the psychological dimensions of chronic diseases like asthma. Despite growing evidence linking asthma with various psychopathological conditions, comprehensive data remains scarce. AIM This study aims to explore the psychopathological status of asthma patients and identify demographic and clinical factors associated with higher levels of psychopathological symptoms. METHODS Data were collected from 42 asthma patients attending the Asthma Outpatient Clinic at the University of Thessaly, Greece. Participants completed a detailed questionnaire on demographics and clinical parameters, along with the Symptoms Checklist-90 (SCL-90) to assess psychological symptoms. RESULTS The sample included patients with varying asthma severity: 38% with severe asthma and 62% with mild-moderate asthma, with a mean age of 60.8 ± 15.6 years. Results indicated that 23.8% exhibited somatization symptoms, 23.8% showed compulsive behaviors, 33.8% reported interpersonal sensitivity, and 38.1% experienced depression and 38.1% aggressiveness. Additionally, 45.2% struggled with fearful anxiety, 4.8% showed paranoid ideation, and 11.9% had traits of psychoticism. Women had significantly higher psychopathology scores than men. Factors such as longer disease duration, uncontrolled asthma, severe asthma, and comorbid conditions like atopy and gastroesophageal reflux disease (GERD) were linked to higher psychopathological scores. CONCLUSIONS The study found a high prevalence of psychopathological symptoms among asthma patients. Female gender, prolonged asthma duration, persistent symptoms, comorbid diseases (GERD, atopy) and greater disease severity were significantly associated with higher psychopathology, underscoring the need for integrated mental health care in asthma management.
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Affiliation(s)
- Ourania S Kotsiou
- Laboratory of Human Pathophysiology, Department of Nursing, University of Thessaly School of Health Sciences, Gaiopolis, Greece
- Department of Nursing, University of Thessaly, Gaiopolis, Greece
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly School of Health Sciences, Biopolis, Greece
| | - Georgios I Barkas
- Laboratory of Human Pathophysiology, Department of Nursing, University of Thessaly School of Health Sciences, Gaiopolis, Greece
- Department of Nursing, University of Thessaly, Gaiopolis, Greece
| | - Katerina Kokkinidou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly School of Health Sciences, Biopolis, Greece
| | - Dimitra I Siachpazidou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly School of Health Sciences, Biopolis, Greece
| | - Konstantinos I Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly School of Health Sciences, Biopolis, Greece
| | - Zoe Daniil
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly School of Health Sciences, Biopolis, Greece
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Leso V, Candia C, Pacella D, Molino A, Nocera C, Maniscalco M, Iavicoli I. Quality of life and work functionality in severe asthma patients: the impact of biological therapies. J Occup Med Toxicol 2024; 19:8. [PMID: 38509562 PMCID: PMC10953125 DOI: 10.1186/s12995-024-00406-9] [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: 01/31/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Severe asthma can cause poor health status, poor health-related quality of life (HRQoL) and an impaired functioning at work. However, to date, limited data are available on the impact of the biological therapies on such outcomes. Therefore, aim of the present study was to prospectively assess the clinical, quality of life and work functionality issues in severe asthma patients both at baseline and after 6 months of biological therapies and determine which individual, pathological and occupational factors can influence such parameters. METHODS Fifty-two patients were enrolled between December 2022 and June 2023. Patients' personal, clinical, functional and occupational features were assessed. The Short Form Health Survey (SF-12), the Work Productivity and Activity Impairment (WPAI) questionnaire and the Work Ability Index (WAI) were employed to assess HRQoL, the employee's productivity and perception of work ability, respectively. RESULTS Among the enrolled patients, 30 (57.70%) were employed. Biological therapy induced a significant improvement in clinical and functional parameters, e.g., FEV1% (72 ± 12 vs.87 ± 13%; 72 ± 14 vs. 86 ± 14%), FVC% (92 ± 11 vs. 101 ± 11%; 90 ± 13 vs. 98 ± 14%) and FEV1/FVC (62 ± 11 vs. 71 ± 8%; 64 ± 9 vs. 70 ± 8%) in workers and non-workers, respectively (P < 0.001). Comparably, the perception of life quality significantly improved, as physical and mental health scores, in the overall cohort, increased from 40.7 ± 10.3 and 48.5 ± 8.5 to 46.8 ± 8.6 and 51.6 ± 6.4, respectively (P < 0.001). The work ability perception significantly improved from a moderate to a good one (34 ± 6 vs. 40 ± 6, P = 0.001). A significant reduction in the absenteeism (19 ± 15 vs. 3 ± 11%; P < 0.001) and presenteeism rate (53 ± 24 vs. 29 ± 26%; P < 0.001), and an improvement in daily (40 ± 27.5% vs. 28.9 ± 24.7%, P < 0.001, in the overall population) and work activities (57 ± 25 vs. 29 ± 27%, P < 0.001) was determined. Gender, age, symptoms control and pulmonary functionality were correlated with the physical and mental health perception, daily activity impairment and work ability. CONCLUSIONS Our study pointed out that biological therapies improved clinical, general life and occupational outcomes in patients with severe asthma. The correlation between clinical aspects and psychological and occupational issues suggest the relevance for a multidisciplinary management of the disease for an effective participation of patients in the world of work.
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Affiliation(s)
- Veruscka Leso
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy.
| | - Claudio Candia
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, 80131, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
| | - Antonio Molino
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, 80131, Italy
| | - Caterina Nocera
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
| | - Mauro Maniscalco
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, 80131, Italy
- Pulmonary Rehabilitation Unit of Telese Terme Institute, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme, 82037, Italy
| | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
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Moitra S, Adan A, Akgün M, Anderson A, Brickstock A, Eathorne A, Farshchi Tabrizi A, Haldar P, Henderson L, Jindal A, Jindal SK, Kerget B, Khadour F, Melenka L, Moitra S, Moitra T, Mukherjee R, Semprini A, Turner AM, Murgia N, Ferrara G, Lacy P. Less Social Deprivation Is Associated With Better Health-Related Quality of Life in Asthma and Is Mediated by Less Anxiety and Better Sleep Quality. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2115-2124.e7. [PMID: 37087095 DOI: 10.1016/j.jaip.2023.03.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Previous studies on health-related quality of life (HRQoL) in asthma have mainly focused on clinical and environmental determinants. Little is known about the role of social determinants on HRQoL in asthma. OBJECTIVES We aimed to investigate the association between social deprivation and HRQoL in asthma. METHODS A total of 691 adult asthmatics from Canada, India, New Zealand, and the United Kingdom were administered a digital questionnaire containing demographic information and questions about social and psychological attributes, sleep disturbances, and alcohol abuse. HRQoL was measured using the Short Form of the Chronic Respiratory Questionnaire (SF-CRQ). We analyzed the direct and indirect relationships between social deprivation and HRQoL using structural equation models with social deprivation as a latent variable. We tested for mediation via anxiety, depression, sleep disturbances, and alcohol abuse. RESULTS We found that less social deprivation (latent variable) was directly associated with better SF-CRQ domain scores such as dyspnea (regression coefficient β: 0.33; 95% confidence interval [CI]: 0.07 to 0.58), fatigue (β: 0.39; 95% CI: 0.14 to 0.64), and emotional function (β: 0.37; 95% CI: 0.11 to 0.62), but with the worse mastery score (β: -0.29; 95% CI: -0.55 to -0.03); however, those associations varied across participating countries. We also observed that among all individual social deprivation indicators, education, companionship, emotional support, instrumental support, and social isolation were directly associated with HRQoL, and the relationship between social deprivation and HRQoL was mediated through anxiety and sleep disturbances. CONCLUSIONS Our results demonstrated that less social deprivation was directly, and indirectly through less anxiety and better sleep quality, associated with better HRQoL in asthma.
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Affiliation(s)
- Subhabrata Moitra
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada.
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Metin Akgün
- Department of Chest Diseases, Ataturk University, Erzurum, Turkey; Department of Pulmonary Medicine, Ağrı İbrahim Çeçen University, School of Medicine, Ağrı, Turkey
| | | | - Amanda Brickstock
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Allie Eathorne
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Ali Farshchi Tabrizi
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Prasun Haldar
- Department of Medical Laboratory Technology, Supreme Institute of Management and Technology, Mankundu, West Bengal, India; Department of Physiology, West Bengal State University, Barasat, West Bengal, India
| | - Linda Henderson
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | | | | | - Bugra Kerget
- Department of Chest Diseases, Ataturk University, Erzurum, Turkey
| | - Fadi Khadour
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Lyle Melenka
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Saibal Moitra
- Department of Pulmonary Medicine, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Tanusree Moitra
- Department of Psychology, Barrackpore Rashtraguru Surendrananth College, Barrackpore, West Bengal, India
| | - Rahul Mukherjee
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Alex Semprini
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Alice M Turner
- Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Ferrara
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Paige Lacy
- Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Cardet JC, Chang KL, Rooks BJ, Carroll JK, Celedón JC, Coyne-Beasley T, Cui J, Ericson B, Forth VE, Fagan M, Fuhlbrigge AL, Hernandez PA, Kruse J, Louisias M, Maher NE, Manning B, Pace WD, Phipatanakul W, Rodriguez-Louis J, Shields JB, Israel E, Wisnivesky JP. Socioeconomic status associates with worse asthma morbidity among Black and Latinx adults. J Allergy Clin Immunol 2022; 150:841-849.e4. [PMID: 35597370 PMCID: PMC9724153 DOI: 10.1016/j.jaci.2022.04.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/11/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Asthma disproportionately affects African American/Black (AA/B) and Hispanic/Latinx (H/L) patients and individuals with low socioeconomic status (SES), but the relationship between SES and asthma morbidity within these racial/ethnic groups is inadequately understood. OBJECTIVE To determine the relationship between SES and asthma morbidity among AA/B and H/L adults with moderate to severe asthma using multidomain SES frameworks and mediation analyses. METHODS We analyzed enrollment data from the PeRson EmPowered Asthma RElief randomized trial, evaluating inhaled corticosteroid supplementation to rescue therapy. We tested for direct and indirect relationships between SES and asthma morbidity using structural equation models. For SES, we used a latent variable defined by poverty, education, and unemployment. For asthma morbidity, we used self-reported asthma exacerbations in the year before enrollment (corticosteroid bursts, emergency room/urgent care visits, or hospitalizations), and Asthma Control Test scores. We tested for mediation via health literacy, perceived stress, and self-reported discrimination. All models adjusted for age, sex, body mass index, ethnicity, and comorbidities. RESULTS Among 990 AA/B and H/L adults, low SES (latent variable) was directly associated with hospitalizations (β = 0.24) and worse Asthma Control Test scores (β = 0.20). Stress partially mediated the relationship between SES and increased emergency room/urgent care visits and worse asthma control (β = 0.03 and = 0.05, respectively). Individual SES domains were directly associated with asthma morbidity. Stress mediated indirect associations between low educational attainment and unemployment with worse asthma control (β = 0.05 and = 0.06, respectively). CONCLUSIONS Lower SES is directly, and indirectly through stress, associated with asthma morbidity among AA/B and H/L adults. Identification of stressors and relevant management strategies may lessen asthma-related morbidity among these populations.
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Affiliation(s)
- Juan Carlos Cardet
- Division of Allergy and Immunology, Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, Fla
| | - Ku-Lang Chang
- Department of Community Health and Family Medicine, University of Florida College of Medicine, Gainesville, Fla
| | - Benjamin J Rooks
- Department of Community Health and Family Medicine, University of Florida College of Medicine, Gainesville, Fla
| | - Jennifer K Carroll
- American Academy of Family Physicians, National Research Network, Leawood, Kan; CU Anschutz Department of Family Medicine, University of Colorado, Aurora, Colo
| | - Juan Carlos Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pa
| | - Tamera Coyne-Beasley
- Department of Medicine, University of Alabama at Birmingham, Children's of Alabama, Birmingham
| | - Jing Cui
- Divisions of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, Mass
| | - Brianna Ericson
- Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Victoria E Forth
- Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Mass
| | | | - Anne L Fuhlbrigge
- Department of Medicine, Pulmonary Science and Critical Care Medicine, University of Colorado School of Medicine, Aurora, Colo
| | - Paulina Arias Hernandez
- Divisions of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, Mass
| | - Jean Kruse
- Divisions of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, Mass
| | - Margee Louisias
- Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Mass
| | - Nancy E Maher
- Divisions of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, Mass
| | - Brian Manning
- American Academy of Family Physicians, National Research Network, Leawood, Kan
| | - Wilson D Pace
- American Academy of Family Physicians, National Research Network, Leawood, Kan; DARTNet Institute, Aurora, Colo
| | | | | | - Joel B Shields
- American Academy of Family Physicians, National Research Network, Leawood, Kan
| | - Elliot Israel
- Divisions of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, Boston, Mass; Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Boston, Mass.
| | - Juan P Wisnivesky
- Divisions of General Internal Medicine and Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
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5
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Tilahun D, Michael M, Gashaye M, Melkamu E, Mekoya T. Retrospective cross-sectional study of asthma severity in adult patients at the Jimma Medical Center, Ethiopia. Sci Rep 2022; 12:11483. [PMID: 35798821 PMCID: PMC9263158 DOI: 10.1038/s41598-022-15807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/29/2022] [Indexed: 11/09/2022] Open
Abstract
Asthma is one of the most prevalent chronic diseases and is a public health problem worldwide. It is a long-standing condition affecting the respiratory system. Thus this study aimed to assess the severity of asthma in patients at the adult emergency department of Jimma Medical Center (JMC), Southwest Ethiopia. A one year (1 May, 2020, to 1 May, 2021) retrospective cross-sectional study was conducted among 189 patients at the adult emergency department of JMC. Data were collected between 25 July, 2021 to 25 August, 2021 by two Bachelor of Science degree holders in nursing (BSC) nurses after providing proper training. We used structured checklist that was obtained from previous studies to collect the data. Finally, data were entered into EpiData version 3.1 then exported to Stata version 15.0 for further analysis. Multinomial analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between risk factors and severity of asthma. Of 195 patients retrieved from the Health management information system (HMIS) logbook and patient profile, 189 fulfilled the eligibility criteria giving a response rate of 96.9%. The mean age of patients was 47.69 (± 19.02) years old ranging from 20 to 85. More than one third of the patients were age range of 20-39 years. Only more than half of the patients were women. Almost 46% of the patients had moderate asthma. Being male, merchant and government employees had lower odds of asthma than their counterparts whereas being daily laborers and smoking contributed to increased odds of moderate asthma. Patients' age and comorbidities had increased odds of severe asthma in relation to the participants of their reference category. Urban residents had decreased odds of severe asthma compared to their rural counterparts. This study highlights that majority of patients had moderate asthma. Health care providers should pay special attention to accurately diagnosing asthma according to its severity which is essential to the optimal management of asthma. This study calls JMC health care providers to give due attention while providing routine care for their patients in accordance to identified factors.
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Affiliation(s)
- Desalew Tilahun
- School of Nursing, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Mesay Michael
- Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mihret Gashaye
- School of Nursing, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Eneyew Melkamu
- School of Midwifery, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tsiyon Mekoya
- School of Nursing, Institute of Health, Jimma University, Jimma, Ethiopia
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Amaro J, Ubalde-López M, Lucas R. History of work-related health problems in a population-based sample of women: An exploratory factor analysis. Work 2021; 68:563-576. [PMID: 33612504 DOI: 10.3233/wor-203394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Beyond the health-enhancing effects, work also has the potential of causing or worsening different health conditions in the same individual. However, research on within-worker aggregation of work-related health problems is scarce. OBJECTIVE To describe the history and aggregation of work-related health problems in a population-based sample of women. METHODS A total of 4330 women were asked whether they had ever had "a physical or mental health problem that was caused or made worse by your work". The aggregation of work-related health problems was assessed using an exploratory factor analysis. RESULTS Five groups were identified. Factor 1 included all items on musculoskeletal disorders - lower socioeconomic position, higher BMI, smokers and history of occupational accidents. Factor 2 included mental disorders together with headache and/or eyestrain - higher socioeconomic position. Factor 3 included the other disorders item with some loading from digestive disorders - older and public sector workers. Factor 4 included respiratory disorders - lower socioeconomic position and history of occupational accidents. Factor 5 included hearing and ear problems - blue-collar workers. CONCLUSION There was a relevant aggregation of work-related health problems, which may inform the selection of specific components for interventions that aim to improve women's work-related health.
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Affiliation(s)
- Joana Amaro
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | | | - Raquel Lucas
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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7
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Papapostolou G, Tunsäter A, Binnmyr J, Telg G, Roslind K. Patient perspectives on living with severe asthma in Denmark and Sweden. Eur Clin Respir J 2020; 8:1856024. [PMID: 33414901 PMCID: PMC7751392 DOI: 10.1080/20018525.2020.1856024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Background: Severe asthma has an acknowledged impact on health-related quality of life (HRQOL) and is associated with substantial health care costs. This study aimed to investigate the patients' own experiences of the disease, perceptions of HRQOL, and awareness of disease management. Methods: This study included severe asthma patients in Sweden and Denmark. A quantitative Web-based survey and qualitative in-depth interviews (IDIs) were conducted. The survey included St. George's Respiratory Questionnaire (SGRQ), Asthma Control Test (ACT), Work Productivity and Activity Impairment (WPAI), and a study-specific questionnaire on quality of care and disease awareness. Telephone-based IDIs were conducted by medical interviewers following a semi-structured interview guide. Results: A total of 93 patients participated in the Web survey, and 33 participated in the IDIs. In the survey, the vast majority (77%; 72/93) had uncontrolled asthma (ACT<20). Mean total SGRQ score was 47.4 (59.7 symptom, 53.7 activity, 39.9 impact scores). Nearly 60% were treated in primary care. The IDIs revealed a long path to diagnosis, substantial and constant need for adaptations because of disease limitations, high burden on family members, social restrictions, and sick leaves and income losses. Patient awareness about guidelines, treatment goals, and available therapies was poor, and a low level of satisfaction by primary health care was seen. Conclusions: The vast majority of this severe asthma population had uncontrolled asthma and poor access to lung expert physicians. Impaired HRQOL despite patients' adaptations was indicated. These findings highlight the need for structured patient education and greater access to units with disease-specific knowledge.
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Affiliation(s)
- Georgia Papapostolou
- Department of Clinical Sciences, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Alf Tunsäter
- Department of Clinical Sciences, Respiratory Medicine and Allergology, Lund University, Lund, Sweden
| | - Jonas Binnmyr
- Swedish Asthma and Allergy Association, Stockholm, Sweden
| | - Gunilla Telg
- Medical Department, AstraZeneca NordicBaltic, Södertälje, Sweden
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8
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Hirvonen E, Karlsson A, Kilpeläinen M, Lindqvist A, Laitinen T. Development of self-assessed work ability among middle-aged asthma patients-a 10 year follow-up study. J Asthma 2020; 58:1042-1050. [PMID: 32308068 DOI: 10.1080/02770903.2020.1759089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The prevalence of asthma has been growing among working age people over the last decades. In this study, we examine the development of Work Ability Score (WAS) among middle-aged asthmatics in a longitudinal setting, in order to find risk factors for poor development. METHODS We followed the development of WAS trends during 10 years in a cohort of 529 middle-aged asthmatics, who were active in working life. Follow-up questionnaires were mailed in years 1, 2, 4, 6, 8, and 10. To study the development of WAS over time, we computed the discrete Frechet distance, which describes the similarity between the shapes of WAS curves. RESULTS Sixty-eight percent of the patients' WAS remained good or excellent throughout the follow-up period, while 24% of the patients WAS trend remained moderate. However, in 8%, the WAS was poor already in baseline and decreased further throughout the study. Using logistic regression, the moderate/poor development was associated significantly with high body mass index (BMI), pack years, adult onset asthma, physically strenuous work, number of co-morbidities, especially in psychiatric conditions, hypertension, and gastroesophageal reflux disease(GERD). When the model was adjusted for age and gender, adulthood onset of asthma and pack years lost their significance. Based on medication (high dose of inhaled corticosteroids (ICS) and second controller in use), 8% of the patients had severe asthma. CONCLUSION In the great majority of middle-aged asthma patients WAS remained stable throughout the follow-up period. However, 8% of the patients, who had more severe asthma and multiple co-morbidities, showed significantly poorer outcomes.
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Affiliation(s)
- Eveliina Hirvonen
- Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland.,Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - Antti Karlsson
- Turku University Hospital and University of Turku, Auria Biobank, Turku, Finland
| | - Maritta Kilpeläinen
- Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland
| | - Ari Lindqvist
- Clinical Research Unit of Pulmonary Diseases, HUS Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Tarja Laitinen
- Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland.,Research, Development and Innovation Centre, Tampere University Hospital, Tampere, Finland
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9
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De Bortoli MM, Fell AKM, Svendsen MV, Henneberger PK, Kongerud J, Oellingrath IM. Lifestyle, sick leave and work ability among Norwegian employees with asthma-A population-based cross-sectional survey conducted in Telemark County, Norway. PLoS One 2020; 15:e0231710. [PMID: 32302337 PMCID: PMC7164599 DOI: 10.1371/journal.pone.0231710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/30/2020] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate whether physician-diagnosed asthma modifies the associations between multiple lifestyle factors, sick leave and work ability in a general working population. Methods A cross-sectional study was conducted in Telemark County, Norway, in 2013. A sample of 16 099 respondents completed a self-administered questionnaire. We obtained complete data on lifestyle, work ability and sick leave for 10 355 employed persons aged 18–50 years. We modelled sick leave and work ability using multiple logistic regression, and introduced interaction terms to investigate whether associations with lifestyle factors were modified by asthma status. Results Several lifestyle risk factors and a multiple lifestyle risk index were associated with sick leave and reduced work ability score among persons both with and without physician-diagnosed asthma. A stronger association between lifestyle and sick leave among persons with asthma was confirmed by including interaction terms in the analysis: moderate lifestyle risk score * asthma OR = 1.4 (95% CI 1.02–2.1); high lifestyle risk score * asthma OR = 1.6 (95% CI 1.1–2.3); very high lifestyle risk score * asthma OR = 1.6 (95% CI 0.97–2.7); obesity * asthma OR = 1.5 (95% CI 1.02–2.1); past smoking * asthma OR = 1.4 (95% CI 1.01–1.9); and current smoking * asthma OR = 1.4 (95% CI 1.03–2.0). There was no significant difference in the association between lifestyle and work ability score among respondents with and without asthma. Conclusions In the present study, we found that physician-diagnosed asthma modified the association between lifestyle risk factors and sick leave. Asthma status did not significantly modify these associations with reduced work ability score. The results indicate that lifestyle changes could be of particular importance for employees with asthma.
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Affiliation(s)
- Marit Müller De Bortoli
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern, Porsgrunn, Vestfold and Telemark, Norway
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Vestfold and Telemark, Norway
- * E-mail:
| | - Anne Kristin Møller Fell
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Vestfold and Telemark, Norway
| | - Martin Veel Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Vestfold and Telemark, Norway
| | - Paul K. Henneberger
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, United States of America
| | - Johny Kongerud
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Inger M. Oellingrath
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern, Porsgrunn, Vestfold and Telemark, Norway
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Heinrichs K, Hummel S, Gholami J, Schultz K, Wild B, Li J, Sheikh A, Loerbroks A. Psychosocial working conditions and the subjective prognosis of gainful employment among employees with asthma: a cross-sectional study. Disabil Rehabil 2019; 43:1299-1306. [PMID: 31522569 DOI: 10.1080/09638288.2019.1662496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE The present study set out to examine whether low job decision latitude (JDL, i.e., limited work autonomy) and low social support at work are related to a poor subjective prognosis of gainful employment (SPE) among working rehabilitants with asthma. METHODS JDL and support were assessed by the Copenhagen Psychosocial Questionnaire. The SPE was measured by a validated three-item scale. Separate logistic regression analyses were conducted for all variables to calculate odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Among the 221 participants (response rate = 29.3%), those reporting low JDL or low support had more than doubled odds of being unsure that they would be working until retirement age (OR = 2.28; 95% CI = 1.19-4.37; OR = 2.78; 95% CI = 1.43-5.40, respectively) and of considering their work ability permanently at risk due to ill-health (OR = 3.89; 95% CI = 2.03-7.46; OR = 2.05; 95% CI = 1.08-3.90, respectively) compared to those with good working conditions. The associations of JDL or support were weaker with one's consideration to apply for premature pension (OR = 1.54; 95% CI = 0.60-3.98; OR = 2.18; 95% CI = 0.83-5.77, respectively). Additional analyses identified job satisfaction as a possible explanatory factor for the observed relationships. CONCLUSIONS Adverse psychosocial working conditions are related to a poor SPE, and low job satisfaction may explain those relationships. Future prospective research is needed to confirm our findings.Implications for rehabilitationEarlier research suggested that asthma increases the risk of disability retirement and thus causes high direct and indirect costs.Prior findings showed that adverse psychosocial working conditions are related to poorer asthma self-management and increased asthma morbidity among rehabilitants with asthma.Consistent with earlier work the present study found that job decision latitude and social support at work are associated with the subjective prognosis of gainful employment among working rehabilitants with asthma.If the reported findings are confirmed by prospective studies, interventions could be developed to improve the working conditions for rehabilitants with asthma and to thereby reduce their risk of disability retirement.
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Affiliation(s)
- Katherina Heinrichs
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | | | - Jalal Gholami
- Nordseeklinik Borkum der DRV Rheinland*, Borkum, Germany
| | - Konrad Schultz
- Klinik Bad Reichenhall der DRV Bayern Süd*, Bad Reichenhall, Germany
| | - Burkhard Wild
- refonet - Rehabilitations-Forschungsnetzwerk der DRV Rheinland*, Bad Neuenahr, Germany
| | - Jian Li
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany.,Department of Environmental Health Sciences, Fielding School of Public Health; School of Nursing, University of California, Los Angeles, USA
| | - Aziz Sheikh
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, UK
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
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Asthma trigger perceptions are associated with work disability. Respir Med 2018; 139:19-26. [PMID: 29857997 DOI: 10.1016/j.rmed.2018.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To study the association between perceptions of various triggers of asthma and employment status. METHODS A questionnaire was administered to all those adults living in the city of Tampere, Finland, who were entitled to special reimbursement for asthma medication by the Social Insurance Institution (n = 2613). The response rate was 79%. The study population (n = 1657) consisted of individuals who worked full-time (n = 967), were unemployed (n = 197), had all-cause work disability (n = 334), or were retired due to old age (n = 159). Given a list of potential asthma triggers, the respondents were asked how often (never/sometimes/often) the trigger caused or worsened their asthma symptoms during leisure time. RESULTS After adjusting for background variables (age, sex, smoking, and professional status), frequency of asthma symptoms, and the use of asthma medication during the last year, any individual trigger identified as asthma-relevant was associated with having work disability (vs. working full-time). The highest odds ratio (OR) was found for vehicle exhaust (OR 5.0, CI 2.2-11.4). We found similar but less consistent associations between asthma trigger perceptions and unemployment. No elevated ORs were found regarding asthma trigger perceptions for old-age retirement. CONCLUSIONS Perceptions of asthma triggers are associated with all-cause work disability. Our findings suggest that asthmatics have excess trigger perceptions that are not explained by asthma alone. Asthmatics need to be informed that inaccurate trigger perceptions may develop, and how they are induced, because unnecessary trigger avoidance may interfere with work life.
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Taponen S, Lehtimäki L, Karvala K, Luukkonen R, Uitti J. Employment status and changes in working career in relation to asthma: a cross-sectional survey. J Occup Med Toxicol 2018; 13:8. [PMID: 29456589 PMCID: PMC5813354 DOI: 10.1186/s12995-018-0189-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 02/07/2018] [Indexed: 12/11/2022] Open
Abstract
Background Asthmatics confront inconveniences in working life that make it more difficult to pursue a sustainable career, such as unemployment and work disability. Ways of dealing with these inconveniences may be career changes. More needs to be known about the backgrounds and consequences of career changes among asthmatics, especially their relation to asthma or a change in asthma symptoms. The aim of this study was to compare earlier career changes of adults with asthma who are working full time to those who have drifted away from active working life because of work disability, unemployment or early retirement. The frequency of having changed tasks, work place or occupation, whether the changes had been driven by asthma and furthermore, whether the changes had affected their asthma symptoms were investigated. Methods In this population-based survey study, all patients with reimbursement rights for asthma aged 20–65 years in the city of Tampere (total population 190,000), Finland (n = 2613) were recruited. The questionnaire was sent in October 2000 and the response rate was 79%. The questionnaire included questions e.g. on changing tasks, work place and occupation, whether these changes were driven by asthma or associated with change of asthma symptoms. The respondents were divided into four groups: working full-time, work disability, unemployed and retired due to age. We applied ANOVA with Dunnet’s post-test (variances were not equal between the groups) for a continued variable age and Chi-squared tests for categorical variables. Logistic regression models were built using unemployed vs. full-time work or work disability vs. full-time work as an outcome variable. A p-value of <.05 was considered statistically significant. Results Adults with asthma working full time had more often made changes in their career, but not as often driven by asthma as those with current work disability. The reason for changing work place compared to full-time workers (24.9%) was more often mainly or partly due to asthma among those with work disability (47.9%, p < 0.001) and the unemployed (43.3%, p = 0.006). Of those who made career changes because of asthma, a major proportion (over 67%) reported relief in asthma symptoms. Changing tasks (OR 5.8, 95% CI 1.9–18.0, for unemployment vs. full-time work), work place (OR 2.8, 95% CI 1.1–7.0, for work disability vs. full-time work and OR 2.6, 95% CI 1.3–5.4, for unemployment vs. full-time work) or occupation (OR 2.7, 95% CI 1.2–6.0, for unemployment vs. full-time work) mainly because of asthma was associated with an elevated risk for undesirable employment status even after adjusting for age, gender, smoking and professional status. Conclusions Career changes that were made mainly because of asthma were associated with undesirable employment status in this study. However, asthma symptoms were relieved after career changes especially among those who reported asthma to be the reason for the change. In addition to proper treatment and counselling of asthma patients towards applicable area of work or study, it may be beneficial to support early career changes in maintaining sustainable working careers among adults with asthma.
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Affiliation(s)
- Saara Taponen
- Finla Occupational Health, Satakunnankatu 18 B, 33210 Tampere, Finland.,3Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Lauri Lehtimäki
- 2Allergy Centre, Tampere University Hospital, PO Box 2000, 33521 Tampere, Finland.,3Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland
| | - Kirsi Karvala
- 4Finnish Institute of Occupational Health, PO Box 40, 00251 Helsinki, Finland
| | - Ritva Luukkonen
- 5Clinicum, Faculty of Medicine, University of Helsinki, PO Box 63, 00014 Helsinki, Finland
| | - Jukka Uitti
- 3Faculty of Medicine and Life Sciences, University of Tampere, 33014 Tampere, Finland.,4Finnish Institute of Occupational Health, PO Box 40, 00251 Helsinki, Finland
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