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Bdier D, Veronese G, Mahamid F. Quality of life and mental health outcomes: the role of sociodemographic factors in the Palestinian context. Sci Rep 2023; 13:16422. [PMID: 37775535 PMCID: PMC10541401 DOI: 10.1038/s41598-023-43293-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 09/21/2023] [Indexed: 10/01/2023] Open
Abstract
The Mental health of Palestinians has been described as among the lowest in the world, with over half of Palestinian adults meeting the diagnostic threshold for depressive symptoms and a significant portion of Palestinians experiencing mental distress and anxiety. The aim of the current study was to test the correlation between quality of life (QoL) and mental health outcomes, and the role of sociodemographic variables in predicting mental health outcomes (depression, anxiety, and stress) among Palestinian adults during a challenging period of political conflict. The sample of our study consisted of 957 participants, 283 males and 674 females they were recruited using online methods; online advertisements, e-mail campaigns and social media. Our findings showed that QoL negatively correlated with stress (r = - 0.43, p < 0.01), anxiety (r = - 0.46, p < 0.01), and depression (r = - 0.47, p < 0.05). Moreover, stress positively correlated with anxiety (r = 0.81, p < 0.01), and depression (r = 0.89, p < 0.01). Finally, anxiety positively correlated with depression (r = 0.82, p < 0.01). Results of hierarchical regression analysis to predict stress, anxiety and depression, indicated that QoL, educational level, gender, region of residence, and age explained in a significant way variance in depression, anxiety and stress. Our findings are promising to conduct other studies in order to understand better how current study variables correlate to each other, so appropriate clinical interventions to mitigate the negative effects of depression, anxiety, and stress through enhancing quality of life and positive coping strategies can be developed and implemented by mental health providers.
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Affiliation(s)
- Dana Bdier
- Psychology and Counseling Department, An-Najah National University, Nablus, Palestine
- University of Milano-Bicocca, Milan, Italy
| | | | - Fayez Mahamid
- Psychology and Counseling Department, An-Najah National University, Nablus, Palestine.
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Silvestro O, Ricciardi L, Catalano A, Vicario CM, Tomaiuolo F, Pioggia G, Squadrito G, Schwarz P, Gangemi S, Martino G. Alexithymia and asthma: a systematic review. Front Psychol 2023; 14:1221648. [PMID: 37609491 PMCID: PMC10441120 DOI: 10.3389/fpsyg.2023.1221648] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/17/2023] [Indexed: 08/24/2023] Open
Abstract
Growing evidence from scientific research elucidates the important role of alexithymia in chronic immune diseases. This Review aims to explore the presence of alexithymia in patients affected by asthma and clarify its associations with other involved psychological and physical factors. In January 2023, according to PRISMA guidelines, a systematic search using PubMed and Scopus was conducted. Twenty-six studies were eligible based on inclusion criteria. Alexithymia was significantly present in asthma patients, with most studies reporting a higher prevalence (from 9 to 62.8%) than in control groups (approximately 10%). The coexistence of asthma and alexithymia was associated with a worse quality of life, psychiatric comorbidity, poor symptom control, and difficulty in recognizing exacerbations of the disease. These results suggest that alexithymia can negatively impact the management of asthma. For this reason, we recommend an accuracy assessment in clinical settings and the implementation of psychological interventions to promote the emotional and physical wellbeing of asthmatic patients.
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Affiliation(s)
- Orlando Silvestro
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Luisa Ricciardi
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Carmelo Mario Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| | - Francesco Tomaiuolo
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Giovanni Squadrito
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Peter Schwarz
- Department of Endocrinology, Research Centre for Ageing and Osteoporosis, Rigshospitalet-Glostrup Hospital, Copenhagen, Denmark
| | - Sebastiano Gangemi
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
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Louis G, Pétré B, Schleich F, Zahrei HN, Donneau AF, Henket M, Paulus V, Guissard F, Guillaume M, Louis R. Predictors of change in asthma-related quality of life: a longitudinal real-life study in adult asthmatics. Qual Life Res 2023; 32:1507-1520. [PMID: 36595128 PMCID: PMC10123047 DOI: 10.1007/s11136-022-03339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE Asthma negatively impacts health-related quality of life (HRQL). The objective is to investigate the longitudinal relationship between HRQL in asthma and disease control, demographic and clinical objective parameters in an adult population in real-life settings. METHODS We conducted a longitudinal study on adult asthmatics recruited from Liege University Hospital Asthma Clinic (Belgium) between 2011 and 2019. We selected those who had two visits and completed two patient-reported outcome measures (PROMs), the asthma control test (ACT) and the mini asthma quality of life questionnaire (AQLQ) (n = 290). AQLQ was the dependent variable. Demographic, functional and inflammatory characteristics, asthma control, and exacerbations were the independent variables. We applied generalized linear mixed models to identify the factors associated with change in AQLQ and its dimensions. RESULTS Median (IQR) time interval between the two visits was 7 (5-19) months. Overall, median (IQR) global AQLQ increased from 4.1 (3-5.1) to 4.6 (3.4-5.9) (p < 0.0001). All AQLQ dimensions significantly improved, apart the environmental one. AQLQ improved in patients who had both step-up and step-down pharmacological treatment as well as in patients reporting no change between the two visits. The fitted models indicated that change in ACT was the main predictor of change in AQLQ (p < 0.0001). A rise in 3 units in ACT predicted an improvement of 0.5 AQLQ (AUC-ROC = 0.85; p < 0.0001). Change in BMI inversely impacted global AQLQ (p < 0.01) and its activity dimension (p < 0.0001). CONCLUSION Asthma control and BMI are key predictors of asthma quality of life acting in an opposite direction. AQLQ may improve without step-up in the pharmacological treatment.
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Affiliation(s)
- Gilles Louis
- Department of Public Health, University of Liège, Liège, Belgium.
| | - Benoit Pétré
- Department of Public Health, University of Liège, Liège, Belgium
| | - Florence Schleich
- Department of Pneumology, University of Liège, GIGAI3, Liège, Belgium
| | | | | | - Monique Henket
- Department of Pneumology, University of Liège, GIGAI3, Liège, Belgium
| | - Virginie Paulus
- Department of Pneumology, University of Liège, GIGAI3, Liège, Belgium
| | | | | | - Renaud Louis
- Department of Pneumology, University of Liège, GIGAI3, Liège, Belgium
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Kharaba Z, Feghali E, El Husseini F, Sacre H, Abou Selwan C, Saadeh S, Hallit S, Jirjees F, AlObaidi H, Salameh P, Malaeb D. An Assessment of Quality of Life in Patients With Asthma Through Physical, Emotional, Social, and Occupational Aspects. A Cross-Sectional Study. Front Public Health 2022; 10:883784. [PMID: 36117601 PMCID: PMC9477115 DOI: 10.3389/fpubh.2022.883784] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/07/2022] [Indexed: 01/21/2023] Open
Abstract
Background Asthma is a prevalent hyperactive airway disease with physical and emotional impact. Severe asthma is associated with considerable health-related quality of life (HRQoL). The aim of this study is to assess the quality of life through physical, emotional, social and occupational aspects and evaluate the factors affecting HRQoL in patients with asthma. Methods This is a cross-sectional multicenter study conducted on adult asthmatic patients enrolled from community pharmacies across different Lebanese geographic areas. Results Having wheezing sometimes and most of the time (Beta = -0.144 and -0.552), experiencing anxiety sometimes and most of the time (Beta = -0.205 and -0.573), encountering sleep problems sometimes and most of the time (Beta = -0.270 and -0.553), having previous chest discomfort sometimes and most of the time (Beta = -0.421 and -0.713), and having depression most of the times (Beta = -0.415) were associated with higher lower quality of life scores. On the other side, holding a secondary level of education was associated with a higher quality of life score (Beta = 0.192). Conclusion This study highlights that asthma affects adults' quality of life through social, emotional, physical, and occupational impacts. Improved follow-up and patient education may be essential in the future to stop disease progression and achieve ideal therapeutic outcomes.
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Affiliation(s)
- Zelal Kharaba
- Department of Clinical Sciences, College of Pharmacy, Al-Ain University of Science and Technology, Abu Dhabi, United Arab Emirates,Al Ain University Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, United Arab Emirates
| | - Emilie Feghali
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Farah El Husseini
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Carla Abou Selwan
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Sylvia Saadeh
- Life Sciences and Health Department, Paris-Est University, Paris, France,Health and Sciences Department, American University of Health and Sciences, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon,Psychology Department, College of Humanities, Effat University, Jeddah, Saudi Arabia,Research Department, Psychiatric Hospital of the Cross, Jal El Dib, Lebanon
| | - Feras Jirjees
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Hala AlObaidi
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon,School of Medicine, Lebanese American University, Byblos, Lebanon,Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Diana Malaeb
- School of Pharmacy, Lebanese International University, Beirut, Lebanon,College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates,*Correspondence: Diana Malaeb
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Impact of Hospitalization on the Quality of Life of Patients with Chronic Kidney Disease in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159718. [PMID: 35955072 PMCID: PMC9368667 DOI: 10.3390/ijerph19159718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/28/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022]
Abstract
Chronic kidney disease (CKD) is a global health problem. CKD causes patients to be hospitalized for a longer time to treat the disease. The impact of the hospitalization brings major changes and affects the quality of life (QoL) of the patients. In this study, we aimed to evaluate the impact of hospitalization on the QoL of patients with CKD. A cross-sectional study was conducted at the inpatient departments (IPDs) and outpatient departments (OPDs) of selected hospitals, in the eastern region of Saudi Arabia. The kidney disease quality of life (KDQOL) scale was used for the data collection and the findings were analyzed. The hospitalized patients had a poorer QoL than the OPD patients. The physical component summary (PCS) and mental component summary (MCS) mean scores were 52.82 ± 2.32 and 52.57 ± 2.93 in IPD patients, respectively, and 63.46 ± 3.65 and 66.39 ± 0.91 in OPD patients, respectively, which was significant (p < 0.0001). The QoL of patients decreased in the end stages of CKD. A significant association was observed between gender, occupation, smoking, and the stages of CKD with the QoL of the hospitalized patients. Measures must be taken to improve the QoL of these patients at all levels.
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Alfano P, Cuttitta G, Audino P, Fazio G, La Grutta S, Marcantonio S, Bucchieri S. Relationship between Multimorbidity and Quality of Life in a Primary Care Setting: The Mediating Role of Dyspnea. J Clin Med 2022; 11:jcm11030656. [PMID: 35160105 PMCID: PMC8837036 DOI: 10.3390/jcm11030656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 11/25/2022] Open
Abstract
Multimorbidity is known to impair Quality of Life (QoL) in patients in a primary setting. Poor QoL is associated with higher dyspnea perception. How multimorbidity and dyspnea perception are related to QoL needs clarification. The aim of the present study is to evaluate the mediating role of dyspnea perception in the relationship between multimorbidity and QoL in adults with and without airflow obstruction in a primary care setting. Seventeen general practitioners participated in the study: a total of 912 adult patients attending the practitioner’s surgery for a generic consultation completed a preliminary respiratory screening; 566 of them answered a respiratory questionnaire between January and June 2014, and 259 of the latter (148 M, aged 40–88) agreed to go through all the of procedures including spirometry, the IMCA and QoL (SF-36 through Physical Health “PCS” and Mental Health components) questionnaires, evaluation of comorbidities and the mMRC Dyspnea Scale. For screening purpose, a cut-off of FEV1/FVC < 70% was considered a marker of airflow obstruction (AO). Of the sample, 25% showed airflow obstruction (AO). No significant difference in mMRC score regarding the number of comorbidities and the PCS was found between subjects with and without AO. Multimorbidity and PCS were inversely related in subjects with (p < 0.001) and without AO (p < 0.001); mMRC and PCS were inversely related in subjects with (p = 0.001) and without AO (p < 0.001). A mediation analysis showed that the relation between number of comorbidities and PCS was totally mediated by mMRC in subjects with AO and partially in subjects without AO. We conclude that the effect of multimorbidity on PCS is totally mediated by mMRC only in AO. Detecting and monitoring mMRC in a primary care setting may be a useful indicator for evaluating a patient’s global health.
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Affiliation(s)
- Pietro Alfano
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 90146 Palermo, Italy; (G.C.); (P.A.); (S.B.)
- Institute of Traslational Pharmacology (IFT), National Research Council of Italy, Via Fosso del Cavaliere 100, 00133 Roma, Italy
- Correspondence:
| | - Giuseppina Cuttitta
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 90146 Palermo, Italy; (G.C.); (P.A.); (S.B.)
- Institute of Traslational Pharmacology (IFT), National Research Council of Italy, Via Fosso del Cavaliere 100, 00133 Roma, Italy
| | - Palma Audino
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 90146 Palermo, Italy; (G.C.); (P.A.); (S.B.)
| | - Giovanni Fazio
- Triolo Zanca Clinic, Piazza Fonderia 23, 90133 Palermo, Italy;
| | - Sabina La Grutta
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy;
| | - Salvatore Marcantonio
- Quality, Planning and Strategic Support Area, University of Palermo, Piazza Marina 61, 90133 Palermo, Italy;
| | | | - Salvatore Bucchieri
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 90146 Palermo, Italy; (G.C.); (P.A.); (S.B.)
- Institute of Traslational Pharmacology (IFT), National Research Council of Italy, Via Fosso del Cavaliere 100, 00133 Roma, Italy
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Health-related quality of life and associated factors in HIV-positive transplant candidates and recipients from a HIV-positive donor. Qual Life Res 2022; 31:171-184. [PMID: 34156597 DOI: 10.1007/s11136-021-02898-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION HRQOL in transplant candidates and recipients who are also infected with HIV and are awaiting a kidney, or have received one from a HIV-positive donor, has not been previously investigated. METHODS The HRQOL of 47 HIV-positive kidney transplant candidates and 21 recipients from HIV-positive donors was evaluated using the Short Form-36 (SF-36) and face to face interviews at baseline and at 6 months. The correlation between SF-36 scores and sociodemographic, clinical and nutritional factors was determined. RESULTS 68 patients completed the SF-36 at baseline and 6 months. Transplant candidates: transplant candidates had lower HRQOL than recipients. The main mental stressors were income, employment and waiting for a donor. Physical health complaints were body pain (BP) and fatigue. Pre-albumin and BMI was positively correlated with general health at baseline (r = 0.401, p = 0.031 and r = 0.338, p = 0.025). Besides a positive association with role physical (RP) and BP, albumin was associated with overall physical composite score (PCS) (r = 0.329, p = 0.024) at 6 months. Transplant recipients: Transplant recipients had high HRQOL scores in all domains. PCS was 53.8 ± 10.0 and 56.6 ± 6.5 at baseline and 6 months respectively. MCS was 51.3 ± 11.5 and 54.2 ± 8.5 at baseline and 6 months respectively. Albumin correlated positively with PCS (r = 0.464, p = 0.034) at 6 months and role emotional (RE) (r = 0.492, p = 0.024). Higher pre-albumin was associated with better RE and RP abilities and MCS (r = 0.495, p = 0.034). MAMC was associated with four domains of physical health and strongly correlated with PCS (r = 0.821, p = 0.000). CONCLUSION Strategies to improve HRQOL include ongoing social support, assistance with employment issues and optimising nutritional status.
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Sánchez Castillo S, Smith L, Díaz Suárez A, López Sánchez GF. Levels of Physical Activity in Spanish Asthmatics: A Cross-Sectional Study. ACTA ACUST UNITED AC 2020; 56:medicina56120643. [PMID: 33255663 PMCID: PMC7760910 DOI: 10.3390/medicina56120643] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 12/30/2022]
Abstract
Background and objectives: 339 million people in the world suffer from asthma. Regular physical activity (PA) could help in its control. Therefore, the aim of this research was to determine the level of PA in Spanish people with asthma considering variation by, age, sex, education, marital status, living together, smoking habits, alcohol intake and body mass index (BMI). Materials and Methods: 1014 Spanish people from 15 to 69 years were included in the study. Data of the Spanish Health Survey (year 2017) were analysed. PA levels were measure with the international physical activity questionnaire short version (IPAQ-SF). PA was categorized as low, moderate and high, and analyzed by sample characteristics. Mann-Whitney U test, Kruskall Wallis H and crosstabs were used to calculate statistical significance (p < 0.05). Results: On average, Spanish asthmatics engaged in a weekly volume of 2228.9 metabolic equivalent of task (MET)·min/week. Males revealed significantly higher PA than females (2516.8 vs. 2019.5 MET·min/week; p = 0.005), younger participants (<30 years) compared to people aged 30–60 years and older than 60 years (2699.0; 2243.2; 1619.3 MET·min/week; p < 0.001) and those with tertiary level of education than those without secondary (2368.3 vs. 2168.3 MET·min/week; p = 0.001). Level of PA was lower in those married (p = 0.001) and/or living together (p = 0.010). Alcohol consumers showed a higher level than the participants who did not drink (2378.3 vs. 1907.9 MET·min/week; p = 0.001), but no significant differences were found within current, past and never smokers (p = 0.890). Obese asthmatics engaged in less PA than their normal weight and overweight peers (p < 0.001). Overall, moderate level was significantly the most frequent (47.7%), but 31.6% showed a low level. Conclusions: Three out of ten Spanish people with asthma do not achieve PA recommendations, so PA programs should be executed to make people aware of its benefits in asthma control, focusing on those groups with lower PA levels.
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Affiliation(s)
- Sheila Sánchez Castillo
- Faculty of Sports Sciences, University of Murcia, 30720 Murcia, Spain;
- Correspondence: (S.S.C.); (G.F.L.S.)
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge CB5 8DZ, UK;
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Counted V, Possamai A, McAuliffe C, Meade T. Attachment to Australia, attachment to God, and quality of life outcomes among African Christian diasporas in New South Wales: A cross-sectional study. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2020. [DOI: 10.1080/19349637.2018.1499165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Victor Counted
- School of Social Sciences and Psychology, Western Sydney University, Penrith, Australia
| | - Adam Possamai
- School of Social Sciences and Psychology, Western Sydney University, Penrith, Australia
| | - Cameron McAuliffe
- School of Social Sciences and Psychology, Western Sydney University, Penrith, Australia
| | - Tanya Meade
- School of Social Sciences and Psychology, Western Sydney University, Penrith, Australia
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Impact of asthma on women and men: Comparison with the general population using the EQ-5D-5L questionnaire. PLoS One 2018; 13:e0202624. [PMID: 30138415 PMCID: PMC6107204 DOI: 10.1371/journal.pone.0202624] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/07/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The aim was to evaluate the impact of asthma on patients' Health-Related Quality of Life (HRQoL) by comparing asthmatic women and men with reference norms, to examine the factors which contributed to an impaired HRQoL, and to identify groups at higher risk. METHODS Cross-sectional evaluation of 222 primary care patients with persistent asthma (18-40 years old). HRQoL impact was estimated with the EuroQol-5 Dimensions (EQ-5D), which allows calculating Quality-Adjusted Life-Years (QALYs) by applying society preferences. Participants self-completed the EQ-5D questionnaire online. Telephonic interviews collected information on medication and adherence, and administered the Asthma Control Questionnaire. Severity markers included asthma-related comorbidity, previous oral corticosteroids course prescription, and inhaled corticosteroids daily dose. After bivariate analyses, multiple linear regression models were constructed to examine the relations between HRQoL asthma impact and socio-demographic and clinical variables, using as dependent variable the deviation from general population-based EQ-5D reference norms. RESULTS Deviation from the EQ-5D index norms was moderate in most age/gender groups (-0.1, which corresponds to 0.6 standard deviations), while it was large in women aged 18-24 years (-0.18, corresponding to 1.1 standard deviations). In regression models, a poor asthma control was the only factor independently associated to HRQoL impact in both women and men: β -0.18 (p<0.001) and -0.15 (p = 0.01) respectively. Translating these β coefficients to QALYs, they are interpretable as 66 fewer days of full health per year in women with uncontrolled asthma and 55 for men, compared with those with controlled asthma. CONCLUSION Persistent asthma has a moderately negative HRQoL impact on patients of both genders, and the youngest women have been identified as a high risk group which merits further research. We identified asthma control as the major contributor to impaired HRQoL in patients, regardless of their gender, suggesting that asthma HRQoL impact could be alleviated by achieving a good control of symptoms.
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Taype-Rondan A, Abbs ES, Lazo-Porras M, Checkley W, Gilman RH, Smeeth L, Miranda JJ, Bernabe-Ortiz A. Association between chronic conditions and health-related quality of life: differences by level of urbanization in Peru. Qual Life Res 2017; 26:3439-3447. [PMID: 28712003 PMCID: PMC5681970 DOI: 10.1007/s11136-017-1649-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2017] [Indexed: 11/30/2022]
Abstract
Purpose To evaluate the role of urbanization as an effect modifier for the association between specific chronic conditions and number of conditions with health-related quality of life (QOL). Methods We analyzed cross-sectional data from the CRONICAS Cohort Study conducted in Lima (highly urbanized), Tumbes (semi-urban), as well as rural and urban sites in Puno. Exposures of interest were chronic bronchitis, depressive mood, hypertension, type 2 diabetes, and a composite variable aggregating the number of chronic conditions (the four exposures plus heart disease and stroke). QOL outcomes were assessed with EuroQol’s EQ-5D visual analogue scale (EQ-VAS). We fitted linear regressions with robust variance to evaluate the associations of interest. Study site was assessed as a potential effect modifier using the likelihood-ratio (LR) test. Results We evaluated data on 2433 subjects: 51.3% were female, mean age was 57.2 years. Study site was found to be an effect modifier only for the association between depressive mood and EQ-VAS score (LR test p < 0.001). Compared to those without depressive mood, participants with depressive mood scored −13.7 points on the EQ-VAS in Lima, −7.9 in urban Puno, −11.0 in semi-urban Tumbes, and −2.7 in rural Puno. Study site was not found to be an effect modifier for the association between the number of chronic conditions and EQ-VAS (LR test p = 0.64). Conclusion The impact of depressive mood on EQ-VAS was larger in urban than in rural sites, while site was not an effect modifier for the remaining associations. Electronic supplementary material The online version of this article (doi:10.1007/s11136-017-1649-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alvaro Taype-Rondan
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru
| | - Elizabeth Sarah Abbs
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru.,School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Maria Lazo-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru
| | - William Checkley
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru.,Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, 18, Lima, Peru. .,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
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Böhmer MM, Brandl M, Brandstetter S, Finger T, Fischer W, Pfeifer M, Apfelbacher C. Factors associated with generic health-related quality of life in adult asthma patients in Germany: Cross-sectional study. J Asthma 2016; 54:325-334. [PMID: 27624747 DOI: 10.1080/02770903.2016.1206563] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Given a 9% lifetime prevalence of asthma in Germany and the impairment of health-related quality of life (HRQOL) that goes along with it, it is important to understand parameters affecting HRQOL in asthma patients. Objective of this study was therefore to determine factors associated with generic HRQOL in asthma patients. METHODS Data for cross-sectional analyses were obtained from the baseline of an ongoing cohort study. INCLUSION CRITERIA physician-diagnosed asthma; age ≥18 years; disease duration ≥3 months; no acute psychiatric/neurological disease; sufficient knowledge of German. HRQOL was assessed by the Short Form 12 Health Survey Questionnaire (SF-12), which comprises a physical (PCS-12) and a mental component (MCS-12). Information on a broad range of parameters potentially influencing HRQOL was collected by examining the patients' medical records and via a self-administered questionnaire. Those parameters were of socio-demographic, disease-specific, treatment-related or psychosocial nature. We conducted multivariable linear regression analyses to assess determinants of HRQOL. RESULTS In total, 196 asthma patients participated in the study (mean age: 48 years (range: 18-90); 60.2% females). In multivariable analysis, PCS-12 was negatively associated with older age, being female, insufficient disease control, higher number of medications in tablet form and reporting symptoms of depression. MCS-12 was negatively associated with being female, living alone, insufficient disease control, and reporting symptoms of anxiety or depression. CONCLUSIONS Focusing on disease control and screening for depression and anxiety may be promising approaches to improve HRQOL in adult asthma patients. If a patient shows alarming symptoms of anxiety and/or depression, the patient should then be referred for psychiatric treatment.
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Affiliation(s)
- Merle M Böhmer
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
| | - Magdalena Brandl
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
| | - Susanne Brandstetter
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
| | - Tamara Finger
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
| | - Wiebke Fischer
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
| | - Michael Pfeifer
- b Department of Pneumology , Donaustauf Hospital , Donaustauf , Germany
| | - Christian Apfelbacher
- a Medical Sociology, Department for Epidemiology and Preventive Medicine , University of Regensburg , Regensburg , Germany
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