Health-related quality of life and its associated factors in patients with chronic obstructive pulmonary disease

OBJECTIVE

The present study aimed to evaluate HRQOL and to explore the factors associated with poor HRQOL among patients with COPD.

METHODS

In the present cross-sectional study, the validated St George's Respiratory Questionnaire for COPD patients (SGRQ-C) was used to evaluate HRQOL among 702 patients with COPD at two major hospitals in Jordan in the period between January and April 2022. Quantile regression analysis was used to explore the factors associated with HRQOL among the study participants.

RESULTS

According to SGRQ-C, the HRQOL of the study participants was greatly impaired with a total SGRQ of 55.2 (34-67.8). The highest impairment in the HRQOL was in the impact domain with a median of 58.7 (29-76.3). Increased number of prescribed medications (β = 1.157, P<0.01), older age (β = 0.487, P<0.001), male gender (β = 5.364, P<0.01), low education level (β = 9.313, P<0.001), low and moderate average income (β = 6.440, P<0.05, and β = 6.997, P<0.01, respectively) were associated with poorer HRQOL. On the other hand, being married (β = -17.122, P<0.001), living in rural area (β = -6.994, P<0.01), non-use of steroids inhalers (β = -3.859, P<0.05), not receiving long acting muscarinic antagonists (LAMA) (β = -9.269, P<0.001), not receiving LABA (β = -8.243, P<0.001) and being adherent to the prescribed medications (β = -6.016, P<0.001) were associated with improved HRQOL. Furthermore, lower disease severity (stage A, B, and C) (β = -23.252, -10.389, and -9.696 respectively, P<0.001), and the absence of comorbidities (β = -14.303, P<0.001) were associated with better HRQOL.

CONCLUSIONS

In order to maximize HRQOL in patients with COPD, future COPD management interventions should adopt a multidisciplinary approach involving different healthcare providers, which aims to provide patient-centered care, implement personalized interventions, and improve medication adherence, particularly for patients who are elderly, males, have low socioeconomic status, receive multiple medications and have multiple comorbid diseases.

Chronic obstructive pulmonary disease patients' quality of life and its related factors: A cross-sectional study of the Jordanian population

Background: Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death globally, mostly in low- and middle-income countries. It is estimated that 6.5% of Jordanians under 50 and 37.5% of those over 70 years of age are affected. The country's air pollution levels surpass recommended levels, increasing the disease incidence and burden on individuals and the health system. COPD is a long-term, severe, and exhausting condition. In Jordan, patients are highly dependent and frequent users of the healthcare services; therefore, their Quality of Life (QoL) is highly influenced by the health care they receive. The QoL of COPD patients must be studied to devise interventions that can help patients cope with this disease and for healthcare systems to improve their service.  Method: A cross-sectional correlational study of 200 COPD patients. The Arabic WHO Quality of Life Questionnaire Short Form was used to collect data.   Results: The mean COPD patient QoL score was 10.66 (SD=1.58), showing poor QoL perception. The physical domain had the lowest perceived QoL (10.232, SD=1.912), while the environmental domain had the highest (10.948, SD=1.636). Unmarried, non-smokers, and employed had better QoL (M=11.04, M=10.92, M=12.04). Age categories 50-61 exhibited greater mean QoL than age category 61 or higher (M=11.44, M=10.84, M=10.08). Private health services are characterized by short waiting times, availability of different diagnostic and treatment services, and skilled staff was related to better QoL.  Conclusions: QoL for COPD patients seems to be an area requiring urgent attention from Health service providers and planners. Patients should be adequately supported and cared for to have a good QoL. In Jordan, COPD patients' QoL is highly influenced by lack of physical activity, emotional distress, and anxiety. Therefore, better health care services is needed to address all these areas adequately.

Communicating uncertainty: contrasting the communication experiences of patients with advanced COPD and incurable lung cancer

BACKGROUND

Due to the uncertain disease trajectory and variable rate of progression in chronic obstructive pulmonary disease (COPD), health care professionals (HCPs) are challenged in explaining what the future may hold for patients compared to those with lung cancer (LC). Support and communication of timely information can significantly improve health outcomes.

OBJECTIVE

This study sought to identify factors that impact communication and support and recommend ways to improve patients' understanding of living with life-threatening illness.

METHODS

Semi-structured interviews with patients with LC (n = 22) and advanced COPD (n = 18), their informal carers (21 LC and 18 COPD) and HCPs (n = 51). Patients were recruited from primary and secondary care in the East of England, UK, during 2010-12.

RESULTS

Directness and clarity characterized communication in LC, whereas uncertainty and limited explanations predominated in COPD. Discussions on how the disease might impact on decisions and preferences to be made in the future were less common in COPD. Information for LC patients was mainly from hospital clinicians and any information for COPD patients mainly from primary care clinicians.

CONCLUSIONS

The experience of COPD patients could be improved by professionals soon after diagnosis explaining to them the typical pattern of decline in COPD, highlighting the inherent uncertainties about when exacerbations and death may occur. This conversation should lead to planning for the different challenges that the patient and informal carer recognize as most important to them. This contrasts with the 'breaking bad news' conversation that oncologists are highly trained to deliver.

Health-Related Quality Of Life, Uncertainty, ‎and Anxiety among Patients with Chronic Obstructive Pulmonary Disease

Patients' with Chronic Obstructive Pulmonary Disease suffer from serious respiratory symptoms that increase anxiety, stress, and uncertainty, and affect quality of life. The aim of this study was to assess level of anxiety, uncertainty, and health related quality of life (HRQoL) among COPD patients in Jordan. Correlational cross-sectional survey design was used to collect data from 153 COPD patients. ‎The study was conducted at pulmonary clinics in three major referral hospitals in Jordan that provide care for COPD patients from different parts of the country. To assess HRQoL, St. George ‎Respiratory Questionnaire‎ was completed. Uncertainty and anxiety level was measured by Mishel's uncertainty of illness scale and state anxiety inventory respectively. The mean age of participants was 66.8 (SD= 10.3) and most participants were males (94.1%) with. The mean score of HRQoL was 57.9 (SD = 20.5). The mean score of participants' level of anxiety was 38.1 (SD = 11.1). The mean score of uncertainty was 66.1 (SD= 11.1). There is a statistically significant positive relationship between HRQoL and anxiety (r =.433, p< .01), and uncertainty (r=.483, p<.01). Increased anxiety and uncertainty among COPD patients was associated with low HRQoL. Health care providers need to pay attention the effect of anxiety and uncertainty on COPD patients' quality of life and institute appropriate management.