Department of Research, Haugesund Hospital, Haugesund, Norway,
Qual Life Res. 2014 Apr;23(3):991-8. doi: 10.1007/s11136-013-0515-5. Epub 2013 Sep 3.
Despite an increasing interest in the relationships among multiple symptoms and quality of life (QOL), little known about the association between anxiety, depression, and pain and both disease-specific and generic QOL in patients with chronic obstructive pulmonary disease (COPD).
In a cross-sectional study of 100 COPD patients, disease-specific QOL was measured by St. George's Respiratory Questionnaire and generic QOL by the QOL scale. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale, and pain was assessed with a numeric rating scale.
Of the 100 patients, 31 % reported clinically meaningful anxiety, 13 % depression, and 45 % reported the presence of pain. Younger patients (p = 0.02) and those with higher anxiety scores (p = 0.02) reported worse disease-specific QOL. Patients with lower physical function (p = 0.04) and those with higher depression scores (p < 0.001) reported worse generic QOL. Age, comorbidity, physical function, anxiety, depression, and pain explained 19.2 and 49.6 % of the variance in disease-specific and generic QOL scores, respectively.
Findings from this study suggest that the relationships between patient characteristics and common symptoms and QOL differ when disease-specific and generic measures of QOL are evaluated. Additional research is warranted to confirm these findings in COPD patients. Clinicians need to evaluate these common symptoms when planning and implementing symptoms management interventions to improve COPD patients' QOL.
尽管人们对多种症状与生活质量(QOL)之间的关系越来越感兴趣,但对于慢性阻塞性肺疾病(COPD)患者的焦虑、抑郁和疼痛与疾病特异性和一般性 QOL 之间的关系知之甚少。
在对 100 例 COPD 患者的横断面研究中,使用圣乔治呼吸问卷(St. George's Respiratory Questionnaire)测量疾病特异性 QOL,使用 QOL 量表测量一般性 QOL。使用医院焦虑和抑郁量表(Hospital Anxiety and Depression Scale)评估焦虑和抑郁,使用数字评分量表评估疼痛。
在 100 例患者中,31%报告有临床意义的焦虑,13%报告有抑郁,45%报告有疼痛。年轻患者(p=0.02)和焦虑评分较高的患者(p=0.02)报告疾病特异性 QOL 较差。身体功能较差的患者(p=0.04)和抑郁评分较高的患者(p<0.001)报告一般性 QOL 较差。年龄、合并症、身体功能、焦虑、抑郁和疼痛分别解释了疾病特异性和一般性 QOL 评分方差的 19.2%和 49.6%。
本研究结果表明,当评估疾病特异性和一般性 QOL 测量时,患者特征与常见症状和 QOL 之间的关系不同。需要进一步的研究来证实 COPD 患者中的这些发现。临床医生在计划和实施症状管理干预措施以改善 COPD 患者的 QOL 时,需要评估这些常见症状。