González-Freire Beatriz, Vázquez Isabel, Pértega-Díaz Sonia
Private Psychological Practice Beatriz González Freire, Ourense, Spain.
Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain.
J Allergy Clin Immunol Pract. 2020 Jan;8(1):197-207. doi: 10.1016/j.jaip.2019.07.009. Epub 2019 Jul 18.
Psychological variables (anxiety, depression, and coping strategies) and asthma control (assessed from the patient's perspective or from the physician's perspective) affect health-related quality of life (HRQoL) in asthmatic patients. However, no study has simultaneously evaluated these variables to understand the independent contribution of each one of these factors to HRQoL.
To determine the impact of anxiety, depression, coping strategies, and asthma control on HRQoL, and to compare the impact of asthma control on HRQoL when it is established by the physician versus when it is considered by the patient.
A total of 373 asthmatics completed the Hospital Anxiety and Depression Scale, Coping Orientations to Problems Experienced Inventory, 36-Item Short-Form Health Survey, and St. George Respiratory Questionnaire. Asthma control was measured by the patient with Asthma Control Test and by the physician with the classification asthma control of Global Initiative for Asthma. Demographic and clinical characteristics were also collected.
Anxiety, depression, and poor patient-rated asthma control status were associated with worse HRQoL in all dimensions (except Mental Health for asthma control). Physician-rated asthma control was related to worse HRQoL in physical generic and specific dimensions. Among coping strategies, only avoidant coping impacted HRQoL in a few dimensions.
Anxiety, depression, and asthma control (especially patient-rated asthma control) were important independent predictors of asthma HRQoL, and all of them should therefore be considered in interventions to improve HRQoL in asthmatic patients.
心理变量（焦虑、抑郁和应对策略）以及哮喘控制（从患者角度或医生角度评估）会影响哮喘患者的健康相关生活质量（HRQoL）。然而，尚无研究同时评估这些变量以了解这些因素中每个因素对HRQoL的独立贡献。
确定焦虑、抑郁、应对策略和哮喘控制对HRQoL的影响，并比较医生判定的哮喘控制与患者自我感知的哮喘控制对HRQoL的影响。
共有373名哮喘患者完成了医院焦虑抑郁量表、应对方式问卷、36项简短健康调查和圣乔治呼吸问卷。患者通过哮喘控制测试评估哮喘控制情况，医生则依据全球哮喘防治创议的哮喘控制分级进行评估。同时收集了人口统计学和临床特征数据。
焦虑、抑郁以及患者自评哮喘控制不佳与各维度较差的HRQoL相关（哮喘控制对心理健康维度除外）。医生评定的哮喘控制与身体总体及特定维度较差的HRQoL相关。在应对策略中，只有回避应对在几个维度上影响HRQoL。
焦虑、抑郁和哮喘控制（尤其是患者自评的哮喘控制）是哮喘HRQoL的重要独立预测因素，因此在改善哮喘患者HRQoL的干预措施中均应予以考虑。
