Independent determinants of disease-related quality of life in COPD - scope for non-pharmacological interventions?
Independent determinants of disease-related quality of life in COPD - scope for non-pharmacological interventions?
Purpose: Quality of Life (QoL) scores in COPD have a weak relationship with physiological impairment. We investigated factors associated with poor QoL, focusing on psychological measures potentially amenable to intervention.
Patients and methods: We utilised a pre-existing Birmingham (UK) COPD cohort to assess factors associated with QoL impairment (CAT scores). Univariate and multivariate regression models were constructed from three categories of variables: demographic, lung function/COPD-related symptoms, and psychosocial/behavioural factors
Results: Analyses were based on self-report questionnaire data from 735 participants. The multivariate model of variables independently associated with COPD Assessment Test (CAT) included: depression, dysfunctional breathing symptoms (Nijmegen score) and illness perception, in addition to COPD symptoms (wheeze, cough), exercise capacity, breathlessness, exacerbations and deprivation; this model explained 72% of CAT score variation. In a dominance analysis assessing the relative contribution of variables, similar contributions were made by breathlessness (20.2%), illness perception (19.8%), dysfunctional breathing symptoms (17.5%) and depression (12.5%) with other variables contributing < 5%.
Conclusion: Psychological factors significantly contribute to disease-specific QoL impairment in COPD, and potentially explain the mismatch between objective physiological impairment and patients’ experience of their disease. Interventions targeting psychological factors, illness perception and dysfunctional breathing should be assessed.
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Brien, Sarah B.
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Stuart, Beth
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Dickens, Andrew P.
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Kendrick, Tony
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Jordan, Rachel E.
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Adab, Peymane
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Thomas, Mike
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9 January 2018
Brien, Sarah B.
4e8e97cd-7bc3-4efd-857e-20790040b80f
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Dickens, Andrew P.
4d4f4e0f-ec12-4671-82b7-078273250efc
Kendrick, Tony
c697a72c-c698-469d-8ac2-f00df40583e5
Jordan, Rachel E.
811f2226-ee6f-4d19-86aa-0155519e0072
Adab, Peymane
2f1ad47b-19bb-4b1d-a2d7-67193a2cf28f
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Brien, Sarah B., Stuart, Beth, Dickens, Andrew P., Kendrick, Tony, Jordan, Rachel E., Adab, Peymane and Thomas, Mike
(2018)
Independent determinants of disease-related quality of life in COPD - scope for non-pharmacological interventions?
International Journal of Chronic Obstructive Pulmonary Disease, 13, , [13].
(doi:10.2147/COPD.S152955).
Abstract
Purpose: Quality of Life (QoL) scores in COPD have a weak relationship with physiological impairment. We investigated factors associated with poor QoL, focusing on psychological measures potentially amenable to intervention.
Patients and methods: We utilised a pre-existing Birmingham (UK) COPD cohort to assess factors associated with QoL impairment (CAT scores). Univariate and multivariate regression models were constructed from three categories of variables: demographic, lung function/COPD-related symptoms, and psychosocial/behavioural factors
Results: Analyses were based on self-report questionnaire data from 735 participants. The multivariate model of variables independently associated with COPD Assessment Test (CAT) included: depression, dysfunctional breathing symptoms (Nijmegen score) and illness perception, in addition to COPD symptoms (wheeze, cough), exercise capacity, breathlessness, exacerbations and deprivation; this model explained 72% of CAT score variation. In a dominance analysis assessing the relative contribution of variables, similar contributions were made by breathlessness (20.2%), illness perception (19.8%), dysfunctional breathing symptoms (17.5%) and depression (12.5%) with other variables contributing < 5%.
Conclusion: Psychological factors significantly contribute to disease-specific QoL impairment in COPD, and potentially explain the mismatch between objective physiological impairment and patients’ experience of their disease. Interventions targeting psychological factors, illness perception and dysfunctional breathing should be assessed.
Text
Brien COPD survey final for submission amended
- Accepted Manuscript
Text
COPD-152955-independent-determinants-of-disease-related-quality-of-life-_010818
- Version of Record
More information
Accepted/In Press date: 10 November 2017
e-pub ahead of print date: 9 January 2018
Published date: 9 January 2018
Identifiers
Local EPrints ID: 416230
URI: http://eprints.soton.ac.uk/id/eprint/416230
ISSN: 1176-9106
PURE UUID: 7bfe415a-74aa-4b4c-86a9-2eaf163b3ea8
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Date deposited: 08 Dec 2017 17:30
Last modified: 03 Sep 2024 04:05
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Author:
Andrew P. Dickens
Author:
Rachel E. Jordan
Author:
Peymane Adab
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