Advertisement

Quality of Life Research

, Volume 23, Issue 3, pp 991–998 | Cite as

Demographic and clinical characteristics associated with quality of life in patients with chronic obstructive pulmonary disease

  • Signe Berit BentsenEmail author
  • Christine Miaskowski
  • Tone Rustøen
Article

Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusions

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.

Keywords

Anxiety Chronic obstructive pulmonary disease Depression Pain Physical function Quality of life Symptoms 

Notes

Acknowledgments

This study was supported by a grant from Haugesund Hospital, Department of Research.

References

  1. 1.
    HajGhanbari, B., Holsti, L., Road, J. D., & Ried, D. W. (2012). Pain in people with chronic obstructive pulmonary disease (COPD). Respiratory Medicine, 106(7), 998–1005.PubMedCrossRefGoogle Scholar
  2. 2.
    Borge, C. H., Wahl, A. K., & Moum, T. (2010). Association of breathlessness with multiple symptoms in chronic obstructive pulmonary disease. Journal of Advanced Nursing, 66(12), 2688–2700.PubMedCrossRefGoogle Scholar
  3. 3.
    Elkington, H., White, P., Addington-Hall, J., Higgs, R., & Edmonds, P. (2005). The healthcare needs of chronic obstructive pulmonary disease patients in the last year of life. Palliative Medicine, 19(6), 485–491.PubMedCrossRefGoogle Scholar
  4. 4.
    Blindermann, C. D., Homel, P., Billings, A., Tennstedt, S., & Portenoy, R. K. (2009). Symptoms, distress and quality of life in patients with advanced chronic obstructive pulmonary disease. Journal of Pain and Symptom Management, 38(1), 115–123.CrossRefGoogle Scholar
  5. 5.
    Cleland, J. A., Lee, A. J., & Hall, S. (2007). Associations of depression and anxiety with gender, age, health-related quality of life and symptoms in primary care COPD patients. Family Practice, 24(3), 217–223.PubMedCrossRefGoogle Scholar
  6. 6.
    Janssen, D., Spruit, M., Uszko-Lencer, N., schols, J., & Wouters, E. (2011). Symptoms, comorbidities, and health care in advanced chronic obstructive pulmonary disease or chronic heart failure. Journal of Palliative Medicine, 14(6), 735–743.PubMedCrossRefGoogle Scholar
  7. 7.
    Borge, C., Wahl, A., & Moum, T. (2011). Pain and quality of life with chronic obstructive pulmonary disease. Heart and Lung, 40(3), E90–E101.PubMedCrossRefGoogle Scholar
  8. 8.
    Anderson, K. L. (1995). The effect of chronic obstructive pulmonary disease on quality of life. Research in Nursing & Health, 18(6), 547–556.CrossRefGoogle Scholar
  9. 9.
    Hynninen, K. M. J., Pallesen, P., & Nordhus, I. H. (2007). Factors affecting health status in COPD patients with co-morbid anxiety and depression. International Journal of Chronic Obstructive Pulmonary Disease, 2(3), 323–328.PubMedCentralPubMedGoogle Scholar
  10. 10.
    Stavem, K. (1999). Reliability, validity and responsiveness of two multiattribute utility measures in patients with chronic obstructive pulmonary disease. Quality of Life Research, 8, 45–54.PubMedCrossRefGoogle Scholar
  11. 11.
    Stavem, K. J., Eriksen, J., & Boe, J. (1999). Health status, dyspnea, lung function and exercise capacity in patients with chronic obstructive pulmonary disease. The International Journal of Tuberculosis Lung Disease, 3(10), 921–926.Google Scholar
  12. 12.
    Pickard, S., Wilke, S., Jung, E., Patel, S., Stavem, K., & Lee, T. A. (2008). Use of e preference-based measure of health (EQ-5D) in COPD and asthma. Respiratory Medicine, 102, 519–536.PubMedCrossRefGoogle Scholar
  13. 13.
    Cazzola, M., McNee, W., Martinez, F. J., Rabe, K. F., Franciosi, L. G., Barnes, P. J., et al. (2008). Outcomes for COPD pharmacological trials: From lung function to biomarkers. European Respiratory Journal, 31, 416–468.PubMedCrossRefGoogle Scholar
  14. 14.
    Wilke, S., Janssen, D. J. A., Wouters, E. F. M., Schols, J. M. G. A., Franssen, F. M. E., & Spruit, M. A. (2012). Correlations between disease-specific and generic health status questionnaires in patients with advanced COPD: A one-year observational study. Health Qual Life Outcomes, 10(98), 1–13.Google Scholar
  15. 15.
    Pickard, S., Yang, Y., & Lee, T. (2011). Comparison of health-related quality of life measures in chronic obstructive pulmonary disease. Health Qual Life Outcomes, 9(26), 1–6.Google Scholar
  16. 16.
    Plummer, M., & Molzahn, A. (2009). Quality of life in contemporary nursing theory. Nursing Science Quarterly, 22(2), 134–140.PubMedCrossRefGoogle Scholar
  17. 17.
    Anderson, K. L., & Burckhardt, C. S. (1999). Conceptualization and measurement of quality of life as an outcome variable for health care intervention and research. Journal of Advanced Nursing, 29(2), 298–306.PubMedCrossRefGoogle Scholar
  18. 18.
    Moons, P., Budts, W., & DeGeest, S. (2006). Critique on the conceptualization of quality of life: A review and evaluation of different conceptual approaches. International Journal of Nursing Studies, 43(7), 891–901.PubMedCrossRefGoogle Scholar
  19. 19.
    Wood-Dauphniee, S. (1999). Assessing quality of life in clinical research: From where have we come and where are we going? Journal of Clinical Epidemiology, 52(4), 355–363.CrossRefGoogle Scholar
  20. 20.
    Wilson, I. B., & Cleary, P. D. (1995). Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. The Journal of the American Medical Association, 273(1), 59–65.CrossRefGoogle Scholar
  21. 21.
    Katsura, H., Yamada, K., Wakabayashi, R., & Kida, K. (2007). Gender associated differences in dyspnoea and health-related quality of life in patients with chronic obstructive pulmonary disease. Respirology, 12(3), 427–432.PubMedCrossRefGoogle Scholar
  22. 22.
    Snaith, R. P. (1987). The concepts of mild depression. The British Journal of Medicine Psychiatry, 150(Mars), 387–393.CrossRefGoogle Scholar
  23. 23.
    Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.PubMedCrossRefGoogle Scholar
  24. 24.
    Snaith, R. P., & Zigmond, A. S. (1994). The hospital anxiety and depression scale manual. London: NFRF-Nelson Publishing Company Ltd.Google Scholar
  25. 25.
    Bjelland, I., Dahl, A. A., Haug, T. T., & Necklemann, D. (2002). The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research, 52(2), 69–77.PubMedCrossRefGoogle Scholar
  26. 26.
    Dowson, C., Laing, R., Barraclough, R., Mulder, R., & Norris, K. (2001). The use of Hospital Anxiety and Depression Scale (HADS) in patients with chronic obstructive pulmonary disease: A pilot study. New Zealand Medical Journal, 114(1141), 447–449.PubMedGoogle Scholar
  27. 27.
    Olssøn, I., Mykletun, A., & Dahl, A. A. (2003). The Hospital Anxiety and Depression rating Scale: A cross-sectional study of psychometrics and case finding abilities in general practice. BMC Psychiatry, 5, 46.CrossRefGoogle Scholar
  28. 28.
    Trappenburg, J. C., Troosters, T., Spruit, M. A., Vandebrouck, N., Decramer, M., & Gosselink, R. (2005). Psychosocial conditions do not affect short-term outcome of multidisciplinary rehabilitation in chronic obstructive pulmonary disease. Archives of Physical Medicine and Rehabilitation, 86(9), 1788–1792.PubMedCrossRefGoogle Scholar
  29. 29.
    Rustøen, T., Wahl, A., Hanestad, B. R., Lerdal, A., Paul, E. A., & Miaskowski, C. (2004). Prevalence and characteristics of chronic pain in the general Norwegian population. European Journal of Pain, 8(6), 555–565.PubMedCrossRefGoogle Scholar
  30. 30.
    Breivik, E. K., Bjørnsson, G. A., & Skovlund, E. (2000). A comparison of pain rating scales by sampling from clinical trial data. Clinical Journal of Pain, 16(1), 22–28.PubMedCrossRefGoogle Scholar
  31. 31.
    Lundber, T., Lund, I., Dahlin, L., Borg, E., Gustafsson, C., & Sandin, L. (2001). Reliability and responsiveness of three different pain assessments. Journal of Rehabilitation Medicine, 33(6), 279–283.CrossRefGoogle Scholar
  32. 32.
    Jones, N. M., Quirk, F. H., & Baveystock, C. M. (1991). The St George`s Respiratory Questionnaire. Respiratory Medicine, 85(Suppl), 25–35.PubMedCrossRefGoogle Scholar
  33. 33.
    Jones, P. W., Spencer, S., & Adie, S. (2003). The St. George`s Respiratory Questionnaire manual. London: Respiratory Medicine, St George’s Hospital Medical School.Google Scholar
  34. 34.
    Barr, J. T., Schumacher, G. E., Freeman, S., LeMoine, M., Bakst, A. W., & Jones, P. W. (2000). American translation, and validation of the St. George’s Respiratory Questionnaire. Clinical Therapeutics, 22(9), 1121–1145.PubMedCrossRefGoogle Scholar
  35. 35.
    Engström, C. P., Persson, L. O., Larsson, S., & Sullivan, M. (1998). Reliability and validity of the Swedish version of the St George’s Respiratory Questionnaire. European Respiratory Journal, 11(1), 61–66.PubMedCrossRefGoogle Scholar
  36. 36.
    Ferrer, M., Alonso, J., Prieto, L., Plaza, V., Monsò, E., Marrades, R., et al. (1996). Validity and reliability of the St. George’s Respiratory Questionnaire after adaptation to a different language and culture: the Spanish example. European Respiratory Journal, 9(6), 1160–1166.PubMedCrossRefGoogle Scholar
  37. 37.
    Burckhardt, C. S., Woods, S. L., Schultz, A. A., & Ziebarth, D. M. (1989). Quality of life of adults with chronic illness: A psychometric study. Research in Nursing & Health, 12(6), 347–354.CrossRefGoogle Scholar
  38. 38.
    Burckhardt, C. S., Anderson, K. L., Archenholtz, B., & Hägg, O. (2003). The Flanagan Quality of Life Scale: Evidence of construct validity. Health and Quality of Life Outcomes, 1(1), 159–166.Google Scholar
  39. 39.
    Archenholtz, B., Burckhardt, C. S., & Segesten, K. (1999). Quality of life of women with systemic lupus erythematosus or rheumatoid arthritis: Domains of importance and dissatisfaction. Quality of Life Research, 8(5), 411–416.PubMedCrossRefGoogle Scholar
  40. 40.
    Burckhardt, C. S., & Anderson, K. L. (2003). The Quality of Life Scale (QOLS): Reliability, validity, and utilization. Health and Quality of Life Outcomes, 23(1), 60–67.CrossRefGoogle Scholar
  41. 41.
    Liedberg, G. M., Burckhardt, C. S., & Henriksson, C. M. (2005). Validity and reliability testing of the Quality of Life Scale, Swedish version in women with fibromyalgia—Statistical analysis. Scandinavian Journal of Caring Sciences, 19(1), 64–70.PubMedCrossRefGoogle Scholar
  42. 42.
    Wahl, A., Burckhardt, C., Wiklund, I., & Hanestad, B. R. (1998). The Norwegian version of the Quality of Life Scale (QOLS-N). Scandinavian Journal of Caring Sciences, 12(4), 215–222.PubMedGoogle Scholar
  43. 43.
    Quanjer, P. H., Tammeling, J. E., Cotes, J. E., Pedersen, O. F., Peslin, R., & Yernault, J. C. (1993). Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests European community for steel and coal. Official statement of the European respiratory society. European Respiratory Journal, 16(Suppl), 5–40.PubMedCrossRefGoogle Scholar
  44. 44.
    Gulsvik, A., Tosteson, T., Bakke, P. S., Humerfelt, S., Weiss, S. T., & Speizer, F. E. (2001). Expiratory and inspiratory forced vital capacity and one-second forced volume in asymptomatic never-smokers in Norway. Clinical Physiology, 21(8), 648–660.PubMedCrossRefGoogle Scholar
  45. 45.
    GOLD. (2013). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. GOLD Science Committee (pp. 1–76). Oregon: Global Initiative for Chronic Obstructive Lung Disease.Google Scholar
  46. 46.
    Singh, S. J., Morgan, M. D. L., Scott, S., Walters, D., & Hardman, A. E. (1992). Development of a shuttle walking test of disability in patients with chronic airways obstruction. Thorax, 47(12), 1019–1024.PubMedCentralPubMedCrossRefGoogle Scholar
  47. 47.
    Singh, S. J., Morgan, M. D. L., & Hardam, A. E. (1996). The shuttle walking test manual. Leicester: Department of Respiratory Medicine, The Glenfield Hospital.Google Scholar
  48. 48.
    Singh, S. J., Morgan, M. D. L., Hardam, A. E., Rowe, C., & Bardsley, P. A. (1994). Comparison of oxygen uptake during a conventional treadmill test and the shuttle walking test in chronic airflow limitation. European Respiratory Journal, 7(11), 2016–2020.PubMedGoogle Scholar
  49. 49.
    Dowson, L. J., Newall, C., Guest, P. J., Hill, S. L., & Stockley, R. A. (2001). Exercise capacity predicts health status in alpha 1—Antitrypsin deficiency. American Journal of Respiratory and Critical Care Medicine, 163(4), 936–941.PubMedCrossRefGoogle Scholar
  50. 50.
    Haave, E., Hyland, M. E., & Engvik, H. (2007). Improvements in exercise capacity during a 4-weeks pulmonary rehabilitation program for COPD patients do not correspond with improvements in self-reported health status or quality of life. International Journal of Chronic Obstructive Pulmonary Disease, 2(3), 355–359.PubMedCentralPubMedGoogle Scholar
  51. 51.
    VonLeupoldt, A., & Dahme, B. (2005). Cortical substrates for perception of dyspnea. Chest, 128(1), 345–354.CrossRefGoogle Scholar
  52. 52.
    Williams, M., Cafarella, P., Olds, T., Petkov, J., & Frith, P. (2008). The language of breathlessness. Differentiates between patients with COPD and age-matched adults. Chest, 134(3), 489–496.PubMedCrossRefGoogle Scholar
  53. 53.
    DePeuter, S., VanDiest, I., Lemaigre, V., Verleden, G., Demedts, M., & VandenBergh, O. (2004). Dyspnea: The role of psychological processes. Clinical Psychology Review, 24(5), 557–581.CrossRefGoogle Scholar
  54. 54.
    Lansing, R. W., Gracely, R. H., & Banzet, R. B. (2009). The multiple dimensions of dyspnea: Review and hypotheses. Respiratory Physiology & Neurobiology, 167(1), 53–60.CrossRefGoogle Scholar
  55. 55.
    Rinder, S. H. (2004). Psychological distress: Concept analysis. Journal of Advanced Nursing, 45(5), 536–545.CrossRefGoogle Scholar
  56. 56.
    Wahl, A., Rustøen, T., Rokne, B., Lerdal, A., Knudsen, Ø., Miaskowski, C., et al. (2009). The complexity of the relationship between chronic pain and quality of life: A study of the general Norwegian population. Quality of Life Research, 18(8), 971–980.PubMedCentralPubMedCrossRefGoogle Scholar
  57. 57.
    Skilbeck, J., Mott, L., Page, H., & Smith, D. (1998). Palliative care in chronic obstructive airways disease: A needs assessment. Palliative Medicine, 12(4), 245–254.PubMedCrossRefGoogle Scholar
  58. 58.
    Bandura, A. (1997). Self-efficacy. The exercise of control. New York: Freeman and Company.Google Scholar
  59. 59.
    Fayers, P. M., & Machin, D. (2007). Quality of life. The assessment, analysis and interpretation of patient-reported outcomes. West Sussex: Wiley.Google Scholar
  60. 60.
    Sprangers, M. A. G., DeRegt, E. B., Andries, F., & van Agt, H. M. E. (2000). bijl RV, DeBoer JB, Foets M, Hoeymans N, Jacobs AE, Kempen GIJM, Miedema HS, Tijhuis MAR, DeHaes HCJM: Which chronic conditions are associated with better or poorer quality of life? J Clin Epidemiol, 53(9), 895–907.PubMedCrossRefGoogle Scholar
  61. 61.
    Altman, D. G. (1999). Practical statistics for medical research. London: Champmand & Hall/CRC.Google Scholar
  62. 62.
    Lohne, V., Heer, H. C. D., Andersen, M., Miaskowski, C., Kongerud, J., & Rustøen, T. (2010). Qualitative study of pain of patients with chronic obstructive pulmonary disease. Heart and Lung, 39(3), 225–234.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Signe Berit Bentsen
    • 1
    Email author
  • Christine Miaskowski
    • 2
  • Tone Rustøen
    • 3
    • 4
  1. 1.Department of ResearchHaugesund HospitalHaugesundNorway
  2. 2.Department of Physiological Nursing, School of NursingUniversity of CaliforniaSan FranciscoUSA
  3. 3.Division of Emergencies and Critical Care, Department of Research and DevelopmentOslo University HospitalOsloNorway
  4. 4.Department of Nursing Science, Institute of Health and SocietyUniversity of OsloOsloNorway

Personalised recommendations