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Fluctuating patterns in quality of life outcomes among patients with moderate and severe stages of chronic obstructive pulmonary disease

Abstract

Purpose

How changes in depression and anxiety and well-being may fluctuate with changes in disease-specific quality of life (QOL), and further how changes in well-being may fluctuate with changes in depression and anxiety among patients with moderate and severe chronic obstructive pulmonary disease (COPD).

Methods

In a longitudinal study (as part of a randomized controlled trial), we investigated 150 patients with moderate and severe COPD at baseline, 143 at 4 weeks, and 130 at 4 months. Lung function was tested, and a questionnaire was completed at all appointments. The questions captured demographic variables, disease-specific QOL (St. George’s Respiratory Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), and well-being (World Health Organization-5 Well-being Index). Multiple regression analyses were performed.

Results

At 4 weeks and 4 months, changes in disease-specific QOL (st. β = –0.35, p < 0.001, partial (p) R 2 = 11–12 %), depression (st. β = –0.32 to –0.36, p < 0.001, pR 2 = 9–12 %), and anxiety (st. β = –0.21 to –0.40, p < 0.02–0.001, pR 2 = 4–15 %) were significantly associated with changes in well-being. Changes in disease-specific QOL were significantly associated with changes in anxiety at 4 months (st. β = 0.21, p = 0.02, pR 2 = 4 %), but not with changes in depression.

Conclusions

Changes in disease-specific QOL, depression, and anxiety were associated with changes in well-being. Changes in disease-specific QOL contributed slightly to changes in anxiety, but not to changes in depression. Well-being may capture some aspects of mental QOL in COPD patients better than depression and anxiety.

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Acknowledgments

This study was supported by the Norwegian Extra Foundation for Health and Rehabilitation through EXTRA funds, University of Oslo Department of Health Sciences, Lovisenberg Diaconal Hospital, Norwegian Union of Nursing, and The Norwegian Heart and Lung Patient Organization. The authors are grateful to all the participants in the study and to Lovisenberg Diaconal Hospital, Ullevål University Hospital, and Diakonhjemmet Hospital (all in Oslo), for help with the recruitment of participants.

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Correspondence to Christine R. Borge.

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Borge, C.R., Mengshoel, A.M., Moum, T. et al. Fluctuating patterns in quality of life outcomes among patients with moderate and severe stages of chronic obstructive pulmonary disease. Qual Life Res 25, 2041–2051 (2016). https://doi.org/10.1007/s11136-016-1227-4

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  • DOI: https://doi.org/10.1007/s11136-016-1227-4

Keywords

  • Chronic obstructive pulmonary disease
  • Quality of life
  • Symptoms
  • Outcomes
  • Well-being