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Background
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.
Objective
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.
Results
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.
Conclusions
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.
Section snippets
Patients
Using a cross-sectional study, we recruited participants consecutively from outpatients of the allergy or pneumology practices of the University Hospital Complex of Ourense [Spain], a tertiary center belonging to the Spanish public health care system that attends to patients referred from primary care. Inclusion criteria were: [1] a physician's diagnosis of asthma, [2] at least 6 months since the diagnosis, [3] age between 18 and 75 years, [4] reading-writing ability in Spanish, and [5] no
Results
A total of 373 asthmatic patients [55.3% were recruited in allergy practices, and 44.7% in pneumology practices] participated in the study. Characteristics of the sample are summarized in Table I. The mean age of this sample was 36.88 ± 14.90 years [range, 18-75 years], the mean age of the patients when they were diagnosed with asthma was 25.62 ± 14.82 years [range, 1-67 years], and the mean duration of the disease was 11.98 ± 10.90 years [range, 0-67 years]. The treatment the patients were
Discussion
Our results show that asthma affects both generic dimensions and specific dimensions of HRQoL, and the main variables that determine this impact on HRQoL are anxiety, depression, and patient-rated asthma control.
The impact of asthma on HRQoL was assessed using 2 complementary approaches: a generic questionnaire [SF-36] and a specific questionnaire [SGRQ]. Both questionnaires coincided in indicating the physical dimensions as the most damaged, whereas the mental dimensions remain the least
Acknowledgments
We thank Dr. José Manuel García Pazos, Dr. Pedro Marcos Velázquez, Dr. Carlos García de la Cuesta, Dra. María Genoveva Álvarez Eire, and Dra. Susana Varela for their support in registering the clinic data of the patients. We also thank Dr. Salvador Pita Fernández [deceased] for his valuable contribution in the development of this study.
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Cited by [16]
Update in Pediatric Asthma: Selected Issues
2020, Disease-a-Month
The threat of having sudden shortness of breath with potential death and/or disability has been studied by researchers of the 20th and now 21st century revealing a complex link of mental health themes with asthma in persons of all ages.282,293,304–337 Research in the 21st century reveals links between asthma and combinations of mental illness [i.e., depression, anxiety, others].311–325 Studies have also seen links with asthma and specifically depression326–332 as well as asthma and specifically anxiety.333–337
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