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Determinants for a low health-related quality of life in asthmatics
The Swedish Red Cross University College. Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala.ORCID iD: 0000-0002-3944-8633
Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala.
Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala.
Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology, Uppsala University, Uppsala.
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2012 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 117, no 1, 57-66 p.Article in journal (Refereed) Published
Abstract [en]

People with asthma suffer from impaired health-related quality of life (HRQL), but the determinants of HRQL among asthmatics are not completely understood. The aim of this investigation was to study determinants of low HRQL in asthmatics and to study whether the determinants of HRQL differ between sexes and age groups. A cohort of three age groups in Sweden was investigated in 1990 using a questionnaire with focus on respiratory symptoms. To study quality of life, the generic instrument Gothenburg Quality of Life was used. The participants were also investigated with interviews, spirometry, and allergy testing. Asthma was diagnosed in 616 subjects. Fifty-eight per cent (n = 359) of the subjects were women; and 24% were smokers, 22% ex-smokers, and 54% were non-smokers. Women were more likely than men to report poor health-related quality of life. Respiratory symptoms severity was another independent determinant of a lower quality of life as well as airway responsiveness to irritants. Current and former smokers also reported lower quality of life. Finally, absenteeism from school and work was associated with lower quality of life. Factors such as sex, smoking habits, airway responsiveness to irritants, respiratory symptom severity, allergy, and absenteeism from school and work were associated with low HRQL in asthmatics.

Place, publisher, year, edition, pages
Informa Healthcare, 2012. Vol. 117, no 1, 57-66 p.
Keyword [en]
asthma, GQL, generic instrument, quality of life
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:rkh:diva-531DOI: 10.3109/03009734.2011.638730PubMedID: 22200102OAI: oai:DiVA.org:rkh-531DiVA: diva2:607769
Note

Som manuskript i avhandling. As manuscript in dissertation

Available from: 2013-02-25 Created: 2013-02-25 Last updated: 2017-07-14Bibliographically approved
In thesis
1. Health-related quality of life in asthma
Open this publication in new window or tab >>Health-related quality of life in asthma
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Health-related quality of life (HRQL) has become an important outcome in asthma, since traditional outcomes, such as respiratory symptoms and pulmonary function, might not entirely express the patient’s perception of the limitations caused by the disease. The aim of this thesis was to study HRQL in asthma and to analyse if HRQL was related to asthma onset and prognosis. Other aims were to identify determinants of low HRQL in clinically-verified asthmatics, and to study whether low HRQL was a predictor of mortality.

In 1990, a self-administered questionnaire was completed by 12,560 individuals from three age groups (16, 30-39, and 60-69 years) in two counties of Sweden. In a second phase, all subjects who reported a history of obstructive respiratory symptoms (n = 1,851) and 600 randomly-selected controls were invited to a clinical investigation including spirometry, allergy testing, and assessment of HRQL with the Gothenburg Quality of Life instrument. In 2003, the eligible subjects in the cohort (n=11,282) were sent a new questionnaire. Mortality data in the cohort was followed up during 1990–2008 using data from the National Board of Health and Welfare Mortality Database.

The 616 subjects with clinically-verified asthma 1990 had significantly lower HRQL than subjects without asthma. In the 2003 follow-up, the 305 subjects with persistent asthma had a lower HRQL than the 155 subjects who showed improvement in asthma during the follow-up. Subjects who had developed asthma by the follow-up had a significantly lower HRQL at baseline than those who did not develop asthma. Significant determinants of quality of life in asthma were female sex, smoking habits, higher airway responsiveness to irritants, respiratory symptom severity, positive skin prick test, and absenteeism from work or school. Low HRQL was related to increased mortality, but this association was not found when analyzing the asthmatic group alone.

In conclusion, measurements of HRQL are of value for evaluating both the impact and progression of asthma.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 71 p.
Keyword
asthma, adult, quality of life, cohort studies, longitudinal study, questionnaires, epidemiology, prognosis, Gothenburg quality of life instrument
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-532 (URN)978-91-554-7864-3 (ISBN)
Public defence
2010-10-02, Hörsalen, Akademiska sjukhuset, Dag Hammarskjölds väg 17, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Note

medicine doktorsexamen

Available from: 2014-07-08 Created: 2013-02-25 Last updated: 2017-05-17Bibliographically approved

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