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Rask-Andersen, A., Leander, M., Sundbom, F., Lampa, E., Oudin, A., Leynaert, B., . . . Janson, C. (2022). Health-related quality of life as associated with asthma control, psychological status and insomnia. Upsala Journal of Medical Sciences, 127, Article ID e8967.
Öppna denna publikation i ny flik eller fönster >>Health-related quality of life as associated with asthma control, psychological status and insomnia
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2022 (Engelska)Ingår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 127, artikel-id e8967Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Asthma is associated not only with lower health-related quality of life (HRQL) but also with psychological health and insomnia. The aim of this study was to investigate associations between HRQL, asthma symptoms, psychological status and insomnia in adults from three Nordic countries.

Methods: This study comprised 2,270 subjects aged 29–55 from Sweden, Iceland and Norway. HRQL was measured with the 36-Item Short Form Health Survey (SF-36). The physical (PCS) and mental health (MCS) component scores were calculated with higher values, indicating better health status. Symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Insomnia was assessed with the Basic Nordic Sleep Questionnaire. An asthma score consisting of a sum of the positive answers to five respiratory symptoms was used in the analysis. Spirometry and allergy tests were also performed.

Results: High HADS and sleep disturbance scores were both related to a low PCS and MCS, respectively, after adjusting for confounders. High age and high body mass index (BMI) were associated with low scores on the PCS, whilst the opposite was found for the MCS. A higher asthma score was related to a low PCS. An interaction between the HADS and the asthma symptom score was observed for the PCS (P = 0.0002), where associations between psychological status and the PCS were more pronounced for individuals with more symptoms than for individuals without symptoms.

Conclusions: In this study, we found that HRQL of life was independently related to the HADS, insomnia and asthma symptoms. Further prospective studies to identify the most efficient target for intervention in order to improve asthma control are needed.

Ort, förlag, år, upplaga, sidor
Upsala Medical Society, 2022
Nyckelord
Health-related quality of life, asthma symptoms, anxiety, depression, insomnia
Nationell ämneskategori
Arbetsmedicin och miljömedicin Lungmedicin och allergi
Identifikatorer
urn:nbn:se:uu:diva-492072 (URN)10.48101/ujms.v127.8967 (DOI)000905434200001 ()36590755 (PubMedID)
Forskningsfinansiär
Hjärt-LungfondenAstma- och AllergiförbundetRegion UppsalaVårdalstiftelsenNorges forskningsråd, 135773/330
Tillgänglig från: 2023-01-02 Skapad: 2023-01-02 Senast uppdaterad: 2023-03-02Bibliografiskt granskad
Leander, M., Lampa, E., Rask-Andersen, A., Franklin, K., Gislason, T., Oudin, A., . . . Janson, C. (2014). Impact of anxiety and depression on respiratory symptoms. Respiratory Medicine, 108(11), 1594-1600
Öppna denna publikation i ny flik eller fönster >>Impact of anxiety and depression on respiratory symptoms
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2014 (Engelska)Ingår i: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 108, nr 11, s. 1594-1600Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Psychological factors such as anxiety and depression are prevalent in patients with asthma. The purpose of this study was to investigate the relationship between respiratory symptoms and psychological status and to estimate the importance of psychological status in comparison with other factors that are known to be associated with respiratory symptoms. This study included 2270 subjects aged 20-44 (52% female) from Sweden, Iceland, and Norway. Each participant underwent a clinical interview including questions on respiratory symptoms. Spirometry and methacholine challenge were performed. Symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Eighty-two percent of the subjects reported no anxiety or depression whatsoever, 11% reported anxiety, 2.5% depression and 4% reported both anxiety and depression. All respiratory symptoms, such as wheezing, breathlessness and nightly symptoms, were more common, at a statistically significant level, in participants who had depression and anxiety, even after adjusting for confounders (ORs 1.33-1.94). The HADS score was the most important determinant for nightly symptoms and attacks of breathlessness when at rest whereas bronchial responsiveness was the most important determinant for wheezing, and breathlessness when wheezing. The probability of respiratory symptoms related to HADS score increased with increasing HADS score for all respiratory symptoms. In conclusion, there is a strong association between respiratory symptoms and psychological status. There is therefore a need for interventional studies designed to improve depression and anxiety in patients with respiratory symptoms.

Nationell ämneskategori
Lungmedicin och allergi
Identifikatorer
urn:nbn:se:uu:diva-239379 (URN)10.1016/j.rmed.2014.09.007 (DOI)000345733800004 ()25282543 (PubMedID)
Tillgänglig från: 2014-12-25 Skapad: 2014-12-22 Senast uppdaterad: 2017-12-05Bibliografiskt granskad
Leander, M., Lampa, E., Janson, C., Svärdsudd, K., Uddenfeldt, M. & Rask-Andersen, A. (2012). Determinants for a low health-related quality of life in asthmatics. Upsala Journal of Medical Sciences, 117(1), 57-66
Öppna denna publikation i ny flik eller fönster >>Determinants for a low health-related quality of life in asthmatics
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2012 (Engelska)Ingår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 117, nr 1, s. 57-66Artikel i tidskrift (Refereegranskat) 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 study 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 respiratory questionnaire. 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 percent (n=359) of the subjects were women. Twenty-four percent 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.

Nyckelord
asthma, GQL, quality of life, generic instrument, prognostic
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Forskningsämne
Arbets- och miljömedicin
Identifikatorer
urn:nbn:se:uu:diva-129457 (URN)10.3109/03009734.2011.638730 (DOI)000300304000010 ()
Tillgänglig från: 2010-08-16 Skapad: 2010-08-16 Senast uppdaterad: 2017-12-12Bibliografiskt granskad
Leander, M., Janson, C., Uddenfeldt, M., Cronqvist, A. & Rask-Andersen, A. (2010). Associations between mortality, asthma, and health-related quality of life in an elderly cohort of Swedes. Journal of Asthma, 47(6), 627-632
Öppna denna publikation i ny flik eller fönster >>Associations between mortality, asthma, and health-related quality of life in an elderly cohort of Swedes
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2010 (Engelska)Ingår i: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 47, nr 6, s. 627-632Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Asthma is a common chronic health condition among the elderly and an important cause of morbidity and mortality. Some studies show that subjective assessments of health-related quality of life (HRQL) are important predictors of mortality and survival. The primary aim of this study was to investigate whether low HRQL was a predictor of mortality in elderly subjects and whether such an association differed between subjects with and without asthma. METHODS: In 1990, a cohort in middle Sweden was investigated using a respiratory questionnaire. To assess HRQL, the generic instrument Gothenburg Quality of Life (GQL) was used. The participants were also investigated by spirometry and allergy testing. The present study was limited to the subjects in the oldest age group, aged 60-69 years in 1990, and included 222 subjects with clinically verified asthma, 148 subjects with respiratory symptoms but no asthma or other lung diseases, and 102 subjects with no respiratory symptoms. Mortality in the cohort was followed during 1990-2008. RESULTS: Altogether, 166 of the 472 subjects in the original cohort had died during the follow-up period of 1990-2008. Mortality was significantly higher in men, in older subjects, in smokers, and subjects with a low forced expiratory volume in one second (FEV(1)). There was, however, no difference in mortality between the asthmatic and the nonasthmatic groups. A higher symptoms score for GQL was significantly related to increased mortality. No association between HRQL and mortality was found when limiting the analysis to the asthmatic group, although the asthmatics had a lower symptom score for GQL compared to the other groups. CONCLUSION: A higher symptom score in the GQL instrument was significantly related to increased mortality, but this association was not found when analyzing the asthmatic group alone. The negative prognostic implications of a low HRQL in the whole group and the fact that the asthmatic group had a lower HRQL than the other group supports the use of HRQL instruments in clinical health assessments.

Nyckelord
asthma, generic instrument, GQL, mortality, quality of life
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:uu:diva-134194 (URN)10.3109/02770901003617402 (DOI)000282518900006 ()20626313 (PubMedID)
Tillgänglig från: 2010-11-22 Skapad: 2010-11-22 Senast uppdaterad: 2017-12-12Bibliografiskt granskad
Leander, M. (2010). Health-Related Quality of Life in Asthma. (Doctoral dissertation). Uppsala: Acta Universitatis Upsaliensis
Öppna denna publikation i ny flik eller fönster >>Health-Related Quality of Life in Asthma
2010 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
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.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2010. s. 71
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 584
Nyckelord
Asthma, Adult, Quality of Life, Cohort Studies, Longitudinal study, Questionnaires, Epidemiology, Prognosis, Gothenburg Quality of Life Instrument, Göteborg Quality of Life Instrument
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:uu:diva-129626 (URN)978-91-554-7864-3 (ISBN)
Disputation
2010-10-02, Hörsalen, Akademiska sjukhuset, Dag Hammarskjölds väg 17, Uppsala, 09:15 (Svenska)
Opponent
Handledare
Tillgänglig från: 2010-09-08 Skapad: 2010-08-19 Senast uppdaterad: 2010-09-08Bibliografiskt granskad
Organisationer
Identifikatorer
ORCID-id: ORCID iD iconorcid.org/0000-0002-3944-8633

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