Chest
Volume 131, Issue 6, June 2007, Pages 1890-1897
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ORIGINAL RESEARCH
HEALTH-RELATED QUALITY OF LIFE
Changes in Respiratory Symptoms and Health-Related Quality of Life

https://doi.org/10.1378/chest.06-2629Get rights and content

Background

For a number of chronic diseases, health-related quality of life (HRQoL) has become an important outcome measure. Little data are available on how incidence, remission, or persistence of respiratory symptoms affect HRQoL.

Methods

The Hordaland County Cohort Study was conducted between 1985 and 1997, and comprised 3,786 subjects, randomly selected, and aged 15 to 70 years in 1985. Respiratory symptoms were assessed both in 1985 and 1996/1997, and HRQoL was measured by the Short-Form 12 questionnaire in 1996/1997. Robust linear regression analysis was used to examine the relationship between changes in six respiratory symptoms and the physical component score (PCS) and mental component score (MCS).

Results

Among subjects with incidence or persistence of any of the six examined respiratory symptoms, PCS and MCS were significantly lower than among subjects without symptoms. The PCS was more reduced than the MCS in symptomatic subjects; however, this trend was reduced after adjustment for the confounder's gender, age, educational level, body mass index, and smoking status. Dyspnea attacks and dyspnea grade 2 had the largest negative impact on both PCS and MCS.

Conclusions

This is the first longitudinal population study to show the negative impact of incidence and persistence of respiratory symptoms on HRQoL.

Section snippets

Study Population and Sample

In 1985, 3,786 randomly selected subjects aged 15 to 70 years in the Norwegian city of Bergen and 11 surrounding municipalities were mailed a questionnaire regarding respiratory symptoms. After up to two reminder letters, 3,370 subjects (89%) responded to the questionnaire.15 A follow-up was conducted in 1996/1997. Then, in addition to being sent a questionnaire on respiratory symptoms, the subjects were invited to a clinical examination. Between 1985 and 1996, 189 persons were deceased,

Results

Characteristics of the study sample are presented in Table 1. A larger percentage of men had a university educational level. More women than men were neversmokers, and men tended to have higher smoking loads measured by pack-years (Table 1). The distribution of the changes in respiratory symptoms between genders is shown in Table 2. The distribution varied between genders for the symptoms phlegm cough and dyspnea grade 2. The occurrence of not having a symptom at either time point was higher

Discussion

Among subjects with incidence or persistence of any of the six examined respiratory symptoms, the PCS and MCS were lower than among subjects without symptoms. In general, the PCS was more reduced than the MCS in symptomatic subjects; however, this trend was reduced after adjustment for the confounder's gender, age, educational level, and smoking status. Dyspnea grade 2 had a larger negative impact on the PCS in older subjects, whereas it affected the MCS more in younger subjects.

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Appendix

The wording of the questions on respiratory symptoms was identical at baseline and follow-up except for the questions regarding chronic cough and wheezing:

ACKNOWLEDGMENT

Borghild Hovland and the late Ms. Bjørg Meidel made significant contributions to the collecting and punching of the data.

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