Christine R Borge1,2,3, Anne M Mengshoel4, Torbjørn Moum5, Astrid K Wahl4. 1. Department of Health Sciences, University of Oslo, Oslo, Norway. c.r.borge@medisin.uio.no. 2. Department of Medicine, Lovisenberg Diaconal Hospital, 0440, Oslo, Norway. c.r.borge@medisin.uio.no. 3. Department of Health Sciences, Institute of Health and Society, PB 1089 Blindern, 0317, Oslo, Norway. c.r.borge@medisin.uio.no. 4. Department of Health Sciences, University of Oslo, Oslo, Norway. 5. Department of Behavioral Sciences in Medicine, University of Oslo, Oslo, Norway.
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.
RCT Entities:
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 COPDpatients better than depression and anxiety.
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