Influnencing Factors Of Quality Of Life In Patients With Chronic Obstructive Pulmonary Disease

Objective To study the major factors which could affect the quality of life in patients with chronic obstructive pulmonary disease.Methods 1.126 inpatients or outpatients with stable chronic obstructive pulmonary disease(COPD) were selected from the Department of Respiratory Medicine,No.1 Hospital of Shanxi Medical University between August 2006 and November 2007.2.The quality of life of the patients were measured with COPD questionaire designed by professer Cai Yinyun in shanxi.The questionnaire has 35 items which belong to 4 dimensions:activity of daily living,social activities condition,depressed psychological symptom and anxious psychological symptom.The items are scored from 1 to 4 on the basis of quality.The higher score indicates the worst QOL.The calculation method is as below:(1).The total score is the addition of all project scores.(2).The total average score of projects is the devision by the no of projects.(3).An element is comprised of projects.The element score is the devision of total project score by the no of the projects.3.Based on the demographic characteristics investigation,epidemiologic feature and clinical experience of diagnose and therapia of the patients with COPD,11 factors,which may be interfered in,were investigated and analysed including age,employment, economic status,nutritional status,smoking condition,dyspnea degree,the frequency of acute exacerbation,physical exercise,comorbidity,forced expiratory volume in first second(FEV₁) and partial pressure of oxygen of artery(PaO₂).4.The data were analyzed with corresponding statistical methods,and correlation factor were picked out by general linear model univariate analysis,then the main influencing factors were screened by multivariate regression analysis.Results All the questionnaires filled by the 126 patients were accurate and complete,and all were involved to the analysis of results.(1).Age influenced both the total scores and 2 dimensions including activity of daily living and depressed psychology symptom.(standard regression coefficientβwas 0.128,0.239 and 0.165,t=2.224,4.128 and 2.274,P＜0.05,0.05 and 0.01);(2).BMI affected both the total scores and social activities condition.(standard regression coefficientβwas -0.136 and -0.196,t=-2.526 and -2.864,P＜0.05 and 0.01);(3) partial pressure of oxygen of artery affected the total scores and activity of daily living.(standard regression coefficientβwas -0.192 and -0.205,t=-3.202 and -2.791,P＜0.01,0.01 and 0.05);(4).Comorbidity affected the total scores,social activities condition and anxious psychological symptom.(standard regression coefficientβwas 0.193,0.303 and 0.189,t=3.060,4.174 and 2.304,P＜0.01,0.01 and 0.05);(5).The frequency of acute exacerbation affected the total scores and 4 dimensions including activity of daily living,social activities condition,anxious psychological symptom and depressed psychology symptom.(standard regression coefficientβwas 0.219,0.163,0.203,0.244 and 0.250,t=3.786,2.701,2.763,3.710 and 3.377,P＜0.01);(6).Dyspnea degree affected the total scores and 3 dimensions including activity of daily living,anxious psychological symptom and depressed psychology symptom.(standard regression coefficientβwas 0.204,0.265,0.264,and 0.366,t=2.841,3.487,2.982 and 4.582,P＜0.01);(7)Lung function affected activity of daily living and social activities condition.(standard regression coefficientβwas 0.173 and 0.205,t=2.013 and 2.503,P＜0.01);(8) Physical exercise affected the total scores and 4 dimensions including activity of daily living,social activities condition,anxious psychological symptom and depressed psychology symptom.(standard regression coefficientβwas0.248,0.170,0.207,0.216 and 0.218,t=4.515,2.884,3.023,2.846 and 2.949,P＜0.01).Conclusion The major factors which affect the QOL of stable chronic obstructive pulmonary disease patients are age,BMI,physical exercise,comorbidity,the frequency of acute exacerbation,dyspnea degree,pulmonary ventilation function and PaO₂.ACcording to standard regression coefficientβ,wo can learn about that the main factors that influence total scores are physical exercise,the frequency of acute exacerbation,dyspnea degree,PaO₂,comorbidity,BMI and age.