Quality of life, anxiety and depression in patients with chronic obstructive pulmonary disease

Lima, César de Andrade de; Oliveira, Regina Celia de; Oliveira, Simone Andrade Gonçalves de; Silva, Mônica Alice Santos da; Lima, Alcione de Andrade; Andrade, Maria Sandra; Pinho, Clarissa Mourão

doi:10.1590/0034-7167-2019-0423

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Revista Brasileira de Enfermagem

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Sumário

ARTIGO ORIGINAL • Rev. Bras. Enferm. 73 (Suppl 1) • 2020 • https://doi.org/10.1590/0034-7167-2019-0423 copy

Quality of life, anxiety and depression in patients with chronic obstructive pulmonary disease

Calidad de vida, ansiedad y depresión en pacientes con enfermedad pulmonar obstructiva crónica

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to assess quality of life, anxiety and depression in patients with Chronic Obstructive Pulmonary Disease.

Method:

a cross-sectional, quantitative study, conducted in a reference hospital for the treatment of pulmonary diseases. Seventy patients were assessed, using a sociodemographic and clinical questionnaire, Beck’s anxiety and Depression Inventories and the SF-36 Quality of Life Scale.

Results:

the participants had better quality of life in the vitality, mental health and social role functioning domains (median=50.0) and worse in limitation by physical and emotional role functioning (median=0.0 points). Anxiety, depression and oxygen dependence were associated with poorer results in the quality of life domains.

Conclusion:

all patients were classified with severe anxiety level and moderate depression predominance. Patients had low quality of life scores in all domains.

Descriptors:
Chronic Obstructive Pulmonary Disease; Quality of Life; Anxiety; Depression; Nursing

Variables	n	%	p value¹ 1 P value of the Chi-square test for comparison of proportions.
Gender
Female	21	30.0	0.001
Male	49	70.0	0.001
Age
39 tom59 years	20	28.6	< 0.001
60 years or more	50	71.4	< 0.001
Origin
Recife	23	32.9	< 0.001
Metropolitan Region of Recife	23	32.9
Interior of state	23	32.9
Other state	1	1.3
Work activity
Unemployed	7	10.0	< 0.001
Retired	37	52.9
Social benefit	14	20.0
Employed	3	4.3
Self-employed	7	10.0
Other	2	2.9
Marital status
Single	5	7.1	< 0.001
Common-law	2	2.9
Married	55	78.6
Widower	8	11.4
Level of education
Illiterate	4	5.7	< 0.001
Literate	2	2.9
Elementary school	33	47.1
High school	27	38.6
Higher education	4	5.7
Religion
Catholic	44	62.9	< 0.001
Evangelical	18	25.7
None	4	5.7
Other	4	5.7

Variables	n	%	p value¹ 1 P value of the Chi-square test for comparison of proportions.
Time since diagnosis
1 a 2 years	29	41.4	0.211
3 a 5 years	24	34.3
6 years or more	17	24.3
Minimum - Maximum	1.0 - 20.0		-
Mean ± Standard deviation	4.9 ± 4.3		-
Outpatient Follow-up
Yes	56	80.0	< 0.001
No	14	20.0	< 0.001
Previous hospitalization
Yes	52	74.3	< 0.001
No	18	25.7	< 0.001
Number of hospitalizations
Minimum - Maximum	1.0 - 7.0		-
Mean ± Standard deviation	2.6 ± 1.3		-
Inhalaed medications
Formoterol fumarate/ Budesonide	10	14.3	< 0.001
Formoterol fumarate/ Budesonide + tiotropium bromide	31	44.3
Salbutamol	1	1.4
Salbutamol + Formoterol fumarate/ Budesonide + tiotropium bromide	18	25.7
Salbutamol + tiotropium bromide	2	2.9
Salbutamol + Formoterol fumarate / Budesonide	7	10.0
Fenoterol hydrobromide + Formoterol fumarate / Budesonide	1	1.4

Domain	Minimum	Maximum	Median	Interquartile range
Physical functioning	0.00	65.00	15.00	10.00
Physical role functioning	0.00	25.00	0.00	0.00
Bodily pain	0.00	54.00	41.00	2.50
General health perceptions	5.00	45.00	25.00	5.00
Vitality	10.00	70.00	50.00	5.00
Social role functioning	0.00	62.50	50.00	0.00
Emotional role functioning	0.00	33.33	0.00	0.00
Mental health	36.00	68.00	50.00	4.00

Domain	Minimal effort dyspnea		p value¹ 1 Mann-Whitney test (if p value<0.05 there is a difference between the groups). (-) no interquartile range; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	Dependent on O₂ therapy		p value¹ 1 Mann-Whitney test (if p value<0.05 there is a difference between the groups). (-) no interquartile range; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.
Domain	Yes	No		Yes	No
Capacidade funcional	15.0 (10.0)	15.0 (40.0)	0.037	0.0 (2.5)	15.0 (5.0)	< 0.001
Limitação por aspectos físicos	0.0 (0.0)	0.0 (0.0)	0.782	0.0 (0.0)	0.0 (0.0)	0.633
Dor	41.0 (5.0)	41.0 (5.5)	0.564	31.0 (10.0)	41.0 (0.0)	0.051
Estado de saúde geral	25.0 (5.0)	30.0 (20.0)	0.450	25.0 (5.0)	25.0 (10.0)	0.010
Vitalidade	50.0 (7.5)	50.0 (32.5)	0.132	50.0 (12.5)	50.0 (2.5)	0.727
Aspecto social	50.0 (0.0)	50.0 (18.8)	0.657	37.5 (18.8)	50.0 (0.0)	< 0.001
Aspecto emocional	0.0 (0.0)	0.0 (0.0)	0.693	0.0 (0.0)	0.0 (0.0)	0.496
Saúde mental	48.0 (4.0)	52.0 (18.0)	0.287	48.0 (8.0)	52.0 (4.0)	0.278
BDI (Depressão)	30.0 (10.0)	27.0 (11.0)	0.398	38.0 (8.5)	29.0 (8.5)	0.001
BAI (Ansiedade)	49.0 (7.0)	45.0 (12.0)	0.039	56.0 (16.5)	48.0 (5.5)	0.027

Domain	Factors assessed
Domain	BDI (Depression)	BAI (Anxiety)
Physical functioning	ρ = -0.478; p < 0.001¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	ρ = -0.356; p = 0.003¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.
Physical role functioning	ρ = -0.021; p = 0.864	ρ = -0.027; p = 0.825
Bodily pain	ρ = -0.362; p = 0.002¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	ρ = -0.264; p = 0.027¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.
General health perceptions	ρ = -0.195; p = 0.105	ρ = -0.143; p = 0.237
Vitality	ρ = -0.250; p = 0.037¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	ρ = -0.008; p = 0.950
Social role functioning	ρ = -0.533; p < 0.001¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	ρ = -0.354; p = 0.003¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.
Emotional role functioning	ρ = -0.011; p = 0.930	ρ = -0.038; p = 0.753
Mental health	ρ = -0.308; p = 0.009¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	ρ = -0.429; p < 0.001¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.

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[1] Corresponding author: Maria Sandra Andrade E-mail: sandra.andrade@upe.br