ASTHMA

Negative life events and quality of life in adults with asthma

C Archea, I H Yen, H Chen, M D Eisner, P P Katz, U Masharani, E H Yelin, G Earnest and P D Blanc

Department of Medicine, University of California San Francisco, San Francisco, California, USA

Correspondence to:
Correspondence to:
Dr P D Blanc
Division of Occupational and Environmental Medicine, Department of Medicine, University of California San Francisco, 350 Parnassus Avenue, Suite 609, San Francisco, CA 94117, USA; paul.blanc{at}ucsf.edu

Background: The relationship between stress and quality of life in adults with asthma has not been well studied. Stress, quantified by negative life events, may be linked to quality of life in asthma through multiple pathways, including increase in disease severity and adverse effects on socioeconomic status (SES).

Methods: The responses to a self-completed questionnaire assessing negative life events (NLEs) in the previous 12 months (from a 24-item checklist) among 189 adults with asthma from a well-characterised cohort were analysed. The relationship between the number of NLEs reported and asthma-specific quality of life (AQOL) was measured with the Marks instrument. General linear modelling was used to test the conjoint effects of NLEs, SES and disease severity based on the Severity of Asthma Score, a validated acute and chronic disease measure.

Results: Those with annual family incomes <$60 000 reported significantly more NLEs than those with higher incomes (p = 0.03). The number of NLEs did not differ significantly between those with forced expiratory volume in 1 s <80% predicted and those with >80% predicted, nor among those with lower compared with higher Severity of Asthma Score. The frequency of NLEs was associated with poorer (higher numerical score) AQOL (p = 0.002). When studied together in the same model, combinations of income level and asthma severity (greater or lesser Severity of Asthma Score; p<0.001) and number of NLEs (p = 0.03) were both significantly associated with AQOL.

Conclusion: NLEs are associated with quality of life among adults with asthma, especially among those of lower SES. Clinicians should be aware of this relationship, especially in vulnerable patient subsets.

Abbreviations: ALEQ, Asthma Life Events Questionnaire; AQOL, Asthma Quality of Life; FEV₁, forced expiratory volume in 1 s; MCS, Mental Component Summary; NLE, negative life event; PCS, Physical Component Summary; SES, socioeconomic status; SF-36, short form health survey 36

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