Negative life events and quality of life in adult asthma

Connie Archea ¹, Irene H. Yen ¹, Hubert Chen ¹, Mark D. Eisner ¹, Patricia P. Katz ¹, Umesh Masharani ¹, Edward H. Yelin ¹, Gillian Earnest ¹ and Paul D. Blanc ^1*

¹ University of California San Francisco, United States

^* To whom correspondence should be addressed. E-mail: blancp{at}itsa.ucsf.edu.

Accepted 2 August 2006

Abstract

Background: The relationship between stress and quality of life in adult 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 by increasing disease severity and by adversely affecting socioeconomic status (SES).

Methods: We analyzed 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- characterized cohort. We studied the relationship between the number of NLEs reported and asthma-specific quality of life (AQOL) measured with the Marks instrument. We used general linear modeling 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 less than $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 FEV1 below or above 80% predicted nor among those with lower compared to 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 aoociated 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.

Keywords: asthma, life events, quality of life, severity, socioeconomic status

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