Rhinitis, sinusitis, and ocular diseases
Health-related quality of life in adult rhinitis: The role of perceived control of disease

https://doi.org/10.1016/j.jaci.2004.07.008Get rights and content

Background

Factors affecting health-related quality of life (HRQOL) in adult rhinitis have not been well described.

Objective

To understand how symptom severity, physical functioning, psychological distress, and perceived control of disease relate to HRQOL in a population-based sample of adults with rhinitis.

Methods

We conducted telephone interviews in 109 adults with rhinitis recruited via random digit dialing. We assessed HRQOL by using the Rhinosinusitis Disability Index, physical functioning by using the physical component score of the Short Form-12, and psychological distress by using the Center for Epidemiologic Studies Depression Scale. To evaluate the role of patient-perceived control of disease in rhinitis, we developed a new 8-item instrument, the Perceived Control of Rhinitis Questionnaire.

Results

Lower HRQOL correlated with greater symptom severity (r = 0.57), poorer physical functioning (r = −0.41), greater psychological distress (r = 0.44), and less perceived control (r = −0.53). In a multivariate model, symptom severity (P < .001), psychological distress (P < .001), and perceived control (P < .001) were all independent predictors of HRQOL. Adding functional and psychosocial measures to a base model with demographics and disease severity explained an additional 26% of variance in HRQOL.

Conclusions

Although disease severity is an important factor in HRQOL, psychosocial factors, such as perceived control of disease, explain a substantial amount of the variability in HRQOL among adults with rhinitis

Section snippets

Subjects

Subjects were drawn from a larger prospective study of persons with asthma, rhinitis, or both. Details of the baseline study design and methods have been previously reported.1 Briefly, subjects were originally recruited in northern California via random digit dialing during an 8-week period (May to July 1999). Only English- and Spanish-speaking respondents aged 18 to 50 years were enrolled. Approval for the study of human subjects was obtained from the University of California, San Francisco

Subject characteristics

Table I shows the baseline characteristics of the 175 persons interviewed during the initial recruitment phase. Subjects who completed the follow-up interview (n = 109) were similar demographically to those who did not (n = 66), with the exception of income. Overall, the study population included in this analysis (n = 109) was young (mean age, 37 years), with a large component of college-educated white women (n = 46; 42%). Nearly half the subjects (49%) reported moderate disease, with the remainder

Discussion

In this study we confirmed the utility of 2 disease-specific measures, the RSDI (measuring HRQOL) and the RSS (measuring symptom severity), while introducing a new disease-specific instrument, the PCRQ, which assesses perceived control of disease in rhinitis. To identify predictors of rhinitis-specific HRQOL, we simultaneously evaluated all 3 disease-specific instruments, along with 2 generic health status measures: one for physical health and the other for depressed mood. These results support

Conclusion

Disease severity accounts for only a portion of the variation observed in rhinitis-specific HRQOL. Our findings suggest that psychosocial factors play an equally important role in explaining HRQOL—particularly an individual's perceived ability to deal with his or her condition. We have demonstrated that the PCRQ is a reliable instrument that can be used to assess perceived control in rhinitis. For the practicing physician, this study emphasizes the importance of educating patients to cope with

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Funded by Institutional NRSA T32HL07185.

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