Fatores preditores da qualidade de vida relacionada à saúde física e mental em pacientes com doença pulmonar intersticial: uma análise multifatorial

Abstract

Objective: To determine predictors of health-related quality of life (HRQoL) in patients with interstitial lung disease (ILD). Methods: A cross-sectional study comprising 63 patients, all of whom underwent lung function testing and the six-minute walk test. The following instruments were used: the Medical Outcomes Study 36-item Shortform Survey (SF-36), the Saint George's Respiratory Questionnaire (SGRQ), the Beck Anxiety Inventory, the Beck Depression Inventory, and the Modified Medical Research Council Dyspnea Scale. Principal component analysis was used in order to reduce the dimensionality of the data, thereby identifying the predictor variables, and multiple linear regression analysis was used in order to identify the explanatory variables. Results: Of the 63 patients, 34 were female. The mean age was 60.1 ± 13.3 years, the mean FVC was 64.17 ± 15.54% of predicted, and the mean DLCO was 44.21 ± 14.47% of predicted. All of the patients evaluated had impaired HRQoL, scoring worst for the SF-36 physical functioning and SGRQ activity domains. Of the patients evaluated, 60.3% and 57.1% showed symptoms of anxiety and depression, respectively. The principal component analysis identified one predictor of physical HRQoL and one predictor of mental HRQoL. Depression had a strong influence on the predictor of mental HRQoL, and the degree of dyspnea had a strong influence on both predictors of HRQoL in the patients evaluated. Variables related to lung function, exercise capacity, and anxiety had no impact on these predictors. Conclusions: In our sample of patients with ILD, the degree of dyspnea had a major impact on the physical and mental HRQoL, and depression had an impact on mental HRQoL.Keywords: Anxiety; Depression; Dyspnea; Lung diseases, interstitial; Quality of life; Respiratory function tests. ResumoObjetivo: Avaliar fatores preditores da qualidade de vida relacionada à saúde (QVRS) em pacientes com doença pulmonar intersticial (DPI). Métodos: Estudo transversal com 63 pacientes, submetidos a provas de função pulmonar e teste de caminhada de seis minutos. Foram aplicados os seguintes instrumentos: Medical Outcomes Study 36-item Short-form Survey , Saint George's Respiratory Questionnaire (SGRQ), os inventários de ansiedade e depressão de Beck e Modified Medical Research Council Dyspnea Scale. A análise de componentes principais foi utilizada para reduzir as variáveis em fatores preditivos, e a análise de regressão linear múltipla foi utilizada como um modelo explicativo. Resultados: Dos 63 pacientes, 34 eram mulheres. A média de idade foi de 60,1 ± 13,3 anos, média de CVF = 64,17 ± 15,54% do previsto e média de DLCO = 44,21 ± 14,47% do previsto. Todos os pacientes avaliados tinham sua QVRS prejudicada, e os piores escores foram observados nos domínios capacidade funcional do SF-36 e atividade do SGRQ. Dos pacientes avaliados 60,3% e 57,1% apresentaram sintomas de ansiedade e depressão, respectivamente. A análise de componentes principais identificou um fator preditor para QVRS física e um fator predit...

A survey of recently published cardiovascular, hematological and pneumological original articles in the Brazilian scientific press

“…Coelho et al99 evaluated predictors of health-related quality of life (HRQoL) in patients with interstitial lung disease and found that these in patients the degree of dyspnea had a major impact on the physical and mental HRQoL, and depression had an impact on mental HRQoL. Antunes et al100 determine the interobserver and intraobserver agreement in the diagnosis of interstitial lung diseases based on HRCT scans and the impact of observer expertise, clinical data and confidence level on such agreement.…”

Determinants of health-related quality of life decline in interstitial lung disease

“…Furthermore, a later analysis in the same population also found higher DLCO % predicted to be associated with higher VAS scores [12]. The only study that included different subtypes of ILD did not nd any signi cant impact of lung function with HRQL, but the study was cross-sectional and thus could not detect these long-term associations [28].…”

Determinants of Health-Related Quality of Life Decline in Interstitial Lung Disease

“…Furthermore, a later analysis in the same population also found higher DLCO % predicted to be associated with higher VAS scores [10]. The only study that included different subtypes of ILD did not find any significant impact of lung function with HRQL, but the study was cross-sectional and thus could not detect these long-term associations [23].…”