Symptom Clusters and Quality of Life in Subjects With COPD
Symptom Clusters and Quality of Life in Subjects With COPD
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DOI：
10.4187/respcare.05374
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发表时间：
2017-09-01
期刊：
影响因子：
2.5
通讯作者：
Kim, So Ri
中科院分区：
文献类型：
--
作者：
Lim, Kyeung Eun;Kim, Sung Reul;Kim, So Ri
背景：慢性阻塞性肺疾病是最常见的呼吸系统疾病之一。慢性阻塞性肺疾病患者经历和遭受各种生理和心理症状。我们开展了这项研究，以确定COPD患者的症状群及其对生活质量(QOL)的影响。方法：130例慢性阻塞性肺疾病患者来自韩国一所大学医院。采用结构化问卷对患者的呼吸困难、疲劳、抑郁、焦虑、睡眠障碍、口干和身体功能状况进行评估。采用COPD临床问卷对患者的生活质量进行评估。根据症状体验的严重程度，使用因子分析和聚类分析识别症状聚类。结果：识别出三个不同的簇：呼吸功能簇(症状簇1)、情绪簇(症状簇2)和疲劳睡眠簇(症状簇3)。症状群1由呼吸困难、躯体功能状态和口干组成，症状群2由焦虑和抑郁组成，症状群3由睡眠障碍和疲劳组成。亚组聚类分析显示，症状组1、2和3中症状得分较高的COPD患者的生活质量明显较差。根据年龄、教育水平和月收入的不同，症状群显著不同。结论：慢性阻塞性肺疾病患者可能有特定的症状群模式。症状群与临床特征相关，对生活质量有负面影响。为了提高症状管理和生活质量，基于症状群的方法和干预措施可能比针对每个症状的独立干预更有效。了解COPD症状群有助于成功的症状管理，从而改善COPD患者的生活质量。
BACKGROUND: COPD is one of the most common respiratory diseases. Patients with COPD experience and suffer from various physical and psychological symptoms. We performed this study to identify symptom clusters and the effects on quality of life (QOL) in patients with COPD. METHODS: A total of 130 COPD subjects were recruited from a university hospital in South Korea. Dyspnea, fatigue, depression, anxiety, sleep disturbance, dry mouth, and physical functional status were assessed with structured questionnaires. QOL was measured with the Clinical COPD Questionnaire. Factor analysis and cluster analysis were used to identify symptom clusters based on severity of symptom experiences. RESULTS: Three distinct clusters were identified: a respiratory-functional cluster (symptom cluster 1), a mood cluster (symptom cluster 2), and a fatigue-sleep cluster (symptom cluster 3). Symptom cluster 1 consisted of dyspnea, physical functional status, and dry mouth; symptom cluster 2 consisted of anxiety and depression; and symptom cluster 3 consisted of sleep disturbance and fatigue. Subgroup cluster analysis showed that COPD subjects with higher-scoring symptoms in symptom clusters 1, 2, and 3 had significantly poorer QOL. The symptom clusters were significantly different depending on age, educational level, and monthly income. CONCLUSIONS: COPD subjects may have specific patterns of symptom clusters. The symptom clusters are related with clinical characteristics and had a negative impact on QOL. To enhance symptom management and QOL, approaches and interventions based on symptom clusters, rather than independent intervention for each symptom, may be more effective. Understanding COPD symptom clusters may help successful symptom management, which can improve QOL for COPD patients.