Symptom Clusters and Health-related Quality of Life in Chinese patients with Chronic Obstructive Pulmonary Disease

Abstract

This study aimed to identify symptom clusters of chronic obstructive pulmonary disease (COPD) and to examine the relationship between symptom clusters and health-related quality of life (HRQoL). It included 154 hospitalized patients with COPD. The majority of the participants (88.6%) were aged 60 years and above, and the numbers of men and women were approximately equal (men: 55.2%). The Charlson Comorbidity Index (CCI), the Memorial Symptom Assessment Scale (MSAS), and the Chinese version of the Clinical COPD Questionnaire (CCQ) were used to evaluate comorbidity, participant’s symptoms, and HRQoL, respectively. Five symptom clusters were identified using exploratory factor analysis, and symptom clusters, especially the Psychological, Pain and Fatigue, GI, and Dyspnea-Sweat symptom clusters, had negative effects on HRQoL in patients with COPD. Understanding the patterns and occurrences of symptom clusters could be essential for developing effective interventions to manage COPD symptoms and improve the patients’ HRQoL.

Synergistic Impact of Symptom Clusters on Health-related Quality of Life in Patients With Chronic Obstructive Pulmonary Disease: a Secondary Data Analysis

“…Our study identi ed that all the symptom clusters were signi cantly correlated with HRQoL in COPD population. The result of a correlation between the depression-anxiety symptom cluster and HRQoL in this study is consistent with a previous study, which revealed that psychological symptom clusters are a signi cant predictor of HRQoL [17]. Our results reinforce the signi cant effect of psychological symptom clusters on HRQoL in people living with COPD.…”

“…Validation of the concept of symptom cluster is complicated and di cult because evaluating symptom interrelationships manifests a host of methodological challenges, speci cally the study design, theoretical framework, measurement tools, symptom dimensions, statistical methods to identify the cluster, statistical "cut-off" points to de ne clusters, characteristics of study samples may all contribute to these inconsistencies of symptom clusters [12]. Among previous studies, different symptom assessment tools were used, and each involved a different array of symptoms [13][14][15][16][17][18].…”

“…However, a limitation of the 'all-possible' approach is that it lacks an explanation of the clinical meaning for symptom clusters identi ed by statistical methods [12]. Additionally, in the previous studies which focused on investigating symptom clusters in people living with COPD, most of them adopted the 'all-possible symptom approach' [13,17,18,28], few studies used the 'most-common symptom approach'.…”

Correlates and Predictors of Health-Related Quality of Life among Patients with COPD: An Integrative Review

“…The correlation between HRQoL and age was discussed in several studies, and the results were controversial. Almost seven studies were reported a positive correlation between age and HRQoL [11] [23]- [28]. On the other hand, an old study carried out by Wijnhoven and his colleagues [48] reported a controversial result indicating better HRQoL in current smokers.…”

Chronic Obstructive Pulmonary Disease Symptom Cluster Composition, Associated Factors, and Methodologies: A Systematic Review

“…Only four studies (Park & Larson, 2014;Park et al, 2013;Srirat et al, 2014Srirat et al, , 2015 reported an estimated sample size using appropriate statistical methods. Eight studies (Lim et al, 2017;Park & Larson, 2014;Park et al, 2012Park et al, , 2013Srirat et al, 2014Srirat et al, , 2015Wu et al, 2020;Yang et al, 2020) clearly defined the target/reference population and had an appropriate sampling frame. Two studies (Breland et al, 2015;Li et al, 2013) had no selection process.…”