Depression and anxiety predict health-related quality of life in chronic obstructive pulmonary disease: systematic review and meta-analysis

Abstract Backgrounds:Chronic obstructive pulmonary disease(COPD) is a common,preventable disease of airflow limitation that accounts for the third leading deaths of any disease process in the worldwide. Health benefits of Liuzijue breathing exercise on patients with stable COPD has assessed. This study was designed to perform a systemic review and meta-analysis of the effect of Liuzijue breathing exercise on patients with stable COPD.Methods: Published articles from inception to 2020 were conducted using electronic searches. Two independents reviewers performed data extraction.The Cochrane risk of bias assessment tool was used to evaluate the quality of the included studies.Results:A total of 16 eligible trials with 1039 patients with stable COPD were identified. Compared with control group,the pool meta-analysis of Liuzijue breathing exercise showed a significant improve in FEV1 [MD=-0.16,95%CI (0.09,0.23), P<0.00001], FEV1% [MD=9.71, 95%CI(8.44,10.98), P<0.00001], FEV1/FVC(%) [MD=4.81,95%CI(2.12,7.51),P=0.0005],6MWD [MD=21.89,95%CI（14.67, 29.11）,P<0.00001] , health-related quality of life [SMD=-0.84,95%CI（-1.12,-0.55，P<0.00001] and mMRC [MD= -0.73,95%CI (-0.96,-0.50), P<0.00001]. The observed effect was more pronounced for interventions that were short term and medium-term duration of study. Liuzijue interventions also showed improvement in the secondary outcome measures. Conclusions:In this systematic review and meta-analysis ,Liuzijue breathing exercise can improve lung function,exercise endurance and health-related quality of life of patients with stable COPD.

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

10.21203/rs.3.rs-136125/v1 ◽

2020 ◽

Author(s):

Fei Fei ◽

Jonathan Koffman ◽

Xiaohan Zhang ◽

Wei Gao

Keyword(s):

Quality Of Life ◽

Secondary Data ◽

Symptom Clusters ◽

Chronic Obstructive ◽

Depression And Anxiety ◽

Health Related Quality ◽

Obstructive Pulmonary Disease ◽

Related Quality ◽

Health Related

Abstract Background: Clinical experiences and middle range Theory of Unpleasant Symptoms indicate that the existence of symptom clusters (SCs) may synergistically affect patients’ health-related quality of life (HRQoL). However, no studies have examined this issue. The aim of this study was to identify symptom clusters and quantify the synergistic impact of symptom clusters on health-related quality of life among patients with chronic obstructive pulmonary disease (COPD).Methods: Secondary data analysis of cross-sectional data collected via convenience sampling from patients with COPD in a Chinese university hospital. Assessments included modified MRC dyspnoea scale, Beck Depression Inventory, Beck Anxiety Inventory and Pittsburgh Sleep Quality Index. Health-related quality of life was assessed using the St George's Respiratory Questionnaire. Chi-squared tests were used to identify symptom clusters. Multiple linear regressions were used to examine associations between symptom clusters and health-related quality of life.Results: 106 COPD subjects were recruited. Three symptom clusters were identified in COPD patients and comprised of dyspnoea and depression (OR=2.69, 95%CI:1.19-6.02); anxiety and sleep (OR=2.72, 95%CI:1.20-6.15); depression and anxiety (OR=6.13, 95%CI:2.57-14.60). Two symptom clusters were identified in patients with severe-stage COPD, which were anxiety and sleep (OR=6.21, 95%CI:1.70-22.74), depression and anxiety (OR=5.33, 95%CI:1.64-17.40). All three symptom clusters (anxiety and sleep; dyspnoea and depression; depression and anxiety) were independently associated with health-related quality of life (β=14.56, 95%CI: 5.80-23.31; β =13.95, 95%CI:5.72-22.18; β=13.30, 95%CI:6.88-19.73).Conclusions: This is the first study to validate the synergistic impacts of symptom clusters on health-related quality of life in COPD patients compared with single symptoms. These findings, which offer a detailed understanding of symptom clusters present in COPD, provide a basis to guide efficient clinical assessment and management symptom-related distress.

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