Symptom clusters, associated factors and health-related quality of life in patients with chronic obstructive pulmonary disease: A structural equation modelling analysis.
Fei Fei, Richard J Siegert, Xiaohan Zhang and 2 others
PMID 35098602WHAT IT FOUND
In adults with COPD, breathlessness, weakness, drowsiness and poor mobility clustered together; anxiety and depression also clustered, and each cluster was associated with lower quality of life.
These clusters suggest symptoms can be assessed as groups, not one by one.
Key findings
01Three symptom clusters were identified: respiratory symptoms (shortness of breath, weakness, drowsiness and poor mobility), psychological symptoms (anxiety and depression), and cough-insomnia symptoms (poor appetite, insomnia, dry mouth and cough).
02All three clusters were associated with worse health-related quality of life; the reported association strengths were -0.22 for respiratory symptoms, -0.23 for cough-insomnia symptoms and -0.41 for psychological symptoms.
03More advanced COPD was associated with the respiratory cluster (0.37) and the cough-insomnia cluster (0.20); lower monthly income was associated with the respiratory cluster (-0.12); comorbidities were not significant (-0.05, p = .24).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The study used convenience sampling in three Chinese teaching hospitals, so the results may not apply to other settings or populations. It was cross-sectional, so it cannot show that symptoms caused lower quality of life or which came first. Symptoms and quality of life were self-reported by interview, so memory, social desirability and reporting bias are possible. The analysis used 450 of 493 initially recruited participants. Potential biological factors, such as inflammatory markers, were not measured. The model did not support a feedback loop from quality of life back to symptoms.
Declared interests
No conflicts of interest were declared. Funding was from the China Scholarship Council.
The easy way to misread this
Do not read the model as showing that treating one symptom will improve quality of life. The study was cross-sectional and did not test any treatment.