Less Social Deprivation Is Associated With Better Health-Related Quality of Life in Asthma and Is Mediated by Less Anxiety and Better Sleep Quality.


Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
07 2023
Historique:
received: 10 10 2022
revised: 21 03 2023
accepted: 23 03 2023
medline: 10 7 2023
pubmed: 23 4 2023
entrez: 22 04 2023
Statut: ppublish

Résumé

Previous studies on health-related quality of life (HRQoL) in asthma have mainly focused on clinical and environmental determinants. Little is known about the role of social determinants on HRQoL in asthma. We aimed to investigate the association between social deprivation and HRQoL in asthma. A total of 691 adult asthmatics from Canada, India, New Zealand, and the United Kingdom were administered a digital questionnaire containing demographic information and questions about social and psychological attributes, sleep disturbances, and alcohol abuse. HRQoL was measured using the Short Form of the Chronic Respiratory Questionnaire (SF-CRQ). We analyzed the direct and indirect relationships between social deprivation and HRQoL using structural equation models with social deprivation as a latent variable. We tested for mediation via anxiety, depression, sleep disturbances, and alcohol abuse. We found that less social deprivation (latent variable) was directly associated with better SF-CRQ domain scores such as dyspnea (regression coefficient β: 0.33; 95% confidence interval [CI]: 0.07 to 0.58), fatigue (β: 0.39; 95% CI: 0.14 to 0.64), and emotional function (β: 0.37; 95% CI: 0.11 to 0.62), but with the worse mastery score (β: -0.29; 95% CI: -0.55 to -0.03); however, those associations varied across participating countries. We also observed that among all individual social deprivation indicators, education, companionship, emotional support, instrumental support, and social isolation were directly associated with HRQoL, and the relationship between social deprivation and HRQoL was mediated through anxiety and sleep disturbances. Our results demonstrated that less social deprivation was directly, and indirectly through less anxiety and better sleep quality, associated with better HRQoL in asthma.

Sections du résumé

BACKGROUND
Previous studies on health-related quality of life (HRQoL) in asthma have mainly focused on clinical and environmental determinants. Little is known about the role of social determinants on HRQoL in asthma.
OBJECTIVES
We aimed to investigate the association between social deprivation and HRQoL in asthma.
METHODS
A total of 691 adult asthmatics from Canada, India, New Zealand, and the United Kingdom were administered a digital questionnaire containing demographic information and questions about social and psychological attributes, sleep disturbances, and alcohol abuse. HRQoL was measured using the Short Form of the Chronic Respiratory Questionnaire (SF-CRQ). We analyzed the direct and indirect relationships between social deprivation and HRQoL using structural equation models with social deprivation as a latent variable. We tested for mediation via anxiety, depression, sleep disturbances, and alcohol abuse.
RESULTS
We found that less social deprivation (latent variable) was directly associated with better SF-CRQ domain scores such as dyspnea (regression coefficient β: 0.33; 95% confidence interval [CI]: 0.07 to 0.58), fatigue (β: 0.39; 95% CI: 0.14 to 0.64), and emotional function (β: 0.37; 95% CI: 0.11 to 0.62), but with the worse mastery score (β: -0.29; 95% CI: -0.55 to -0.03); however, those associations varied across participating countries. We also observed that among all individual social deprivation indicators, education, companionship, emotional support, instrumental support, and social isolation were directly associated with HRQoL, and the relationship between social deprivation and HRQoL was mediated through anxiety and sleep disturbances.
CONCLUSIONS
Our results demonstrated that less social deprivation was directly, and indirectly through less anxiety and better sleep quality, associated with better HRQoL in asthma.

Identifiants

pubmed: 37087095
pii: S2213-2198(23)00407-5
doi: 10.1016/j.jaip.2023.03.052
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2115-2124.e7

Informations de copyright

Copyright © 2023 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Auteurs

Subhabrata Moitra (S)

Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada. Electronic address: moitra@ualberta.ca.

Ana Adan (A)

Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain; Institute of Neurosciences, University of Barcelona, Barcelona, Spain.

Metin Akgün (M)

Department of Chest Diseases, Ataturk University, Erzurum, Turkey; Department of Pulmonary Medicine, Ağrı İbrahim Çeçen University, School of Medicine, Ağrı, Turkey.

Augustus Anderson (A)

Medical Research Institute of New Zealand, Wellington, New Zealand.

Amanda Brickstock (A)

Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.

Allie Eathorne (A)

Medical Research Institute of New Zealand, Wellington, New Zealand.

Ali Farshchi Tabrizi (A)

Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada.

Prasun Haldar (P)

Department of Medical Laboratory Technology, Supreme Institute of Management and Technology, Mankundu, West Bengal, India; Department of Physiology, West Bengal State University, Barasat, West Bengal, India.

Linda Henderson (L)

Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada.

Aditya Jindal (A)

Jindal Clinics, Chandigarh, India.

Surinder Kumar Jindal (SK)

Jindal Clinics, Chandigarh, India.

Bugra Kerget (B)

Department of Chest Diseases, Ataturk University, Erzurum, Turkey.

Fadi Khadour (F)

Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada.

Lyle Melenka (L)

Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada.

Saibal Moitra (S)

Department of Pulmonary Medicine, Apollo Gleneagles Hospital, Kolkata, West Bengal, India.

Tanusree Moitra (T)

Department of Psychology, Barrackpore Rashtraguru Surendrananth College, Barrackpore, West Bengal, India.

Rahul Mukherjee (R)

Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.

Alex Semprini (A)

Medical Research Institute of New Zealand, Wellington, New Zealand.

Alice M Turner (AM)

Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom; Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom.

Nicola Murgia (N)

Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy.

Giovanni Ferrara (G)

Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada.

Paige Lacy (P)

Division of Pulmonary Medicine and Alberta Respiratory Centre, Department of Medicine, University of Alberta, Edmonton, AB, Canada.

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