Relationship between symptoms and quality of life in a sarcoidosis population.

Department Psychology and Health, Medical Psychology, Tilburg University, Tilburg, The Netherlands.
Respiration (Impact Factor: 2.92). 02/2007; 74(4):401-5. DOI: 10.1159/000092670
Source: PubMed

ABSTRACT As sarcoidosis is a multisytemic disorder, patients may suffer from various symptoms. The relationship between frequently reported symptoms and quality of life (QOL) has not yet been studied.
The aim of the present cross-sectional study was to examine the predictive value of the most frequently reported subjective symptoms on QOL after controlling for demographic variables and clinical parameters.
A cross-sectional study was conducted at an outpatient pulmonary clinic in Zagreb, Croatia. One hundred and fifty outpatients with sarcoidosis were seen between January 2002 and May 2004. Symptoms were assessed with a symptom inventory questionnaire, and QOL was measured using the World Health Organization Quality of Life Assessment Instrument. Clinical parameters were derived from the patients' medical files. Regression analyses were performed to examine the predictive value of symptoms on QOL.
The four most frequently mentioned symptoms were fatigue, breathlessness, reduced exercise capacity and arthralgia. In various combinations, being female, using corticosteroids and fatigue predicted the QOL domains physical and psychological health as well as level of independence.
Fatigue appeared to be the most important symptom in predicting various QOL domains after controlling for demographics, disease stage and clinical parameters. Therefore, considering improvement in the patients' QOL, it is recommended to focus not only on objective health parameters, but also on fatigue in the management of sarcoidosis.

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    ABSTRACT: Background and objectivesDyspnoea is a common symptom in sarcoidosis and is not predictably related to pulmonary function or radiology. A subjective symptom of dyspnoea is likely to be influenced by patient perception and experience. The aim of this study was to determine the prevalence and nature of dyspnoea in sarcoidosis and describe the relationship of dyspnoea to psychological factors and health-related quality of life (HRQL).Methods Fifty-six subjects (31 men, mean age 51 years) with sarcoidosis completed an HRQL measure, St George's Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Scale (HADS) and Nijmegen questionnaire. The presence of symptoms of dyspnoea was noted and qualitative descriptors for dyspnoea were chosen at peak exercise. Resting pulmonary function was performed.ResultsSixty-four per cent of the subjects reported dyspnoea. Those with symptoms were older, had a longer duration of disease and with lower forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) (all P < 0.05). Symptoms of dyspnoea were associated with worse HRQL (P < 0.005) and higher scores on the Nijmegen questionnaire (P < 0.05). Anxiety was not associated with dyspnoea and only a trend to greater depression was observed (P = 0.066). In multivariate analysis, SGRQ and Nijmegen scores predicted dyspnoea independent of demographic factors and resting pulmonary function.Conclusion Dyspnoea is common in sarcoidosis and is associated with worse HRQL irrespective of baseline pulmonary function. Hyperventilation appears to be a factor contributing to dyspnoea and the Nijmegen questionnaire may be helpful in assessing dyspnoea and hyperventilation in sarcoidosis patients.
    Respirology 09/2014; · 2.78 Impact Factor
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    ABSTRACT: Chronic sarcoidosis is a complex disease with numerous comorbid conditions and can be fatal in some cases. Recognizing causes of morbidity and mortality is important to effectively select treatments, manage symptoms and improve outcomes. The purpose of this review is to examine emerging knowledge on morbidity and mortality in sarcoidosis.
    Current opinion in pulmonary medicine. 07/2014;
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    ABSTRACT: Background: Quality of life (QOL) is often reduced in patients with sarcoidosis. Studies of the associations between physical functions and QOL are lacking. Objectives: So the aims of this study were (i) to evaluate the associations between QOL and physical functions, including muscle strength and exercise capacity, and other clinical characteristics, and (ii) to evaluate whether these associations change over a two-year period. Methods: Eighty-eight sarcoidosis patients (61 men; mean age: 46.1 ± 10.2 years) participated in a two-year follow-up to cross-sectional study. All patients completed the short World Health Organization Quality of Life assessment instrument (WHOQOL-BREF) and Fatigue Assessment Scale (FAS) at the baseline and follow-up assessments. Patients also performed a six-minute walk test (6MWT) and elbow flexor muscle strength, quadriceps and hamstrings peak torque tests. Maximal inspiratory pressure was recorded. Results: QOL in sarcoidosis remained stable over a two-year course of the disease, and was reduced compared with healthy controls, particularly regarding the physical health domain. Fatigue and the six-minute walking distance showed strong associations with QOL at both baseline and follow-up. Fatigue and exercise capacity predicted the scores for the WHOQOL-BREF physical health domain at baseline (59%) and follow-up (64%). QOL at baseline was the best predictor of QOL at follow-up. Conclusions: QOL is reduced in sarcoidosis. Fatigue and exercise capacity showed important stable associations with QOL, especially in the physical health domain. FAS and 6MWT should therefore be included in the management of sarcoidosis.
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