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: 2.59). 02/2007; 74(4):401-5. DOI: 10.1159/000092670
Source: PubMed


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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    • "In the current study, FEV1, FVC and DLCO were found to have significant associations with HRQoL scores on univariate analyses, but not in the multiple regression models. No association was found between HRQoL scores and steroid use in our study, in contradiction to earlier studies [33-35]. Patients with obesity have also been shown to have poor HRQoL scores, but no statistically significant association was found between BMI and the HRQoL scores in our study [36,41]. "
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    ABSTRACT: Sarcoidosis is a chronic disease with different phenotypic manifestations. Health-related quality of life is an important aspect in sarcoidosis, yet difficult to measure. The objective of this study was to identify clinical markers predictive of poor quality of life in sarcoidosis patients that can be followed over time and targeted for intervention. We assessed the quality of life of 162 patients with confirmed sarcoidosis in a prospective, cross-sectional study using the Sarcoidosis Health Questionnaire (SHQ) and Short Form-36 Health Survey (SF-36). We evaluated the validity of these questionnaires and sought to identify variables that would best explain the performance scores of the patients. On multivariate regression analyses, the very best composite model to predict total scores from both surveys was a model containing the distance-saturation product and Borg Dyspnea Scale score at the end of a 6-min walk test. This model could better predict SF-36 scores (R² = 0.33) than SHQ scores (R² = 0.24). Substitution of distanced walked in 6 min for the distance-saturation product in this model resulted in a lesser ability to predict both scores (R² = 0.26 for SF-36; R² = 0.22 for SHQ). Both the SHQ and SF-36 surveys are valuable tools in the assessment of health-related quality of life in sarcoidosis patients. The best model to predict quality of life among these patients, as determined by regression analyses, included the distance-saturation product and Borg score after the 6-min walk test. Both variables represent easily obtainable clinical parameters that can be followed over time and targeted for intervention.
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    • "But patients with chronic sarcoidosis frequently report non-respiratory and respiratory symptoms not necessarily connected with lung function impairment or other evident causes. The most frequent are fatigue, breathlessness, reduced exercise capacity and arthralgia, and they significantly influence the patients' quality of life (Michielsen et al., 2007). Fatigue is reported by more than 80% of patients with sarcoidosis. "

    Full-text · Chapter · Oct 2011
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    • "Because fatigue has a major impact on QOL in sarcoidosis, establishing the extent of fatigue provides valuable insight regarding patients' QOL [6] [10]. There is no objective parameter, however, for assessing fatigue in sarcoidosis [40]. "
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    ABSTRACT: The quality of life and health status are impaired in patients suffering from sarcoidosis, especially in those who have clinical symptoms. Fatigue is an integral part of the clinical picture of sarcoidosis, but is an underestimated problem in clinical practice. Objective test results do not always correlate with the well-being of the patient. Present studies are generally cross-sectional. There is a need for prospective follow-up studies assessing the natural course of patients' disease in relation to symptoms and quality of life.
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