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Symptoms induced by environmental irritants and health-related quality of life in patients with chronic cough - A cross-sectional study.

ABSTRACT: BACKGROUND: Chronic cough is a common condition, but some patients have no evident medical explanation for their symptoms. A group of patients has been identified, characterized by upper and lower airway symptoms triggered by chemicals and scents, and heightened cough sensitivity to inhaled capsaicin. Chronic cough is usually a prominent symptom in these patients, and it has been suggested that they suffer from sensory hyperreactivity.Our main aim was to analyse, in a group of patients with chronic cough, the presence of symptoms induced by environmental factors such as chemicals, scents, and cold air, and to measure the social and emotional influences of these symptoms in relation to quality of life. A second aim was to pilot-test a Swedish translation of a cough-specific questionnaire. METHODS: A total of 119 patients with chronic cough were asked to answer three different questionnaires: a local symptom questionnaire, the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR), and the Nottingham Health Profile (NHP). In addition, a Swedish version of the Hull Airway Reflux Questionnaire (HARQ) was developed and answered by a subgroup of patients and healthy controls. RESULTS: Sixty-two patients (52%) with mean cough duration of 10.6 years answered the local symptom questionnaire, the CSS-SHR, and the NHP. Of these, 39 (63%) claimed to have cough and other symptoms induced by chemicals and scents. Compared to population-based findings, the patients scored higher on the CSS-SHR, and the CSS-SHR score was significantly higher among chemical-sensitive individuals (p < 0.001). The NHP showed that the patients had a significantly reduced quality of life, which was most pronounced among chemical-sensitive individuals. The 31 patients who answered the HARQ had significantly higher scores (p < 0.0001) than 59 healthy controls. CONCLUSIONS: Among patients with chronic cough, a majority claimed that environmental factors induced coughing. Both the CSS-SHR and the HARQ score systems seem to be valuable instruments in the mapping of cough patients, supporting the novel paradigm of a cough hypersensitivity syndrome. Our results emphasize that cough is a substantial burden to the patient, influencing daily living and quality of life.

SUBMITTER: Ternesten-Hasseus E

PROVIDER: S-EPMC3212888 | biostudies-other | 2011

REPOSITORIES: biostudies-other

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Symptoms induced by environmental irritants and health-related quality of life in patients with chronic cough - A cross-sectional study.

Ternesten-Hasséus Ewa E Larsson Sven S Millqvist Eva E

Cough (London, England) 20111007

<h4>Background</h4>Chronic cough is a common condition, but some patients have no evident medical explanation for their symptoms. A group of patients has been identified, characterized by upper and lower airway symptoms triggered by chemicals and scents, and heightened cough sensitivity to inhaled capsaicin. Chronic cough is usually a prominent symptom in these patients, and it has been suggested that they suffer from sensory hyperreactivity.Our main aim was to analyse, in a group of patients wi ...[more]

PMID: 21981855

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Project description:AimTo study health related quality of life (HRQOL) and depressive symptoms in adolescents with chronic fatigue syndrome (CFS) and to investigate in which domains their HRQOL and depressive symptoms differ from those of healthy adolescents.Background and objectiveSeveral symptoms such as disabling fatigue, pain and depressive symptoms affect different life domains of adolescents with CFS. Compared to adolescents with other chronic diseases, young people with CFS are reported to be severely impaired, both physiologically and mentally. Despite this, few have investigated the HRQOL in this group.MethodThis is a cross-sectional study on HRQOL including 120 adolescents with CFS and 39 healthy controls (HC), between 12 and 18 years. The Pediatric Quality of Life Inventory™, 4.0 (PedsQL) was used to assess HRQOL. The Mood and Feelings Questionnaire assessed depressive symptoms. Data were collected between March 2010 and October 2012 as part of the NorCAPITAL project (Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial). Linear and logistic regression models were used in analysis, and all tests were two-sided.ResultsAdolescents with CFS reported significantly lower overall HRQOL compared to HCs. When controlling for gender differences, CFS patients scored 44 points lower overall HRQOL on a scale from 0-100 compared to HCs. The domains with the largest differences were interference with physical health (B = -59, 95 % CI -54 to -65) and school functioning (B = -52, 95 % CI -45 to -58). Both depressive symptoms and being a patient were independently associated with lower levels of HRQOL CONCLUSION: The difference in HRQOL between CFS patients and healthy adolescents was even larger than we expected. The large sample of adolescents with CFS in our study confirms previous findings from smaller studies, and emphasizes that CFS is a seriously disabling condition that has a strong impact on their HRQOL. Even though depressive symptoms were found in the group of patients, they could not statistically explain the poor HRQOL.

Project description:BackgroundThere were few studies exploring the associations between depressive symptoms, anxiety symptoms and health-related quality of life (HRQoL) in the general population, especially in resource limited area. The aims of this study were to assess the associations between depressive symptoms, anxiety symptoms, their comorbidity and HRQoL in rural area.MethodsA total of 23,496 eligible participants from Henan rural cohort were included. The Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2) were employed to assess depressive and anxiety symptoms, respectively. HRQoL was measured via European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L). Tobit regression and generalized linear model were utilized to explore the associations between depressive symptoms, anxiety symptoms, their comorbidity and HRQoL.ResultsA total of 1320 individuals were identified as depressive symptoms with a prevalence rate of 5.62%, while 1198 participants were classified as anxiety symptoms with a prevalence rate of 5.10%. After multiple adjustment, the regression coefficients (β) and 95% confidence interval (CI) of utility index for depressive and anxiety symptoms were - 0.166 (- 0.182, - 0.149) and - 0.132 (- 0.149, - 0.114), respectively. The β and 95% CI of VAS score for depressive and anxiety symptoms were - 7.65 (- 8.60, - 6.70) and - 5.79 (- 6.78, - 4.80), respectively. Additionally, the comorbidity was strongly associated with low utility index and VAS score. These findings were observed robustly in men and women.ConclusionDepressive symptoms, anxiety symptoms and their comorbidity were associated with low HRQoL in rural population, which needed further efforts on preventive and treatment interventions.Clinical trial registrationThe Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699 ). Date of registration: 06 July, 2015.

Project description:BackgroundChronic cough has negative effects on quality of life. However, the changes in health-related quality of life and clinical implications remain unclear in Chinese patients with chronic cough.MethodsA standard Chinese version of Leicester cough questionnaire (LCQ) was developed by an established translation procedure and its repeatability was assessed in a preliminary study involving 20 untreated patients with stable chronic cough. The quality of life was measured with the Short form-36 health survey and compared between 110 patients with chronic cough and 90 healthy volunteers. The changes in health-related quality of life were evaluated in the patients with chronic cough with the LCQ just before the specific treatment was initiated and a week after the cough had resolved completely. Cough threshold with inhaled capsaicin, expressed as the lowest concentration of capsaicin required for the induction of > or = 5 coughs, was also measured.ResultsThe repeatability of the Chinese version of the LCQ was validated at a four day interval with the intraclass correlation coefficients of 0.89-0.94 for total and domain score (n = 20). The scores of the Short form-36 health survey were significantly lower in patients with chronic cough than those in healthy volunteers. In general, there was no significant difference in overall quality of life between different causes of chronic cough or genders although embarrassment, frustration and sleep disturbance were more common in female patients, as indicated by the LCQ. However, the successful treatment of cough obviously increased the total scores of the LCQ from 14.2 +/- 2.7 to 19.5 +/- 1.9 (t = 13.7, P < 0.0001). There was a significant correlation between the total score of the LCQ and physical (r = 0.39, P < 0.0001) or mental (r = 0.30, P < 0.001) component summary of the Short form-36 health survey but not between the LCQ and capsaicin cough threshold.ConclusionThe quality of life is significantly impaired in Chinese patients with chronic cough. The Chinese version of the LCQ is a valid measure of cough related quality of life and is repeatable and responsive.

Project description:BackgroundThis study aimed to identify the significant physical, psychological, and social determinants associated with EuroQuol-5D (EQ-5D) among Chinese older people with chronic musculoskeletal pain, and to evaluate how these determinants affected the five dimensions of EQ-5D.MethodThis is a cross-sectional study. Data were collected through a cohort involving 946 community-dwelling older people aged ≥ 60 with chronic musculoskeletal pain in Hong Kong. Selected independent variables were categorized into physical, psychological, and social domains. Physical variables included age, sex, body mass index (BMI), pain severity score, number of pain regions, the most painful site, and the number of comorbidities. Psychological variables included depression level measured using the 9-question Patient Health Questionnaire (PHQ-9), and anxiety level measured using the Generalized Anxiety Disorder Assessment (GAD-7). Social variables included living, marital, and social welfare recipient's status. The dependent variables comprised the index scores and the five dimensions of the EQ-5D descriptive system. Ordinal least squares (OLS) model and logistic regression model were used for data analysis.ResultsThe mean age of the participants was 67.1 (SD = 5.1), with 77.6% being female. Higher pain severity scores (beta (β) coefficient =-0.044, P < 0.001), depression scores (β=-0.007, P < 0.001) and higher anxiety scores (β=-0.01, P < 0.001) were associated with lower EQ-5D index scores. Specifically, knee pain (β=-0.061, P < 0.001) was significantly associated with lower EQ-5D index scores. Participants with higher pain severity and depression scores were more likely to report problems in most EQ-5D dimensions. Participants with anxiety primarily faced challenges related to mood, and those with knee pain were more likely to have problems with mobility and daily activities.ConclusionAmong the selected determinants in our study, pain intensity, depression, anxiety, and knee pain were identified as key determinants associated with reduced HRQoL in older Chinese people with chronic musculoskeletal pain. Each of these determinants showed distinct associations with different dimensions of the EQ-5D, potentially informed resource allocation and the development of targeted interventions to improve the overall HRQoL of this specific population.

Project description:Background: Health-related quality of life is rapidly becoming recognized as an important indicator of how a disease affects patient lives and for evaluating the quality of care, especially for chronic conditions such as chronic kidney disease (CKD). Objectives: This study is an attempt to assess the quality of life in patients with chronic kidney disease at MMIMSR and also identify characteristics that may be associated with their worsening quality of life. Materials and Methods: This cross-sectional investigation was conducted at the in-patient department (IPD) of the MMIMSR hospital. This study included 105 CKD patients and used a systematic random sampling method for quantitative analysis. This study utilized a 36-item short-form SF-36 (v1.3) questionnaire to assess HRQoL in CKD patients. Descriptive statistics were employed at the baseline. Chi square and ANOVA were used to draw comparisons between two groups or more than two groups, respectively. Logistic regression analysis was utilized to identify the potential QoL determinants. A p value of 0.05 or lower was used to determine statistical significance. Results: Among a total of 105 participants, the mean (±standard deviation) age was found to be 54.53 ± 13.47 years; 48 were male patients, and 57 were female patients. Diabetes Mellitus (61.9%), hypertension (56.2%), chronic glomerulonephritis (7.6%), chronic pyelonephritis (6.7%), and polycystic kidney disease (5.7%) were identified to be the most frequent disorders associated with CKD. The current study also demonstrated that the HRQoL score domains such as symptom problem list, the effect of kidney disease, and the burden of kidney disease decline significantly and progressively as the patient advances into higher stages of CKD (p = 0.005). A similar pattern was observed in work status, sleep, and general health (p < 0.005). Additionally, a statistically significant difference was noted for cognitive function, quality of social interaction, overall health, dialysis staff encouragement, patient satisfaction, social support, physical functioning, role of physical health, pain, emotional well-being, role of emotional health, social functioning, and energy fatigue (p < 0.005). The mean difference for PCS and MCS based on CKD stages was found to be statistically significant (p < 0.005). The PCS and MCS showed a positive correlation with GFR (r = 0.521), and Hb (r = 0.378), GFR (r = 0.836), and Hb (r = 0.488), respectively. Conclusions: The findings of this study demonstrated that a significant decrease in HRQoL was observed among CKD patients, with a progressive deterioration of HRQoL dimensions as the patient advances to end-stage renal disease. This study also revealed that CKD imposes various restrictions on patients' day-to-day lives, particularly in terms of their physical and mental functioning, even in the initial stages of the disease.

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Dataset Information

Symptoms induced by environmental irritants and health-related quality of life in patients with chronic cough - A cross-sectional study.

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Symptoms induced by environmental irritants and health-related quality of life in patients with chronic cough - A cross-sectional study.

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