Health-Related Quality of Life in Adolescents and Adults With Cystic Fibrosis: Physical and Mental Health Predictors

• Published in: Respiratory care Vol. 64; no. 4; pp. 406 - 415
• Main Authors: Cronly, Jennifer A, Duff, Alistair J, Riekert, Kristin A, Fitzgerald, Anthony P, Perry, Ivan J, Lehane, Elaine A, Horgan, Aine, Howe, Barbara A, Ni Chroinin, Muireann, Savage, Eileen
• Format: Journal Article
• Language: English
• Published: United States Daedalus Enterprises, Inc 01.04.2019; Daedalus Enterprises Inc
• Subjects: Adolescent; Adult; Adults; Analysis; Anxiety - diagnosis; Anxiety - physiopathology; Body mass index; Care and treatment; Correlation of Data; Cystic fibrosis; Cystic Fibrosis - diagnosis; Cystic Fibrosis - epidemiology; Cystic Fibrosis - physiopathology; Cystic Fibrosis - psychology; Depression (Mood disorder); Depression - diagnosis; Depression - physiopathology; Female; Fibrosis; Health aspects; Health Status; Health surveys; Humans; Ireland - epidemiology; Male; Mental Health; Original Research; Pediatrics; Physical Functional Performance; Quality of Life; Respiratory Function Tests - methods; Severity of Illness Index; Social media; Surveys and Questionnaires; Youth; Ireland; predictors; anxiety; physical health; cystic fibrosis; mental health; depression; health-related quality of life (HRQOL)
• ISSN: 0020-1324; 1943-3654
• DOI: 10.4187/respcare.06356

People with cystic fibrosis face substantial physical, psychological, and social challenges as they move into adolescence and adulthood, which are likely to impact on their health-related quality of life. This study sought to examine the relative importance of physical and mental health variables associated with health-related quality of life in this group. Adults and adolescents ( = 174; ≥14 y old) from across 11 adult or pediatric cystic fibrosis clinics in the Republic of Ireland, completed a background questionnaire that contained self-reported physical health variables, pulmonary function (ie, FEV %) and body mass index. Questionnaire packs also contained the Hospital Anxiety and Depression Scale (HADS) and the Cystic Fibrosis Questionnaire-Revised, which has been specifically designed to assess health-related quality of life in patients with cystic fibrosis. HADS depression and/or anxiety scores were negatively associated with 11 of the 12 Cystic Fibrosis Questionnaire-Revised domain scores. FEV % was positively associated with 8 domains when controlling for HADS anxiety but only 4 domains when controlling for HADS depression. HADS anxiety and depression scores demonstrated larger effect sizes and explained a greater proportion of the variance than pulmonary function in 8 of the 12 Cystic Fibrosis Questionnaire-Revised domain scores. Mental health variables, depression and anxiety, were strongly associated with health-related quality of life in subjects with cystic fibrosis and demonstrated greater effect sizes and explained a higher proportion of the variance overall than the physical health indicators, FEV % and body mass index, which highlighted the importance of screening for, and treating, depression and anxiety symptoms.