Introduction. There is evidence that psychosocial factors and social support are determinants of health-related quality of life (HRQoL) and health-care services use in patients with chronic diseases. Objective . To evaluate what physiological, psychosocial or HRQoL factors are predictors of health-care services use in COPD. Methods. A combination retrospective/prospective hospital-based cohort study was designed. 90 patients with stable COPD were selected from an out-patient registry at the Montreal Chest Institute. Patient evaluation included an interview with two disease specific HRQoL questionnaires: St. George's Respiratory Questionnaire and Chronic Respiratory Questionnaire; and five psychosocial questionnaires: Coping Inventory for Stressful Situations, State/Trait Anxiety Inventory, Beck Depression Index, NEO Five Factor Personality Inventory, and Interpersonal Relationships Inventory. Physiological measurements and symptom evaluation included spirometry, six-minute walking tests, and the American Thoracic Society Lung Disease Questionnaire (ATS-DLD-78). Outcome. Emergency room visits, return visits to the ER, and overnight hospitalisations were collected from patients' medical charts. Results. Independent associations were observed for age, gender, lung function, six-minute walking test distance, and use of oral cortico-steroids. HRQoL measures also demonstrated an ability to predict health-care service outcomes. Multivariate model selection identified disease severity and HRQoL as the strongest correlates of presentation for an emergency visit in COPD patients.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.21634 |
| Date | January 1999 |
| Creators | Schlecht, Nicolas F. |
| Contributors | Bourbeau, Jean (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001652204, proquestno: MQ50872, Theses scanned by UMI/ProQuest. |
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