Abstract
Objetivos
Analizar la relación entre medidas de salud objetivas (espirometría actual) y medidas de salud subjetivas (calidad de vida autopercibida). Evaluar la correlación entre 2 cuestionarios de valoración de calidad de vida.
Diseño
Descriptivo, transversal.
Emplazamiento
Dos centros de salud urbanos con programa de crónicos (subprograma de enfermedad pulmonar obstructiva crónica [EPOC]).
Participantes
Un total de 278 pacientes diagnosticados de EPOC.
Mediciones principales
Mediante entrevista personal se analizan las siguientes variables: calidad de vida autopercibida (perfil de salud de Nottingham; cuestionario respiratorio St. George; rangos de puntuación de subescalas 0-100 puntos; perfil sociodemográfico, diagnóstico de EPOC, antecedentes personales, espirometría actual.
Resultados
Edad, 66,9 ± 8,9 años; género, 88% varones. Los principales resultados de salud autopercibida fueron (medias e IC del 95%): perfil de salud de Nottingham: subescalas de energía, 40 (35,6-44,4); dolor, 35,9 (32,3-39,5); emotividad, 32,5 (29,4-38,6); sueño, 41,9 (37,8-45,9); social, 15,3 (12,7-17,9); movilidad, 36,7 (33,9-39,5), y total, 33,4 (30,8-36). Cuestionario de St. George: subescalas de impacto, 38,01 (35,08-40,18); actividad, 53,8 (50,2-57,4) síntoma, 37,7 (35,2-40,3) y total, 40,9 (38,6-43,2). Los coeficientes de correlación entre ambos cuestionarios oscilaron entre 0,12 (para las dimensiones sueño y síntoma; p = 0,03) y 0,66 (entre las dimensiones de movilidad y actividad; p < 0,0001). Existe una relación lineal de tendencia positiva entre ambos cuestionarios y las categorías de valores (normal, leve, moderado y grave) del parámetro espirométrico, volumen espiratorio máximo en el primer segundo (p < 0,0001).
Conclusiones
Encontramos una buena correlación entre ambos cuestionarios de salud autopercibida, siendo de mayor especificidad para patología respiratoria el St. George. Existe una correlación levemoderada entre las medidas de salud objetivas y subjetivas en los pacientes con EPOC en nuestro medio.
Palabras clave: Calidad de vida, EPOC, Espirometría
Abstract
Aims
Analize the relation between objective health assessment (OHA) –Forced spirometry– and subjective health assessment (SHA) –quality of life– in patients with chronic obstructive pulmonary disease (COPD). Analize the correlation between two different questionnaires to assess quality of life.
Design
Cross-sectional study.
Participants
278 patients with COPD (confidence level 95%) from two urban health centers.
Main measurements
Personal interview. Variables: quality of life (Nottingham Health Profile; St George Respiratory Questionnaire); sociodemographic profile; diagnose of COPD; comorbidity; recent spirometry. Statistical analises: Descriptive statistics; test ji-squared, Kruskal-Wallis and the correlation coefficient.
Results
Age: 66,9 years; sex: 88% male. Quality of life scales (mean and confidence intervals): Nottingham Health Profile subscales (total score 100 points): energy 40 (35.6-44.4), pain 35.9 (32.3-39.5), emotional reactions 32.5 (29.4-38.6), sleep 41.9 (37.8-45.9), social isolation 15.3 (12.7-17.9), mobility 36.7 (33.9-39.5) and global score 33.4 (30.8-36). St George Respitatory Questionnaire subscales (total scores 100 points): impact 38.01 (35.08-40.18), activity 53.8 (50.2-57.4), symptoms 37.7 (35.2-40.3) and global score 40.0 (38.6-43.2). The correlation coefficients between the two questionnaires ranged between 0.12 (for the sleep and symptoms dimensions: p = 0.03) and 0.66 (for the mobility and activity dimensions; p < 0.0001). There is a positive lineal relation between the two questionnaires and the spirometric stages of COPD (measured by the maximun espiratory volume in the first second).
Conclusions
We found a good correlation between the two quality of life questionnaires, but St George was more specific for respiratory illness. There is a mild-light correlation between objective and subjective health assessment in patients with COPD.
Key words: Quality of life, COPD, Spirometry
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