Patients' perspectives on how idiopathic pulmonary fibrosis affects the quality of their lives

被引：155
作者：
Swigris J.J. [1 ]
Stewart A.L. [2 ]
Gould M.K. [3 ,5 ]
Wilson S.R. [4 ,5 ]
机构：
[1] Division of Pulmonary Medicine, Interstitial Lung Disease Program, National Jewish Medical and Research Center, Denver, CO
[2] University of California San Francisco, San Francisco, CA
[3] VA Palo Alto Health Care System, Palo Alto, CA
[4] Palo Alto Medical Foundation Research Institute, Palo Alto Medical Foundation, Palo Alto, CA
[5] Division of Pulmonary and Critical Care Medicine, Stanford University, Stanford, CA
来源：
Health and Quality of Life Outcomes | / 3卷 / 1期
关键词：
Health-related quality of life; Interstitial lung disease; Pulmonary fibrosis; Qualitative; Quality of life;
D O I：
10.1186/1477-7525-3-61
中图分类号：
学科分类号：
摘要：
Background: Idiopathic pulmonary fibrosis (IPF) is a debilitating lung disease with a survival of only three to five years from the time of diagnosis. Due to a paucity of studies, large gaps remain in our understanding of how IPF affects the quality of patients' lives. In only one other study did investigators ask patients directly for their perspectives on this topic. Further, currently there is no disease-specific instrument to measure health-related quality of life (HRQL) in patients with IPF. A carefully constructed measurement instrument, sensitive to underlying change, is needed for use in clinical trials and longitudinal studies of patients with IPF. Before developing such an instrument, researchers must improve their understanding of the relevant effects of IPF on patients' lives. On a broader scale, to provide the best care for people with IPF, clinicians must appreciate - from patients' perspectives - how this disease affects various aspects of their lives. Methods: We used focus groups and individual in-depth interviews with 20 IPF patients to collect their perspectives on how IPF affects their lives (with a focus on the quality of their lives). We then analyzed these perspectives and organized them into a conceptual framework for describing HRQL in patients with IPF. Next, we examined how well certain existing measurement instruments - which have been administered to IPF patients in prior studies - covered the domains and topics our patients identified. Results: In our framework, we identified 12 primary domains: symptoms, IPF therapy, sleep, exhaustion, forethought, employment and finances, dependence, family, sexual relations, social participation, mental and spiritual well-being, mortality. Each domain is composed of several topics, which describe how IPF affects patients' lives. When we compared the content of our conceptual framework with the existing instruments, we found the coverage of the existing instruments to be inadequate for several reasons, including they may tap general areas of QOL or HRQL but not some areas that appear to be most directly affected by IPF, and they include items that are relevant to symptoms and effects of other respiratory diseases but not IPF. Conclusions: Collecting patients' perspectives and developing an organized inventory of the relevant effects of IPF on patients' lives provides valuable information for improving our understanding of the impact of this disease on patients and their loved ones. We believe our findings will help alert clinicians and researchers to IPF patients' experiences and concerns. Based on the comparison or our conceptual framework with the content of four existing instruments, it would appear that developing an IPF-specific measurement instrument is justified. Our conceptual framework for describing health-related quality of life in patients with IPF lays a solid foundation for constructing such an instrument. © 2005 Swigris et al., licensee BioMed Central Ltd.
引用
收藏
页数：13
相关论文
共 20 条
  • [1] Idiopathic pulmonary fibrosis: Diagnosis and treatment, Am. J. Respir. Crit. Care Med., 161, pp. 646-664, (2000)
  • [2] Coultas D., Zumwalt R., Black W., Sobonya R., The epidemiology of interstitial lung disease, Am. J. Respir. Crit. Care Med., 150, pp. 967-972, (1994)
  • [3] Bjoraker J.A., Ryu J.H., Edwin M.K., Meyers J., Tazelaar H., Schroeder D., Offord K., Prognostic significance of histopathologic subsets in idiopathic pulmonary fibrosis, Am. J. Respir. Crit. Care Med., 157, pp. 199-203, (1998)
  • [4] Daniil Z.D., Gilchrist F.C., Nicholson A.G., Hansell D., Harris J., Colby T., du Bois R.M., A histologic pattern of nonspecific interstitial pneumonia is associated with a better prognosis than usual interstitial pneumonia in patients with cryptogenic fibrosing alveolitis, Am. J. Respir. Crit. Care Med., 160, pp. 899-905, (1999)
  • [5] Nicholson A.G., Colby T.V., du Bois R.M., Hansell D., Wells A., The prognostic significance of the histologic pattern of interstitial pneumonia in patients presenting with the clinical entity of cryptogenic fibrosing alveolitis, Am. J. Respir. Crit. Care Med., 162, pp. 2213-2217, (2000)
  • [6] Flaherty K.R., Toews G.B., Lynch III J.P., Kazerooni E.A., Gross B.H., Strawderman R.L., Hariharan K., Flint A., Martinez F.J., Steroids in idiopathic pulmonary fibrosis: A prospective assessment of adverse reactions, response to therapy, and survival, Am. J. Med., 110, pp. 278-282, (2001)
  • [7] Curtis J., Martin D., Martin T., Patient-assessed health outcomes in chronic lung disease: What are they, how do they help us, and where do we go from here?, Am. J. Respir. Crit. Care Med., 156, pp. 1032-1039, (1997)
  • [8] Chang J., Curtis R., Patrick D., Raghu G., Assessment of health-related quality of life in patients with interstitial lung disease, Chest, 116, pp. 1175-1182, (1999)
  • [9] Clark M., Cooper B., Singh S., Cooper M., Carr A., Hubbard R., A survey of nocturnal hypoxaemia and health related quality of life in patients with cryptogenic fibrosing alveolitis, Thorax, 56, pp. 482-486, (2001)
  • [10] De Vries J., Kessels B., Drent M., Quality of life of idiopathic pulmonary fibrosis patients, Eur. Respir. J., 17, pp. 954-961, (2001)
12