Health-related Quality of Life and its Associated Variables among Individuals with Idiopathic Pulmonary Fibrosis

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Health-related Quality of Life and its Associated Variables among Individuals with Idiopathic Pulmonary Fibrosis

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2019-09

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Abstract

Idiopathic pulmonary fibrosis (IPF) is a debilitating lung disease with a median survival of only three to five years from the time of diagnosis, with no known cure, or treatment to extend survival. Due to a lack of clinical studies, large gaps remain in understanding how IPF affects health-related quality of life (HRQOL). Because of the terminal nature of IPF, an improved understanding of how this disease affects patients' lives is needed. The works presented in this dissertation revealed that individuals with IPF are at greater risk for cognitive abnormalities, and confirmed that they are more likely to have depressive symptoms, and worsened HRQOL. The pathways among the variables cannot be easily elucidated, especially the co-existence of depressive symptoms and cognitive impairment. Nonetheless, the presence of depressive symptoms should not be overlooked in research or in clinical management, as depression may be associated with dyspnea, the symptom most commonly found to be responsible for the compromised HRQOL seen in IPF, and could be of increased interest if treating the depression could result in the alleviation of dyspnea and amelioration of HRQOL. The significance of the cognitive impairment observed among individuals with IPF remains unclear, both for selecting therapies and anticipating expected treatment outcomes. Further research is needed to understand if exertional hypoxia is related to the cognitive abnormalities noted in cases of severe IPF, or if there are long term benefits to correcting exertional hypoxia. Patient reported outcomes and HROQL data assist clinicians by providing insight from the patient’s perspective about the level of illness burden and the effectiveness of a given intervention. Understanding which measures of health are most valued by patients is critical when establishing a plan of care, especially if asking patients to comply with a burdensome therapy such as ambulatory oxygen (AO). The role of AO in treating exertional hypoxia in IPF is obscure and more data are needed about its impact on disease progression, and HRQOL. Determining which variables are associated with HRQOL may facilitate clinician and patient interpretation of disease progression and the effects of therapy.

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University of Minnesota Ph.D. dissertation. September 2019. Major: Nursing. Advisor: Ruth Lindquist. 1 computer file (PDF); vii, 94 pages.

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Bors, Melinda. (2019). Health-related Quality of Life and its Associated Variables among Individuals with Idiopathic Pulmonary Fibrosis. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/259688.

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