Mediating effect of depression on fatigue and quality of life in asthma patients_West China Medical Journal

Authors：

QIN Fujia ¹ ,  CUI Miaoling ²

1. Graduate School of Guangxi Medical University, Nanning, Guangxi 530021, P. R. China;
2. Department of Nursing, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P. R. China;

Corresponding?author：

CUI Miaoling, Email: cuimiaoling@126.com

Keywords：

Bronchial asthma; Depression; Fatigue; Quality of life; Mediating effect

DOI：

10.7507/1002-0179.201908023

Video：

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Objective To explore the mediating effect of depression between fatigue and quality of life in patients with bronchial asthma, and to provide a clinical basis for alleviating fatigue and improving the quality of life in asthma patients.Methods Bronchial asthma patiens were recruited with convenience sampling method to conducta questionnaire survey in outpatients department of respiratory of a tertiary hospital in Guangxi from November 2018 to March 2019. The general data questionnaire, the Chinese version of Checklist Individual Strength-Fatigue, the Self-rating Depression Scale, the Questionnaire for Asthma Quality of Life in Adult, and the Asthma Control Test were used. We collected data to analyze the mediating effects of depression between fatigue and quality of life in patients with bronchial asthma.Results Finally, 120 patients were included. There were statistically significant differences in quality of life among patients with different ages, education levels, residences, time of high incidence of symptoms, degrees of lung function impairment, asthma control conditions, and degrees of depression, and between patients with fatigue and the ones without fatigue (P<0.05). The quality of life score was negatively correlated with depression score and fatigue score (r=?0.749, ?0.770; P<0.001). The depression score was positively correlated with fatigue score (r=0.769, P<0.001). The fatigue score had a negative predictive effect on quality of life score [standardized partial regression coefficient (β’)=?0.587, P<0.001], and a positive predictive effect on depression scores (β’=0.657, P<0.001). After adding depression score, the effect of fatigue score on quality of life score decreased and the β’ changed from ?0.587 to ?0.319, suggesting that depression played a partial mediating role in the relationship between fatigue and quality of life. Mediation tests showed significant mediation effects.Conclusions Relieving or eliminating fatigue can improve the quality of life in asthma patients directly. At the same time, it can indirectly improve the quality of life in asthma patients through relieving depression.

Citation： QIN Fujia, CUI Miaoling. Mediating effect of depression on fatigue and quality of life in asthma patients. West China Medical Journal, 2020, 35(1): 11-16. doi: 10.7507/1002-0179.201908023 Copy

1.	Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD Executive Summary. Am J Respir Crit Care Med, 2017, 195(5): 557-582.
2.	張曉巖, 林江濤. 2017年全球哮喘防治倡議指南解讀. 中國實用內科雜志, 2017, 37(8): 709-711.
3.	Pate CA, Zahran HS, Bailey CM. Impaired health-related quality of life and related risk factors among US adults with asthma. J Asthma, 2018, 56(4): 431-439.
4.	朱聰, 陳敏, 胡丹紅, 等. 老年支氣管哮喘患者生命質量影響因素及相關性分析. 現代實用醫學, 2014, 26(3): 302-303.
5.	葉華, 玉江山?阿吉, 葉瑞麗, 等. 支氣管哮喘患者疲勞狀況及其影響路徑. 職業與健康, 2017, 33(19): 2674-2677.
6.	Van Herck M, Spruit MA, Burtin C, et al. Fatigue is highly prevalent in patients with asthma and contributes to the burden of disease. J Clin Med, 2018, 7(12): E471.
7.	中華醫學會, 中華醫學會雜志社, 中華醫學會全科醫學分會, 等. 支氣管哮喘基層診療指南(2018年). 中華全科醫師雜志, 2018, 17(10): 751-762.
8.	陳亞紅. 2017年GOLD慢性阻塞性肺疾病診斷、治療及預防的全球策略解讀. 中國醫學前沿雜志(電子版), 2017, 9(1): 37-47.
9.	Vercoulen JH, Swanink CM, Fennis JF, et al. Dimensional assessment of chronic fatigue syndrome. J Psychosom Res, 1994, 38(5): 383-392.
10.	吳春薇, 劉占東, 張擁波, 等. 個人疲勞強度問卷中譯本在腦梗死患者中的臨床應用與評價. 中國康復理論與實踐, 2008, 14(2): 116-118.
11.	Schatz M, Sorkness CA, Li JT, et al. Asthma control test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. J Allergy Clin Immunol, 2006, 117(3): 549-556.
12.	段泉泉, 勝利. 焦慮及抑郁自評量表的臨床效度. 中國心理衛生雜志, 2012, 26(9): 676-679.
13.	李凡, 唐世和, 蔡映云, 等. 成人哮喘生命質量量表的評價. 中國行為醫學科學, 1997, 6(2): 98-100.
14.	溫忠麟, 張雷, 侯杰泰, 等. 中介效應檢驗程序及其應用. 心理學報, 2004, 36(5): 614-620.
15.	Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol, 1986, 51(6): 1173-1183.
16.	王天芳, 張翠珍, 劉雁峰, 等. 慢性疲勞綜合征病人的疲勞、抑郁、焦慮與生活事件的特點及其相關性分析. 中國行為醫學科學, 2000, 9(2): 84.
17.	Chen MK. The epidemiology of self-perceived fatigue among adults. Prev Med, 1986, 15(1): 74-81.
18.	Peters JB, Rijssenbeek-Nouwens LH, Bron AO, et al. Health status measurement in patients with severe asthma. Respir Med, 2014, 108(2): 278-286.
19.	Cooper CL, Parry GD, Saul C, et al. Anxiety and panic fear in adults with asthma: prevalence in primary care. BMC Fam Pract, 2017: 62.
20.	房莉穎, 李圣青, 吳林. 支氣管哮喘與抑郁相關性研究. 陜西醫學雜志, 2016, 45(9): 1120-1122.
21.	李志平, 鐘韻, 郭禹標, 等. 支氣管哮喘患者抑郁情緒、哮喘控制及生存質量的調查分析. 實用醫學雜志, 2007, 23(5): 745-746.
22.	Demyttenaere K, De Fruyt J, Stahl SM. The many faces of fatigue in major depressive disorder. Int J Neuropsychopharmacol, 2005, 8(1): 93-105.
23.	Yohannes AM, Baldwin RC, Connolly MJ. Depression and anxiety in elderly patients with chronic obstructive pulmonary disease. Age Ageing, 2006, 35(5): 457-459.

1. Vogelmeier CF, Criner GJ, Martinez FJ, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD Executive Summary. Am J Respir Crit Care Med, 2017, 195(5): 557-582.
2. 張曉巖, 林江濤. 2017年全球哮喘防治倡議指南解讀. 中國實用內科雜志, 2017, 37(8): 709-711.
3. Pate CA, Zahran HS, Bailey CM. Impaired health-related quality of life and related risk factors among US adults with asthma. J Asthma, 2018, 56(4): 431-439.
4. 朱聰, 陳敏, 胡丹紅, 等. 老年支氣管哮喘患者生命質量影響因素及相關性分析. 現代實用醫學, 2014, 26(3): 302-303.
5. 葉華, 玉江山?阿吉, 葉瑞麗, 等. 支氣管哮喘患者疲勞狀況及其影響路徑. 職業與健康, 2017, 33(19): 2674-2677.
6. Van Herck M, Spruit MA, Burtin C, et al. Fatigue is highly prevalent in patients with asthma and contributes to the burden of disease. J Clin Med, 2018, 7(12): E471.
7. 中華醫學會, 中華醫學會雜志社, 中華醫學會全科醫學分會, 等. 支氣管哮喘基層診療指南(2018年). 中華全科醫師雜志, 2018, 17(10): 751-762.
8. 陳亞紅. 2017年GOLD慢性阻塞性肺疾病診斷、治療及預防的全球策略解讀. 中國醫學前沿雜志(電子版), 2017, 9(1): 37-47.
9. Vercoulen JH, Swanink CM, Fennis JF, et al. Dimensional assessment of chronic fatigue syndrome. J Psychosom Res, 1994, 38(5): 383-392.
10. 吳春薇, 劉占東, 張擁波, 等. 個人疲勞強度問卷中譯本在腦梗死患者中的臨床應用與評價. 中國康復理論與實踐, 2008, 14(2): 116-118.
11. Schatz M, Sorkness CA, Li JT, et al. Asthma control test: reliability, validity, and responsiveness in patients not previously followed by asthma specialists. J Allergy Clin Immunol, 2006, 117(3): 549-556.
12. 段泉泉, 勝利. 焦慮及抑郁自評量表的臨床效度. 中國心理衛生雜志, 2012, 26(9): 676-679.
13. 李凡, 唐世和, 蔡映云, 等. 成人哮喘生命質量量表的評價. 中國行為醫學科學, 1997, 6(2): 98-100.
14. 溫忠麟, 張雷, 侯杰泰, 等. 中介效應檢驗程序及其應用. 心理學報, 2004, 36(5): 614-620.
15. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol, 1986, 51(6): 1173-1183.
16. 王天芳, 張翠珍, 劉雁峰, 等. 慢性疲勞綜合征病人的疲勞、抑郁、焦慮與生活事件的特點及其相關性分析. 中國行為醫學科學, 2000, 9(2): 84.
17. Chen MK. The epidemiology of self-perceived fatigue among adults. Prev Med, 1986, 15(1): 74-81.
18. Peters JB, Rijssenbeek-Nouwens LH, Bron AO, et al. Health status measurement in patients with severe asthma. Respir Med, 2014, 108(2): 278-286.
19. Cooper CL, Parry GD, Saul C, et al. Anxiety and panic fear in adults with asthma: prevalence in primary care. BMC Fam Pract, 2017: 62.
20. 房莉穎, 李圣青, 吳林. 支氣管哮喘與抑郁相關性研究. 陜西醫學雜志, 2016, 45(9): 1120-1122.
21. 李志平, 鐘韻, 郭禹標, 等. 支氣管哮喘患者抑郁情緒、哮喘控制及生存質量的調查分析. 實用醫學雜志, 2007, 23(5): 745-746.
22. Demyttenaere K, De Fruyt J, Stahl SM. The many faces of fatigue in major depressive disorder. Int J Neuropsychopharmacol, 2005, 8(1): 93-105.
23. Yohannes AM, Baldwin RC, Connolly MJ. Depression and anxiety in elderly patients with chronic obstructive pulmonary disease. Age Ageing, 2006, 35(5): 457-459.

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Mediating effect of depression on fatigue and quality of life in asthma patients

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