Other Titles
Disease Management: Barriers, Quality of Life and Outcomes
Abstract
Session presented on Monday, July 25, 2016:
Introduction: Pulmonary arterial hypertension (PAH) is a chronic illness affecting primarily young and middle age women. Elevated pulmonary pressures lead to right heart failure and premature death. Patients with PAH report multiple symptoms (e.g. dyspnea, fatigue) that can be severe and impair health-related quality of life (HRQOL). PAH etiology is varied with approximately half being idiopathic PAH. Associated PAH includes those with PAH caused by other disorders such as: connective tissue disease, congenital heart disease, portopulmonary hypertension and anorexigens.
Purpose: The purpose of this study was to determine if there were differences between symptom severity and HRQOL in patients with idiopathic PAH and associated PAH.
Methods: This was a secondary analysis of an existing data set of patients with PAH. The convenience sample included 191 patients with PAH (n=104 idiopathic PAH; n=87 associated PAH). Subjects completed a socio-demographic and clinical data form, the Pulmonary Arterial Hypertension Symptom Scale (PAHSS) (dyspnea on exertion, fatigue, difficulty sleeping, chest pain, dizziness, syncope, palpitations, dyspnea at rest, dyspnea lying down, awaken at night dyspneic, swelling ankles/feet, cough, hoarseness, abdominal swelling, nausea, loss of appetite and Raynaud's phenomenon; scores range 0-10), and the Medical Outcomes Survey Short Form 36 (SF-36) (scores range 0-100). Descriptive statistics described the sample. Independent t-tests and chi square determined differences among continuous and categorical variables for the two groups.
Results: Eighty two with idiopathic PAH were female and 22 male; in contrast, 80 with associated PAH were female and 7 were male (p=0.007). The mean age was 51.8 + 16.6 year for idiopathic PAH and 54.8 +13.0 for associated PAH (p=0.176).There were no significant differences between the groups on marital status, employment status, functional class, oxygen use or medications. There were no significant differences between symptom severity on the PAHSS. Dyspnea on exertion (idiopathic PAH 5.0 + 2.5; associated PAH 5.0 + 2.0, p=0.798) and fatigue (idiopathic PAH 6.3 + 2.7; associated PAH 6.1 + 2.8, p=0.671) were the most severe symptoms reported on the PAHSS. On the SF-36 subscales there were differences between General Health (idiopathic PAH 40.6 + 22.9; associated PAH 32.7 + 18.3, p=0.009) and Emotional (idiopathic PAH 69.1 + 20.5; associated PAH 75.2 + 17.2, p=0.029).
Conclusions: Symptom severity is similar for patients with idiopathic and associated PAH. Those with associated PAH were experiencing worse General Health but better Emotional health than idiopathic PAH. The varied disease states in associated PAH may partially explain the worse reported General Health. This is important for clinicians to understand that there may be differences among the PAH etiologies in order to assess, treat appropriately and improve HRQOL.
Sigma Membership
Theta Alpha
Type
Presentation
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Pulmonary Arterial Hypertension, Symptoms, Health-Related Quality of Life
Recommended Citation
Matura, Lea Ann; McDonough, Annette; and Carroll, Diane L., "Symptoms and health-related quality of life in idiopathic and associated pulmonary arterial hypertension" (2016). INRC (Congress). 192.
https://www.sigmarepository.org/inrc/2016/presentations_2016/192
Conference Name
27th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Cape Town, South Africa
Conference Year
2016
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Acquisition
Proxy-submission
Symptoms and health-related quality of life in idiopathic and associated pulmonary arterial hypertension
Cape Town, South Africa
Session presented on Monday, July 25, 2016:
Introduction: Pulmonary arterial hypertension (PAH) is a chronic illness affecting primarily young and middle age women. Elevated pulmonary pressures lead to right heart failure and premature death. Patients with PAH report multiple symptoms (e.g. dyspnea, fatigue) that can be severe and impair health-related quality of life (HRQOL). PAH etiology is varied with approximately half being idiopathic PAH. Associated PAH includes those with PAH caused by other disorders such as: connective tissue disease, congenital heart disease, portopulmonary hypertension and anorexigens.
Purpose: The purpose of this study was to determine if there were differences between symptom severity and HRQOL in patients with idiopathic PAH and associated PAH.
Methods: This was a secondary analysis of an existing data set of patients with PAH. The convenience sample included 191 patients with PAH (n=104 idiopathic PAH; n=87 associated PAH). Subjects completed a socio-demographic and clinical data form, the Pulmonary Arterial Hypertension Symptom Scale (PAHSS) (dyspnea on exertion, fatigue, difficulty sleeping, chest pain, dizziness, syncope, palpitations, dyspnea at rest, dyspnea lying down, awaken at night dyspneic, swelling ankles/feet, cough, hoarseness, abdominal swelling, nausea, loss of appetite and Raynaud's phenomenon; scores range 0-10), and the Medical Outcomes Survey Short Form 36 (SF-36) (scores range 0-100). Descriptive statistics described the sample. Independent t-tests and chi square determined differences among continuous and categorical variables for the two groups.
Results: Eighty two with idiopathic PAH were female and 22 male; in contrast, 80 with associated PAH were female and 7 were male (p=0.007). The mean age was 51.8 + 16.6 year for idiopathic PAH and 54.8 +13.0 for associated PAH (p=0.176).There were no significant differences between the groups on marital status, employment status, functional class, oxygen use or medications. There were no significant differences between symptom severity on the PAHSS. Dyspnea on exertion (idiopathic PAH 5.0 + 2.5; associated PAH 5.0 + 2.0, p=0.798) and fatigue (idiopathic PAH 6.3 + 2.7; associated PAH 6.1 + 2.8, p=0.671) were the most severe symptoms reported on the PAHSS. On the SF-36 subscales there were differences between General Health (idiopathic PAH 40.6 + 22.9; associated PAH 32.7 + 18.3, p=0.009) and Emotional (idiopathic PAH 69.1 + 20.5; associated PAH 75.2 + 17.2, p=0.029).
Conclusions: Symptom severity is similar for patients with idiopathic and associated PAH. Those with associated PAH were experiencing worse General Health but better Emotional health than idiopathic PAH. The varied disease states in associated PAH may partially explain the worse reported General Health. This is important for clinicians to understand that there may be differences among the PAH etiologies in order to assess, treat appropriately and improve HRQOL.