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.	张晓岩, 林江涛. 2017年全球哮喘防治倡议指南解读. 中国实用内科杂志, 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.	朱聪, 陈敏, 胡丹红, 等. 老年支气管哮喘患者生命质量影响因素及相关性分析. 现代实用医学, 2014, 26(3): 302-303.
5.	叶华, 玉江山•阿吉, 叶瑞丽, 等. 支气管哮喘患者疲劳状况及其影响路径. 职业与健康, 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.	中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 支气管哮喘基层诊疗指南(2018年). 中华全科医师杂志, 2018, 17(10): 751-762.
8.	陈亚红. 2017年GOLD慢性阻塞性肺疾病诊断、治疗及预防的全球策略解读. 中国医学前沿杂志(电子版), 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.	吴春薇, 刘占东, 张拥波, 等. 个人疲劳强度问卷中译本在脑梗死患者中的临床应用与评价. 中国康复理论与实践, 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, 胜利. 焦虑及抑郁自评量表的临床效度. 中国心理卫生杂志, 2012, 26(9): 676-679.
13.	李凡, 唐世和, 蔡映云, 等. 成人哮喘生命质量量表的评价. 中国行为医学科学, 1997, 6(2): 98-100.
14.	温忠麟, 张雷, 侯杰泰, 等. 中介效应检验程序及其应用. 心理学报, 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, 张翠珍, 刘雁峰, 等. 慢性疲劳综合征病人的疲劳、抑郁、焦虑与生活事件的特点及其相关性分析. 中国行为医学科学, 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.	房莉颖, 李圣青, 吴林. 支气管哮喘与抑郁相关性研究. 陕西医学杂志, 2016, 45(9): 1120-1122.
21.	李志平, 钟韵, 郭禹标, 等. 支气管哮喘患者抑郁情绪、哮喘控制及生存质量的调查分析. 实用医学杂志, 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. 张晓岩, 林江涛. 2017年全球哮喘防治倡议指南解读. 中国实用内科杂志, 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. 朱聪, 陈敏, 胡丹红, 等. 老年支气管哮喘患者生命质量影响因素及相关性分析. 现代实用医学, 2014, 26(3): 302-303.
5. 叶华, 玉江山•阿吉, 叶瑞丽, 等. 支气管哮喘患者疲劳状况及其影响路径. 职业与健康, 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. 中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 支气管哮喘基层诊疗指南(2018年). 中华全科医师杂志, 2018, 17(10): 751-762.
8. 陈亚红. 2017年GOLD慢性阻塞性肺疾病诊断、治疗及预防的全球策略解读. 中国医学前沿杂志(电子版), 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. 吴春薇, 刘占东, 张拥波, 等. 个人疲劳强度问卷中译本在脑梗死患者中的临床应用与评价. 中国康复理论与实践, 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, 胜利. 焦虑及抑郁自评量表的临床效度. 中国心理卫生杂志, 2012, 26(9): 676-679.
13. 李凡, 唐世和, 蔡映云, 等. 成人哮喘生命质量量表的评价. 中国行为医学科学, 1997, 6(2): 98-100.
14. 温忠麟, 张雷, 侯杰泰, 等. 中介效应检验程序及其应用. 心理学报, 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, 张翠珍, 刘雁峰, 等. 慢性疲劳综合征病人的疲劳、抑郁、焦虑与生活事件的特点及其相关性分析. 中国行为医学科学, 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. 房莉颖, 李圣青, 吴林. 支气管哮喘与抑郁相关性研究. 陕西医学杂志, 2016, 45(9): 1120-1122.
21. 李志平, 钟韵, 郭禹标, 等. 支气管哮喘患者抑郁情绪、哮喘控制及生存质量的调查分析. 实用医学杂志, 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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