|Institution:||University of Michigan|
|Keywords:||Chronic Obstructive Pulmonary Disease; COPD; Frailty; Health-related Quality of Life; Health Care Utlization; Nursing; Health Sciences|
|Full text PDF:||http://hdl.handle.net/2027.42/107320|
Background: COPD is a chronic disease that not only has a high prevalence but is associated with a significant reduced health- related quality of life (HRQoL). Frailty is a prevalent health problem of older people with adverse outcomes. The purpose of this study was to examine demographic characteristics, clinical characteristics, physical frailty indicators, and psychological frailty indicators and their impact on health care outcomes (health related quality of life, death, and utilization of health care resources) in people with severe COPD over time. Methods: The research was a secondary data analysis of 610 severe COPD individuals. HRQol was assessed using the St. George???s Respiratory Questionnaire (SGRQ), death was all cause mortality, and health care utilization measured by a self- reported questionnaire. Results: Age, gender, education, endurance, balance, mobility, coping, and depression were significant (p = <.05) predictors in the models of HRQOL. The total variance explained by the baseline model (demographic, physical, and psychological frailty indicators) was 36%, F (16, 567) = 20.31, p = < .001. The mean survival time for lower frail individuals was 7.4 years compared to 4.7 years for higher frail individuals (p = <.001). Gender, income, education, smoking history, depression, PaO2 (RA), DLCO, TLC, RV, FEV1, endurance, nutrition, education, and balance were significant (p = <.05) predictors in the models of health care utilization. Conclusions: Mobility and coping were significant indicators (p = <.001) over time predicting quality of life. These indicators should be included in frailty models. Higher frailty was associated with higher mortality. Those with higher COPD disease severity required increased home visits from health professionals.