Relationships Between Social/Emotional Support and Quality of Life, Depression and Disability in Patients With Chronic Obstructive Pulmonary Disease: An Analysis Based on Propensity Score Matching.

Abstract

Patients with chronic obstructive pulmonary diseases (COPD) suffer from impaired Health-Related Quality of Life (HRQoL). Having an adequate social/emotional support may improve the quality of life of COPD patients. To study the relationships between social/emotional support and HRQoL, depression and disability among patients with COPD. We applied a propensity score model using data from a large U.S. population-based health survey to match COPD patients who reported rarely/never receiving social/emotional support with those who received that support. Social/emotional support and all dependent variables were dichotomized into yes/no responses. For HRQoL domains, number of days of poor physical or mental health and activity limitations, "yes" indicated ≥14 unhealthy days in the last 30 days. McNemar's test was used to compare the matched groups. Social/emotional support was rarely/never received by 37% of responders. Standardized differences between matched groups, after propensity score matching, were less than 10% indicating successful matching. COPD patients who rarely/never receive social/emotional support were more likely to report: depression (n = 321 pairs, odds ratio (OR) = 2.2, 95% confidence interval (CI): 1.56-3.14, p < .001), ≥14 poor mental HRQoL days (n = 310 pairs, OR = 3.12, 95% CI: 2.1-4.73, p < .001) and ≥14 poor physical HRQoL days (n = 307 pairs, OR = 1.5, 95% CI: 1.06-2.13, p = .02). There were no significant differences in general health, disability, or activity limitations. Among COPD patients, lower levels of social/emotional support are associated with depression and deterioration of mental and physical HRQoL. The importance of social/emotional support should be emphasized by policy makers, healthcare providers, and family members, to improve functioning among COPD patients.