Sex based differences in depression, anxiety, and quality of life and predictors of quality of life among South Asian individuals with chronic obstructive pulmonary disease: A Bayesian analysis

Abstract

BackgroundCOPD can affect both men and women leading to deteriorating impact on general well-being, personal, and family life and decreased quality of life. Anxiety, depression, and self-care behaviours can affect the quality of life of individuals with COPD. There is a dearth of sex-based comparative analyses of anxiety, depression, quality of life, and predictors of quality of life among South Asian individuals with COPD. PurposeTo identify the sex-based differences in depression, anxiety, and quality of life and the predictors of quality of life among South Asian individuals with COPD. MethodsA cross-sectional survey of 294 men and 114 women with COPD was conducted in Khyber Pakhtunkhwa, Pakistan. Hospital Anxiety and Depression scale, World Health Organization Quality of Life-brief version, Self-Care of Chronic Obstructive Pulmonary Disease Inventory, the Self-Care Self-Efficacy in COPD Scale were used for data collection. Bayesian independent sample t-test was used to compare mean differences in depression, anxiety, and quality of life among men and women. Two regression models were examined to determine if age, years of living with COPD, anxiety, depression, self-care self-efficacy, self-care monitoring, management, and maintenance were predictors of quality of life among men and women. FindingsBayesian analysis showed anecdotal evidence that women had higher levels of depression, but lower levels of anxiety compared to men. Anecdotal evidence indicated that the physical quality of life of men was better than women, but strong evidence that their social relationship and environmental quality of life was better than women. Years of living with COPD, anxiety, depression, self-care self-efficacy, self-care management, self-care monitoring, and self-care maintenance were stronger predictors of women's quality of life. Anxiety and depression only predicted men's psychological quality of life, but predicted women's psychological, social relationships, and environmental quality of life. ConclusionsThe findings contribute to literature highlighting sex-based differences in anxiety, depression, and quality of life among South Asian men and women with COPD. Men generally reported higher levels of quality of life than women across all domains. Women's social relationships and environmental quality of life were greatly impacted by anxiety and depression. Quality of life interventions for women should be targeted at improving their social relationships and environmental satisfaction and addressing anxiety and depression.