The Impact of Socioeconomic Status on the Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Abstract

In addition to the traditional biomedical parameters, quality of life (QoL) evaluation has found its well-deserved place in the overall assessment of patients with chronic obstructive pulmonary disease (COPD). The impact of socioeconomic status (SES) was rarely evaluated in QoL studies in such patients with no such studies having been conducted in Poland. The aim of our study was to compare QoL between COPD patients and the control group and to evaluate the impact of SES, selected demographic characteristics, smoking and bronchial tree obstruction on the QoL in COPD patients. We enrolled 120 patients with COPD (98 men and 22 women; mean age: 62.3 years) with no comorbidities and 85 healthy individuals (39 men and 46 women; mean age: 56.0 years). All the COPD patients underwent spirometry. QoL was assessed with the SF-36 Health Survey and the St George's Respiratory Questionnaire. To assess SES, demographic variables and smoking we used a questionnaire of our own authorship. COPD patients showed a significantly lower QoL compared to controls. Univariate analysis demonstrated effects of educational background, income, occupation, employment status and bronchial obstruction on the individual QoL domains. Multivariate regression analysis revealed that the sociodemographic factors significantly affecting the overall QoL included: present occupation, employment status, monthly income, educational background and total exposure to cigarette smoke. No effects of age, sex or smoking status on the QoL in COPD were shown. The QoL in patients with COPD is affected by many factors. In addition to spirometric abnormalities the significant factors that modify QoL are: educational background, monthly income, present occupation and employment status, while sex, age and smoking status do not significantly affect QoL.