Exposure to stressful life events increases the risk for physical health problems in general, but has not been well studied in asthma specifically. We evaluated the relationship of a subset of stressful life events with asthma quality of life outcomes.
We studied survey data from 190 adults with asthma (mean age 46+9 years; 69% female) participating in a larger study of airways disease. We examined the relationship between a subset of the 41-item version of the Life Events Survey (LES) and the Marks Asthma Quality of Life (AQOL) score.
Seven events from the LES occurring in previous year were associated with significantly poorer AQOL (all p <0.05) These were: serious illness or injury; surgery or hospitalization; death of a pet; someone moved out of the home; a major car accident involving self, a family member or friend; lack of money to pay bills; major argument(s) with a family member or friend. The mean decrement in AQOL (reflected in higher score) associated with these events ranged from 1.8 (death of a pet) to 7.7 points (serious illness or injury). Fifty-five (29%) of subjects experienced none of the 7 events; 50 (26%) reported 1 only; 35 (18%) 2 only; and 50 (26%) reported 3-7. Respondents with no events had a mean AQOL score of 9.5 + 10.6; those with one event, 13.5+11.7; those with two, 19.2+18.4; those with 3-7, 23.6 +18.7 (ANOVA p<0.05). A sensitivity analysis excluding illness/injury and surgery hospitalization [cumulative response frequencies collapsed to 0, 1 or 2 or more events] continued to show an incremental worsening in AQOL with more stressful events (ANOVA p< 0.05).
Selected stressful life events are associated with impaired AQOL. Multiple events have an incremental impact on AQOL.
Certain stressful life events may linked to poorer AQOL; some of these may be clinical (serious illness, hospitalization), while other events may reflect psychological or social stress, including financial and emotional issues.
C. Archea, None.