Factors associated with good self-rated health and quality of life in subjects with self-reported COPD

Mats Arne^1,2, Fredrik Lundin¹, Gunnar Boman², Christer Janson², Staffan Janson^1,3, Margareta Emtner^2,4
1Primary Care Research Unit, County Council of Värmland, Universitetsgatan 3, Karlstad, Sweden; ²Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden; ³Department of Social Sciences, Division of Public Health, Karlstad University, Karlstad, Sweden; ⁴Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden

Background: Recent guidelines for chronic obstructive pulmonary disease (COPD) state that COPD is both preventable and treatable. To gain a more positive outlook on the disease it is interesting to investigate factors associated with good, self-rated health and quality of life in subjects with self-reported COPD in the population.
Methods: In a cross-sectional study design, postal survey questionnaires were sent to a stratified, random population in Sweden in 2004 and 2008. The prevalence of subjects (40–84 years) who reported having COPD was 2.1% in 2004 and 2.7% in 2008. Data were analyzed for 1475 subjects. Regression models were used to analyze the associations between health measures (general health status, the General Health Questionnaire, the EuroQol five-dimension questionnaire) and influencing factors.
Results: The most important factor associated with good, self-rated health and quality of life was level of physical activity. Odds ratios for general health varied from 2.4 to 7.7 depending on degree of physical activity, where subjects with the highest physical activity level reported the best health and also highest quality of life. Social support and absence of economic problems almost doubled the odds ratios for better health and quality of life.
Conclusions: In this population-based public health survey, better self-rated health status and quality of life in subjects with self-reported COPD was associated with higher levels of physical activity, social support, and absence of economic problems. The findings indicated that of possible factors that could be influenced, promoting physical activity and strengthening social support are important in maintaining or improving the health and quality of life in subjects with COPD. Severity of the disease as a possible confounding effect should be investigated in future population studies.

Keywords: chronic obstructive pulmonary disease, health status, physical activity, quality of life, social support