Social Participation and Associated Factors in Individuals with Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy

Figures & data

Table 1. Characteristics of participants.

Characteristics	Participants (n = 57)
Age, years	71.3 ± 8.5
Sex, male	26 (45)
BMI, kg/m^2	26.5 ± 7.8
Pack-years	74.3 ± 51.4
Pulmonary function
FVC, L	1.85 ± 0.63
FVC % predicted	50 ± 23
FEV1, L	0.95 ± 0.34
FEV1 % predicted	40 ± 17
FEV1/FVC	53 ± 11
GOLD status
GOLD 1	1 (2)
GOLD 2	9 (16)
GOLD 3	25 (44)
GOLD 4	13 (23)
Enrolled in PR at the time of assessments	3 (5)
O2 flow, L/min	2 (2–3)
Oxygen use, h/day	14 (8–24)
Lifetime LTOT use, years	1.3 (0.4–10.0)
Length of oxygen tube extension, m	7.3 (2.1–10.0)

Abbreviations: BMI: Body mass index; FVC: Forced vital capacity; FEV₁: forced expiratory volume in 1 s, GOLD: Global initiative for chronic obstructive lung disease; PR: Pulmonary rehabilitation programme.

Data are mean ± SD, n (%), median (25th–75th interquartile).

Figure 1. Participants’ score on the Assessment of Life Habits (LIFE-H) domains: daily activities (nutrition, fitness, PC, communication, housing, and mobility) and social roles (responsibilities, IR, CL and recreation). Education and Employment were nonapplicable. Centre lines show the medians; box limits indicate the 25th and 75th percentiles; whiskers extend 1.5 times the interquartile range from the 25th and 75th percentiles, outliers are represented by dots. Abbreviations: PC: personal care; IR: interpersonal relationship; CL: community life. Weighted score ≤ 7 (vertical dashed line): experiencing difficulties or needing assistance to accomplish activities.

Table 2. Social participation, dyspnoea, exercise capacity, muscle strength, anxiety, depression, and quality of life.

Variable	Participants (n = 57)
Social participation^a
LIFE-H total	5.6 (2.6–9.4)
LIFE-H nutrition	7.5 (2.8–10.0)
LIFE-H fitness	6.1 (3.3–10.0)
LIFE-H personal care	7.4 (1.5–10.0)
LIFE-H communication	8.5 (2.9–10.0)
LIFE-H housing	5.8 (2.1–10.0)
LIFE-H mobility	3.7 (0–10.0)
LIFE-H responsibility	7.1 (2.1–10.0)
LIFE-H interpersonal relationships	8.9 (2.9–10.0)
LIFE-H community life	3.3 (0–10.0)
LIFE-H recreation	0 (0–10.0)
mMRC	3 (2–4)
Exercise capacity
Number of steps on 6MST	61 ± 27
Number of steps on 6MST (% predicted)	48 ± 20
Muscle strength
HGS, kgf	22.5 ± 8.6
HGS % predicted	75 ± 29
Anxiety and depression symptoms^b
HADS-A	7 (0–21)
HADS-D	5 (0–17)
Quality of life^c
CRQ total score	82.8 ± 23.2
CRQ dyspnoea	18.4 ± 7.2
CRQ fatigue	15.5 ± 5.7
CRQ emotional function	32.1 ± 10.0
CRQ mastery	16.6 ± 5.8

Abbreviations: 6MST: 6-Minute Step test; CRQ: Chronic Respiratory Questionnaire; HADS-A: Hospital Anxiety and Depression Scale – Anxiety Score; HADS-D: Hospital Anxiety and Depression Scale – Depression Score; HGS: Handgrip Strength; LIFE-H: Assessment of Life Habits.

Data are mean ± SD, median (25th–75th interquartile).

^aHigher scores indicate higher level of participation. Education and work items were non-applicable due to retirement or no participation in educational activities or vocational training.

^bHigher scores indicate more frequent anxiety and depression symptoms.

^cHigher scores indicate better quality of life.

Table 3. Associations between social participation and dyspnoea, exercise capacity, muscle strength, anxiety, depression, and quality of life (n = 57).

Variable	Social participation (LIFE-H)^a
	Correlation coefficients	p value
Dyspnoea
mMRC^b	–0.46	<0.01
Exercise capacity
Number of steps on 6MST^c	0.32	0.04
Number of steps on 6MST (% predicted)^c	0.25	0.09
Muscle strength
HGS, kgf^c	0.25	0.06
HGS % predicted^b	0.28	0.03
Anxiety and depression^d
HADS-A^b	–0.07	0.60
HADS-D^b	–0.40	<0.01
Quality of life^e
CRQ total score^c	0.32	<0.01
CRQ dyspnoea^b	0.04	0.74
CRQ fatigue^c	0.39	<0.01
CRQ emotional function^c	0.21	0.10
CRQ mastery^b	0.35	<0.01

Abbreviations: 6MST: 6-Minute Step test; CRQ: Chronic Respiratory Questionnaire; HADS-A: Hospital Anxiety and Depression Scale – Anxiety Score; HADS-D: Hospital Anxiety and Depression Scale – Depression Score; HGS: Handgrip Strength; LIFE-H: Assessment of Life Habits; mMRC: modified Medical Research Council.

a Higher scores indicate higher level of participation.

b Spearman correlation.

c Pearson correlation.

d Higher scores indicate more frequent anxiety and depression symptoms.

e Higher scores indicate better quality of life.

Table 4. Multiple linear regression models of factors associated with social participation as measured by LIFE-H.

	β ± SE	95% CI	p value
Model 1 R²=0.21
mMRC	–0.973 ± −0.256	–1.487 to −0.460	<0.01
Model 2 R²=0.20			0.01
mMRC	–0.777 ± 0.349	–1.482 to −0.720	0.03
Number of steps on 6MST	0.140 ± 0.010	–0.006 to −0.035	0.17
Model 3 R²=0.20			0.01
mMRC	–0.754 ± 0.367	–1.495 to −0.12	0.04
Number of steps on 6MST	0.014 ± 0.100	–0.007 to −0.035	0.19
HGS, kgf	0.008 ± 0.035	–0.062 to 0.008	0.82

β, Regression coefficient; 95% CI, 95% confidence interval; 6MST: Six-minute Step Test; HGS: Handgrip Strength; LIFE-H: Assessment of Life Habits; mMRC: Modified Medical Research Council dyspnoea scale; SE: Standard error.