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Disability and long-term breathlessness : A cross-sectional, population study

Kochovska, Slavica ; Ferreira, Diana ; Chang, Sungwon ; Brunelli, Vanessa ; Morgan, Deidre ; Similowski, Thomas ; Johnson, Miriam ; Ekström, Magnus LU orcid and Currow, David (2024) In BMJ Open Respiratory Research 11(1).
Abstract

Introduction Disability, resulting from altered interactions between individuals and their environment, is a worldwide issue causing inequities and suffering. Many diseases associated with breathlessness cause disability but the relationship between disability and the severity of breathlessness itself is unknown. This study evaluated associations between disability using the WHO's Disability Assessment Schedule (WHODAS) 2.0 and levels of long-term breathlessness limiting exertion. Methods This population-based, cross-sectional online survey (n=10 033) reflected the most recent national census (2016) by age, sex, state/territory of residence and rurality. Assessments included self-reported disability (WHODAS 2.0 12-item (range 12 (no... (More)

Introduction Disability, resulting from altered interactions between individuals and their environment, is a worldwide issue causing inequities and suffering. Many diseases associated with breathlessness cause disability but the relationship between disability and the severity of breathlessness itself is unknown. This study evaluated associations between disability using the WHO's Disability Assessment Schedule (WHODAS) 2.0 and levels of long-term breathlessness limiting exertion. Methods This population-based, cross-sectional online survey (n=10 033) reflected the most recent national census (2016) by age, sex, state/territory of residence and rurality. Assessments included self-reported disability (WHODAS 2.0 12-item (range 12 (no disability) to 60 (most severe disability)) assessed in 6 domains) and long-term breathlessness limiting exertion (modified Medical Research Council (mMRC) breathlessness scale; 0-4 (4 - most severe)). Days in the last month affected by breathlessness were reported. Results Of respondents (52% women; mean age 45), mean total disability score was 20.9 (SD 9.5). 42% (n=4245) had mMRC >0 (mMRC1 31% (n=3139); mMRC2 8% (n=806); mMRC3,4 3% (n=300)). Every level of long-term breathlessness limiting exertion was associated with greater levels of disability (total p <0.001; each domain p <0.001). The most compromised domains were Mobility and Participation. In the last 30 days, people with severe breathlessness (mMRC 3-4): experienced disability (20 days); reduced activities/work (10 days); and completely forwent activities (another 5 days). Conclusions Disability should be in the definition of persistent breathlessness as it is systematically associated with long-term breathlessness limiting exertion in a grade-dependent, multidimensional manner. Disability should be assessed in people with long-term breathlessness to optimise their social well-being and health.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Perception of Asthma/Breathlessness, Surveys and Questionnaires
in
BMJ Open Respiratory Research
volume
11
issue
1
article number
e002029
publisher
BMJ Publishing Group
external identifiers
  • scopus:85199547364
  • pmid:39038915
ISSN
2052-4439
DOI
10.1136/bmjresp-2023-002029
language
English
LU publication?
yes
id
e736f779-1a58-4357-a021-6013e836f701
date added to LUP
2024-09-24 14:32:02
date last changed
2024-09-25 03:00:03
@article{e736f779-1a58-4357-a021-6013e836f701,
  abstract     = {{<p>Introduction Disability, resulting from altered interactions between individuals and their environment, is a worldwide issue causing inequities and suffering. Many diseases associated with breathlessness cause disability but the relationship between disability and the severity of breathlessness itself is unknown. This study evaluated associations between disability using the WHO's Disability Assessment Schedule (WHODAS) 2.0 and levels of long-term breathlessness limiting exertion. Methods This population-based, cross-sectional online survey (n=10 033) reflected the most recent national census (2016) by age, sex, state/territory of residence and rurality. Assessments included self-reported disability (WHODAS 2.0 12-item (range 12 (no disability) to 60 (most severe disability)) assessed in 6 domains) and long-term breathlessness limiting exertion (modified Medical Research Council (mMRC) breathlessness scale; 0-4 (4 - most severe)). Days in the last month affected by breathlessness were reported. Results Of respondents (52% women; mean age 45), mean total disability score was 20.9 (SD 9.5). 42% (n=4245) had mMRC &gt;0 (mMRC1 31% (n=3139); mMRC2 8% (n=806); mMRC3,4 3% (n=300)). Every level of long-term breathlessness limiting exertion was associated with greater levels of disability (total p &lt;0.001; each domain p &lt;0.001). The most compromised domains were Mobility and Participation. In the last 30 days, people with severe breathlessness (mMRC 3-4): experienced disability (20 days); reduced activities/work (10 days); and completely forwent activities (another 5 days). Conclusions Disability should be in the definition of persistent breathlessness as it is systematically associated with long-term breathlessness limiting exertion in a grade-dependent, multidimensional manner. Disability should be assessed in people with long-term breathlessness to optimise their social well-being and health.</p>}},
  author       = {{Kochovska, Slavica and Ferreira, Diana and Chang, Sungwon and Brunelli, Vanessa and Morgan, Deidre and Similowski, Thomas and Johnson, Miriam and Ekström, Magnus and Currow, David}},
  issn         = {{2052-4439}},
  keywords     = {{Perception of Asthma/Breathlessness; Surveys and Questionnaires}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open Respiratory Research}},
  title        = {{Disability and long-term breathlessness : A cross-sectional, population study}},
  url          = {{http://dx.doi.org/10.1136/bmjresp-2023-002029}},
  doi          = {{10.1136/bmjresp-2023-002029}},
  volume       = {{11}},
  year         = {{2024}},
}