title: Negative life events and quality of life in adults with asthma.
abstract: BACKGROUND
  The relationship between stress and quality of life in adults with asthma has not been well studied. Stress, quantified by negative life events, may be linked to quality of life in asthma through multiple pathways, including increase in disease severity and adverse effects on socioeconomic status (SES).
  
  
  METHODS
  The responses to a self-completed questionnaire assessing negative life events (NLEs) in the previous 12 months (from a 24-item checklist) among 189 adults with asthma from a well-characterised cohort were analysed. The relationship between the number of NLEs reported and asthma-specific quality of life (AQOL) was measured with the Marks instrument. General linear modelling was used to test the conjoint effects of NLEs, SES and disease severity based on the Severity of Asthma Score, a validated acute and chronic disease measure.
  
  
  RESULTS
  Those with annual family incomes < 60,000 dollars reported significantly more NLEs than those with higher incomes (p = 0.03). The number of NLEs did not differ significantly between those with forced expiratory volume in 1 s <80% predicted and those with >80% predicted, nor among those with lower compared with higher Severity of Asthma Score. The frequency of NLEs was associated with poorer (higher numerical score) AQOL (p = 0.002). When studied together in the same model, combinations of income level and asthma severity (greater or lesser Severity of Asthma Score; p < 0.001) and number of NLEs (p = 0.03) were both significantly associated with AQOL.
  
  
  CONCLUSIONS
  NLEs are associated with quality of life among adults with asthma, especially among those of lower SES. Clinicians should be aware of this relationship, especially in vulnerable patient subsets.
authors.affiliation: Department of Medicine, University of California San Francisco, 350 Parnassus Avenue, Suite 609, San Francisco, CA 94117, USA.
authors.forename: C
authors.initials: C
authors.lastname: Archea
authors.forename: I H
authors.initials: IH
authors.lastname: Yen
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.forename: M D
authors.initials: MD
authors.lastname: Eisner
authors.forename: P P
authors.initials: PP
authors.lastname: Katz
authors.forename: U
authors.initials: U
authors.lastname: Masharani
authors.forename: E H
authors.initials: EH
authors.lastname: Yelin
authors.forename: G
authors.initials: G
authors.lastname: Earnest
authors.forename: P D
authors.initials: PD
authors.lastname: Blanc
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000191:economics / Q000208:ethnology / Q000523:psychology*; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006304:Health Status; D006801:Humans; D007182:Income; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires