title: Assessment of health-related quality of life in end-stage chronic obstructive pulmonary disease and non-small-cell lung cancer patients in Serbia.
abstract: OBJECTIVE
  Under conditions in which palliative care has not yet become part of clinical practice, the differences in palliative care needs between patients with cancer and other life-limiting diseases can yield knowledge that will be very valuable for future planning. The aim of our investigation was to compare health-related quality of life (HRQoL) for patients with end-stage chronic obstructive pulmonary disease (COPD) and those with non-small-cell lung cancer (NSCLC) in Belgrade, Serbia. We also evaluated the influence of demographic, socioeconomic, and clinical factors on HRQoL for both patient groups.
  
  
  METHODS
  This cross-sectional study included 100 NSCLC patients (stages IIIb and IV) and 100 patients with stage IV COPD. Measures included the SF-36 questionnaire, the EORTC QLQ-C30, the St. George's Respiratory Questionnaire, and the Beck Depression Inventory (BDI). Associations of demographic, socioeconomic, and clinical factors with QoL were examined using linear regression analyses.
  
  
  RESULTS
  The COPD group scored significantly lower compared to NSCLC patients in all SF-36 domains except for bodily pain. Additionally, a significantly higher level of depressive symptoms was observed in COPD patients. A worse physical QoL for COPD patients was independently associated with a longer duration of unemployment, a lack of wage earning, lower Karnofsky Performance Status (KPS) scores, and higher levels of depression. A worse mental QoL for COPD patients was related to a longer duration of disease, poorer KPS scores, and higher BDI scores. The independent variables significantly associated with worse physical and mental QoL of NSCLC patients were lower KPS and higher BDI scores.
  
  
  CONCLUSIONS
  A worse QoL, a significantly higher level of depressive symptoms, and adverse socioeconomic status in the COPD group imposes the need for development of more intensive psychosocial and community support for COPD patients during implementation of palliative care.
authors.affiliation: Clinic of Pulmonology,Clinical Center of Serbia,Belgrade,Serbia.
authors.forename: Dragana
authors.initials: D
authors.lastname: Maric
authors.affiliation: Clinic of Pulmonology,Clinical Center of Serbia,Belgrade,Serbia.
authors.forename: Dragana
authors.initials: D
authors.lastname: Jovanovic
authors.affiliation: Clinic of Pulmonology,Clinical Center of Serbia,Belgrade,Serbia.
authors.forename: Ljudmila
authors.initials: L
authors.lastname: Nagorni-Obradovic
authors.affiliation: Clinic of Pulmonology,Clinical Center of Serbia,Belgrade,Serbia.
authors.forename: Mihailo
authors.initials: M
authors.lastname: Stjepanovic
authors.affiliation: Institute of Epidemiology,Faculty of Medicine,University of Belgrade,Belgrade,Serbia.
authors.forename: Darija
authors.initials: D
authors.lastname: Kisic-Tepavcevic
authors.affiliation: Institute of Epidemiology,Faculty of Medicine,University of Belgrade,Belgrade,Serbia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Pekmezovic
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D055771:Serbia; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*
keywords: COPD; Depression; Lung cancer; Quality of life (QoL); Socioeconomic status