The Science Journal of the American Association for Respiratory Care

2005 OPEN FORUM Abstracts

Measurement of the Health-related Quality of Life IN Adults Recovering from SEVERE ACUTE RESPIRATORY SYNDROME

Fiona Ng, RN, MN Continuous Quality Improvement Unit, Queen Elizabeth Hospital Hong Kong SAR of China

Background: Severe acute respiratory syndrome (SARS) is a new disease that has been associated with significant morbidity and mortality. It is not surprising that patients recovered from SARS could suffer from impaired health-related quality of life (HRQoL). To date, very little is known about the HRQoL of recovered SARS adults although the clinical outcomes have been explored and discussed world widely. More indicators are needed to provide quality patient-centered care.

Objective:
To assess the profiles of HRQoL of recovered SARS patients at 3 days and 6 months after their discharge.

Method: Recovered SARS adults were interviewed at 3 days and 6 months after discharge in a pulmonary rehabilitation clinic. After obtaining written consents, their HRQoL scores were measured by the validated Medical Outcomes Study 36-item Short Form (MOS SF-36) Health Survey. Independent two-tailed t-tests were used to compare the mean scores of SF-36. Changes in the mean differences of SF-36 scores were calculated for the period of post-discharge Day 3 to the 6-month follow-up. Data at 6-month post-discharge were compared with published normative values.

Results:
Fifty-eight recovered SARS adults were recruited. During the study period, significant improvement was only observed in social functioning (p< 0.05). Paradoxically, three domains showed significant worsening with time, namely bodily pain (p< 0.01), general health (p< 0.05) and mental health (p< 0.05). At 6-month post-discharge, patients who required mechanical ventilation during the SARS illness had significant improvements in physical functioning, role-physical, vitality and role-emotional (p< 0.05) than those without. Those subjects who subsequently diagnosed with avascular necrosis (AVN) of bone revealed significant worsening in bodily pain when compared to those without (p< 0.05). When compared with published normative data, all domains of SF-36 at the 6-month follow-up were significantly worse than the Hong Kong general population.

Conclusion:
Significant improvement in HRQoL scores at 6 month post-discharge was only seen in social functioning, whereas significant deterioration was noted in domains of bodily pain, general and mental health. On the whole, recovered SARS adults described a low level of perceived HRQoL at 6 months after discharge. This might be associated with the traumatic experiences during isolation, drug treatment and intensive care during hospitalization. Uncertain future sequalae of the disease or treatment (such as AVN) and stigmatization might also contribute.

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