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The influence of social support on COPD outcomes mediated by depression

BACKGROUND: The purpose of this study was to explore the association between perceived social support and COPD outcomes and to determine whether the associations are mediated by depressive symptoms. METHODS: Subjects with COPD who were enrolled as part of SPIROMICS were included in this analysis. Qu...

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Autores principales: Turnier, Leonard, Eakin, Michelle, Woo, Han, Dransfield, Mark, Parekh, Trisha, Krishnan, Jerry A., Kanner, Richard, Cooper, Christopher B., Woodruff, Prescott G., Wise, Robert, Han, MeiLan K., Romero, Karina, Paulin, Laura M., Peters, Stephen, Drummond, Brad, Bleecker, Eugene R., Bowler, Russell, Comellas, Alejandro P., Couper, David, Paine, Robert, Martinez, Fernando, Barr, Graham, Putcha, Nirupama, Hansel, Nadia N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7968645/
https://www.ncbi.nlm.nih.gov/pubmed/33730034
http://dx.doi.org/10.1371/journal.pone.0245478
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author Turnier, Leonard
Eakin, Michelle
Woo, Han
Dransfield, Mark
Parekh, Trisha
Krishnan, Jerry A.
Kanner, Richard
Cooper, Christopher B.
Woodruff, Prescott G.
Wise, Robert
Han, MeiLan K.
Romero, Karina
Paulin, Laura M.
Peters, Stephen
Drummond, Brad
Bleecker, Eugene R.
Bowler, Russell
Comellas, Alejandro P.
Couper, David
Paine, Robert
Martinez, Fernando
Barr, Graham
Putcha, Nirupama
Hansel, Nadia N.
author_facet Turnier, Leonard
Eakin, Michelle
Woo, Han
Dransfield, Mark
Parekh, Trisha
Krishnan, Jerry A.
Kanner, Richard
Cooper, Christopher B.
Woodruff, Prescott G.
Wise, Robert
Han, MeiLan K.
Romero, Karina
Paulin, Laura M.
Peters, Stephen
Drummond, Brad
Bleecker, Eugene R.
Bowler, Russell
Comellas, Alejandro P.
Couper, David
Paine, Robert
Martinez, Fernando
Barr, Graham
Putcha, Nirupama
Hansel, Nadia N.
author_sort Turnier, Leonard
collection PubMed
description BACKGROUND: The purpose of this study was to explore the association between perceived social support and COPD outcomes and to determine whether the associations are mediated by depressive symptoms. METHODS: Subjects with COPD who were enrolled as part of SPIROMICS were included in this analysis. Questionnaires relating to quality of life, symptom burden, and functional status were administered at annual clinic visits for over a 3 year period. In both cross-sectional and longitudinal analyses, we examined the association of social support as measured by the FACIT-F with COPD outcomes. Cross sectional analyses used multivariable linear or logistic regression, adjusting for covariates. For longitudinal analyses, generalized linear mixed models with random intercepts were used. Models were adjusted with and without depressive symptoms and mediation analyses performed. RESULTS: Of the 1831 subjects with COPD, 1779 completed the FACIT- F questionnaire. In adjusted cross-sectional analysis without depressive symptoms, higher perceived social support was associated with better quality of life, well-being, 6 minute walk distance, and less dyspnea. When also adjusting for depressive symptoms, all associations between social support and COPD outcomes were attenuated and no longer statistically significant. Mediation analysis suggested that depressive symptoms explained the majority (> = 85%) of the association between social support and measured COPD outcomes. Results of the longitudinal analysis were consistent with the cross-sectional analyses. There was no association between social support and odds of exacerbations. CONCLUSION: Higher social support was associated with better COPD outcomes across several measures of morbidity including quality of life, respiratory symptoms, and functional status. In addition, these associations were largely attenuated when accounting for depressive symptoms suggesting that the beneficial association of social support with COPD outcomes may be largely mediated by the association between social support and depression. TRIAL REGISTRATION: SPIROMICS was approved by Institutional Review Boards at each center and all participants provided written informed consent (clinicaltrials.gov: NCT01969344).
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spelling pubmed-79686452021-03-31 The influence of social support on COPD outcomes mediated by depression Turnier, Leonard Eakin, Michelle Woo, Han Dransfield, Mark Parekh, Trisha Krishnan, Jerry A. Kanner, Richard Cooper, Christopher B. Woodruff, Prescott G. Wise, Robert Han, MeiLan K. Romero, Karina Paulin, Laura M. Peters, Stephen Drummond, Brad Bleecker, Eugene R. Bowler, Russell Comellas, Alejandro P. Couper, David Paine, Robert Martinez, Fernando Barr, Graham Putcha, Nirupama Hansel, Nadia N. PLoS One Research Article BACKGROUND: The purpose of this study was to explore the association between perceived social support and COPD outcomes and to determine whether the associations are mediated by depressive symptoms. METHODS: Subjects with COPD who were enrolled as part of SPIROMICS were included in this analysis. Questionnaires relating to quality of life, symptom burden, and functional status were administered at annual clinic visits for over a 3 year period. In both cross-sectional and longitudinal analyses, we examined the association of social support as measured by the FACIT-F with COPD outcomes. Cross sectional analyses used multivariable linear or logistic regression, adjusting for covariates. For longitudinal analyses, generalized linear mixed models with random intercepts were used. Models were adjusted with and without depressive symptoms and mediation analyses performed. RESULTS: Of the 1831 subjects with COPD, 1779 completed the FACIT- F questionnaire. In adjusted cross-sectional analysis without depressive symptoms, higher perceived social support was associated with better quality of life, well-being, 6 minute walk distance, and less dyspnea. When also adjusting for depressive symptoms, all associations between social support and COPD outcomes were attenuated and no longer statistically significant. Mediation analysis suggested that depressive symptoms explained the majority (> = 85%) of the association between social support and measured COPD outcomes. Results of the longitudinal analysis were consistent with the cross-sectional analyses. There was no association between social support and odds of exacerbations. CONCLUSION: Higher social support was associated with better COPD outcomes across several measures of morbidity including quality of life, respiratory symptoms, and functional status. In addition, these associations were largely attenuated when accounting for depressive symptoms suggesting that the beneficial association of social support with COPD outcomes may be largely mediated by the association between social support and depression. TRIAL REGISTRATION: SPIROMICS was approved by Institutional Review Boards at each center and all participants provided written informed consent (clinicaltrials.gov: NCT01969344). Public Library of Science 2021-03-17 /pmc/articles/PMC7968645/ /pubmed/33730034 http://dx.doi.org/10.1371/journal.pone.0245478 Text en © 2021 Turnier et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Turnier, Leonard
Eakin, Michelle
Woo, Han
Dransfield, Mark
Parekh, Trisha
Krishnan, Jerry A.
Kanner, Richard
Cooper, Christopher B.
Woodruff, Prescott G.
Wise, Robert
Han, MeiLan K.
Romero, Karina
Paulin, Laura M.
Peters, Stephen
Drummond, Brad
Bleecker, Eugene R.
Bowler, Russell
Comellas, Alejandro P.
Couper, David
Paine, Robert
Martinez, Fernando
Barr, Graham
Putcha, Nirupama
Hansel, Nadia N.
The influence of social support on COPD outcomes mediated by depression
title The influence of social support on COPD outcomes mediated by depression
title_full The influence of social support on COPD outcomes mediated by depression
title_fullStr The influence of social support on COPD outcomes mediated by depression
title_full_unstemmed The influence of social support on COPD outcomes mediated by depression
title_short The influence of social support on COPD outcomes mediated by depression
title_sort influence of social support on copd outcomes mediated by depression
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7968645/
https://www.ncbi.nlm.nih.gov/pubmed/33730034
http://dx.doi.org/10.1371/journal.pone.0245478
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