The relationship between perceived stress and morbidity among adult inner-city asthmatics

Juan P. Wisnivesky, Jessica Lorenzo, Jonathan M. Feldman, Ethan A. Halm

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background. Psychological stress has been linked in some studies to asthma prevalence and outcomes in children. The authors sought to evaluate the relationship between perceived stress and morbidity among inner-city adults with asthma. Methods. The authors interviewed a prospective cohort of 326 moderate-to-severe asthmatics receiving care at two large, urban, hospital-based general medicine clinics in New York City and New Jersey. Psychological stress was assessed at baseline using the Perceived Stress Scale (PSS), a validated 4-item instrument. Outcomes included the Asthma Control Questionnaire (ACQ), the Asthma Quality of Life Questionnaire (AQLQ), and the Medication Adherence Reporting Scale (MARS) measured at baseline, 1, 3, and 12 months of enrollment. Results. Higher perceived stress was significantly correlated with worse asthma control (ACQ scores; r=.30 to -.37, p < .0001), poor quality of life (AQLQ scores; r=-.49 to - .35, p < .0001), and decreased medication adherence (MARS scores; r=-.25 to -.15, p < .028) at baseline and across the follow-up interviews. In multivariate analyses, increased stress remained a significant predictor of worse ACQ (p < .0001), AQLQ scores (p < .0001), and MARS (p < .0001) after adjusting for age, sex, income, number of years with asthma, and comorbidities. Conclusions. Among inner-city asthmatics, higher perceived stress is strongly associated with increased asthma morbidity across a 1-year follow-up. Further research is needed to identify mechanisms mediating the association between stress and asthma morbidity in adults.

Original languageEnglish (US)
Pages (from-to)100-104
Number of pages5
JournalJournal of Asthma
Volume47
Issue number1
DOIs
StatePublished - Feb 12 2010

Fingerprint

Asthma
Morbidity
Medication Adherence
Quality of Life
Psychological Stress
Urban Hospitals
Surveys and Questionnaires
Comorbidity
Multivariate Analysis
Medicine
Interviews
Research

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy

Keywords

  • Asthma control
  • Asthma morbidity
  • Asthma quality of life
  • Medication adherence
  • Perceived stress

Cite this

Wisnivesky, Juan P. ; Lorenzo, Jessica ; Feldman, Jonathan M. ; Halm, Ethan A. / The relationship between perceived stress and morbidity among adult inner-city asthmatics. In: Journal of Asthma. 2010 ; Vol. 47, No. 1. pp. 100-104.
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The relationship between perceived stress and morbidity among adult inner-city asthmatics. / Wisnivesky, Juan P.; Lorenzo, Jessica; Feldman, Jonathan M.; Halm, Ethan A.

In: Journal of Asthma, Vol. 47, No. 1, 12.02.2010, p. 100-104.

Research output: Contribution to journalArticle

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AB - Background. Psychological stress has been linked in some studies to asthma prevalence and outcomes in children. The authors sought to evaluate the relationship between perceived stress and morbidity among inner-city adults with asthma. Methods. The authors interviewed a prospective cohort of 326 moderate-to-severe asthmatics receiving care at two large, urban, hospital-based general medicine clinics in New York City and New Jersey. Psychological stress was assessed at baseline using the Perceived Stress Scale (PSS), a validated 4-item instrument. Outcomes included the Asthma Control Questionnaire (ACQ), the Asthma Quality of Life Questionnaire (AQLQ), and the Medication Adherence Reporting Scale (MARS) measured at baseline, 1, 3, and 12 months of enrollment. Results. Higher perceived stress was significantly correlated with worse asthma control (ACQ scores; r=.30 to -.37, p < .0001), poor quality of life (AQLQ scores; r=-.49 to - .35, p < .0001), and decreased medication adherence (MARS scores; r=-.25 to -.15, p < .028) at baseline and across the follow-up interviews. In multivariate analyses, increased stress remained a significant predictor of worse ACQ (p < .0001), AQLQ scores (p < .0001), and MARS (p < .0001) after adjusting for age, sex, income, number of years with asthma, and comorbidities. Conclusions. Among inner-city asthmatics, higher perceived stress is strongly associated with increased asthma morbidity across a 1-year follow-up. Further research is needed to identify mechanisms mediating the association between stress and asthma morbidity in adults.

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