Grażyna Dębska, Henryk Mazurek

The aim of this study was to determine the effects of clinical factors, physical activity, and sociodemographic variables on 1-year changes in health-related quality of life (HRQoL) in Polish adolescents and adults with cystic fibrosis (CF). The study included 67 subjects with CF (mean age 21.1±5.1 years; range 14-37 years; 34 males and 33 females). The Cystic Fibrosis Quality of Life Questionnaire was used at baseline and after 1 year. Lung function data, body weight, and body height were extracted from medical records. Clinical assessment was performed with the Shwachman-Kulczycki scale. The highest scores in both HRQoL examinations came from the domains of physical and social functioning, and the lowest from future concerns, body image, and career concerns. No significant changes of Cystic Fibrosis Quality of Life Questionnaire scores were documented over a period of 1 year. Patients with better baseline spirometry results more frequently reported an improvement in the treatment issues (subjects with FEV1 >50% of predicted, P=0.020) and in the career concerns (patients with FVC >50% of predicted, P=0.039). The improvement in the career concerns also depended upon daily physical activity (P=0.024), which was shown to modulate future concerns (P=0.032), along with place of residence and living conditions (P=0.003). Moreover, the time elapsed from the last pulmonary exacerbation was related to the change in social functioning (P=0.026). When planning treatment, attention should be paid to interventions which may improve HRQoL. Systematic chronic therapy improves lung function, related to treatment issues and career concerns. Maintaining good physical condition and activity may positively influence future and career concerns. Special attention must be devoted to patients living in rural areas and enduring difficult living conditions, as they are especially vulnerable to deterioration in future concerns.