- Title
- Anxiety and depression in severe asthma
- Creator
- Stubbs, Michelle Anne
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2022
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: In severe asthma, anxiety and depression are commonly associated comorbidities resulting in an increased disease burden and decreased quality of life. Much remains unknown about symptoms of anxiety or depression and the impact of their occurrence in people with severe asthma. Further knowledge is required regarding how the presence of these psychological symptoms impact severe asthma outcomes, and whether they are associated with other asthma related characteristics and comorbidities. Investigating associations will allow for effective and tailored management in individuals with severe asthma. Along with inadequate knowledge of the impact of associated comorbidities in severe asthma, the perspectives of people with severe asthma concerning their experience of living with, and their emotional image of severe asthma alone, and with symptoms of anxiety and depression. Addressing this gap will increase the level of knowledge held by clinicians. Furthermore, understanding the experience of living with both severe asthma and symptoms of anxiety or depression, or the combination of both, is an important step towards understanding what is desired in a model of care for the management of these psychological symptoms in the context of severe asthma care. Investigating appropriate interventions people with severe asthma can engage in to decrease symptoms of anxiety and depression is also necessary. This will afford the development of a model of care in the treatment of symptoms of anxiety and/or depression in severe asthma. Lastly, due to the evolving and ongoing circumstances of the COVID-19 pandemic, exploration of the experience of people living with severe asthma and symptoms of anxiety and depression is warranted as these times are unprecedented. An understanding of this experience will help in the provision of assessment and treatment of severe asthma, anxiety and depression in pandemic times and is an important consideration for holistic severe asthma management. Methods: In this Thesis, I used quantitative methods to determine clinical characteristics associated with anxiety and/or depressive symptoms in severe asthma (Chapter 3). Further, I used an arts-based methodology to (i) explore the experiences of adults with severe asthma living with severe asthma, both with and without symptoms of depression and/or anxiety and (ii) compare characteristics depicted in artworks between those with self-reported psychological symptoms and those without psychological symptom (Chapter 4). I then used qualitative cross- sectional descriptive studies to (i) seek an understanding of the key components of a model of care for the management of psychological symptoms in conjunction with severe asthma care (Chapter 5) and (ii) to examine the experience of people with severe asthma and comorbid symptoms of anxiety and depression during the COVID-19 pandemic (Chapter 6). Results: The findings of this Thesis highlight (via a quantitative cross-sectional method) that people with severe asthma and anxiety and/or depressive symptoms have poorer quality of life (QoL) and asthma control. Dyspnoea, dysfunctional breathing and obesity are associated with these psychological symptoms. The Thesis findings also highlight arts-based research (by way of arts-based activity) in severe asthma facilitates exploration of individual experiences of living with severe asthma, with, themes associated with ‘darkness’, ‘impacts’ and ‘resilience’ emerged from artworks created by participants. The Thesis findings also emphasise (via qualitative descriptive semi-structured interviews) that people with severe asthma and coexisting symptoms of anxiety and/or depression desire nonpharmacological interventions that improve overall quality of life. Interventions are preferably delivered face-to-face on a weekly ongoing basis for a duration of one hour. Support groups, yoga, meditation and breathing exercises/techniques were most desired. Furthermore, during COVID-19 pandemic times, people with severe asthma and symptoms of anxiety and/or depression experience a decline in mental health and increased isolation. During the lockdown period preoccupation with emotions including fear and worry is also experienced. Additionally, fear of death was a major concern. Conclusion: Overall, the Thesis findings indicate that symptoms of anxiety and/or depression in people with severe asthma are problematic and should be routinely assessed in severe asthma clinics using the multidimensional assessment and managed using the treatable traits approach.
- Subject
- severe asthma; anxiety; depression; quality of life; COVID-19; model of care; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1504768
- Identifier
- uon:55571
- Rights
- Copyright 2022 Michelle Anne Stubbs
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 58 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 257 KB | Adobe Acrobat PDF | View Details Download |