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Comorbidity, distress, coping and social support in asthma and allergy
Umeå University, Faculty of Social Sciences, Department of Psychology.ORCID iD: 0000-0003-4045-8748
2015 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Komorbiditet, lidande, hantering och socialt stöd i astma och allergi (Swedish)
Abstract [en]

Asthma and allergies are some of the most common illnesses worldwide that almost everybody will come in contact with. This thesis studied persons with allergic asthma, non-allergic asthma, allergic rhinitis and atopic dermatitis in a population-based sample. At an early stage, these illnesses were regarded as psychosomatic. Over time, as knowledge about asthma/allergy has increased more of a biomedical perspective was taken by the research field. In considering early documentations well as contemporary research, a psychobiosocial perspective was taken in this thesis when conducting the three studies. Thus, as psychological factors may affect the illness and be a result of the illness, it is important to incorporate these factors to better understand asthma and allergy. Study I examined the co- and multimorbidity in asthma/allergy with the environmental intolerances in the form of chemical and building-related intolerance. Study II investigated psychological distress in the four forms of asthma and allergy. Psychological distress was in this study defined as stress, burnout, anxiety, depression and environmental health worries. Study III examined usage of problem and emotion focused coping strategies and perceived social support from the surrounding in high and low asthma/allergy severity. All studies were performed using data from the Västerbotten Environmental Health Study, a questionnaire-based survey with focus on various environmental hypersensitivities and asthma and allergy. The result showed that the co- and multimorbidity with the environmental intolerances in asthma/allergy was larger than what was statistically excepted. Those with allergic asthma and atopic dermatitis experienced more stress, burnout and anxiety than those with non-allergic asthma, allergic rhinitis and non-asthma/allergy. Moreover, the most common way of coping with asthma and allergy was found to be strategies such as avoiding environments that are believed to affect health, and trying to accept the situation, independent of asthma/allergy severity. Finally, in general, those with asthma and allergy reported receiving most support from their partner, other family members and health care, and least support was perceived by those with low asthma/allergy severity.The findings suggest that co- and multimorbidity with environmental intolerances is relatively common in asthma and allergy, and should therefore be included in the clinical anamnesis for this patient group. The elevated level of distress in allergic asthma and atopic dermatitis evokes the question of use of therapies such as mindfulness maybe beneficial in certain afflicted persons. The results on coping and social support provide a foundation for further research regarding informing the asthma/allergy patient and family members about effective coping strategies and the importance of adequate social support. A metaperspective is taken in which interrelations between important variables in the thesis are discussed.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet , 2015. , 62 p.
Keyword [en]
atopy, asthma, allergy, allergic rhinitis, atopic dermatitis, environmental intolerance, chemical intolerance, building intolerance, psychological distress, stress, anxiety, depression, burnout, coping, social support
National Category
Social Sciences
Identifiers
URN: urn:nbn:se:umu:diva-97473ISBN: 978-91-7601-183-6 (print)OAI: oai:DiVA.org:umu-97473DiVA: diva2:773069
Public defence
2015-01-30, Nbvh 1031, Norra Beteendevetarhuset, Umeå Universitet, Umeå, 13:15 (English)
Opponent
Supervisors
Available from: 2015-01-09 Created: 2014-12-18 Last updated: 2015-01-09Bibliographically approved
List of papers
1. Comorbidity and multimorbidity of asthma and allergy and intolerance to chemicals and certain buildings
Open this publication in new window or tab >>Comorbidity and multimorbidity of asthma and allergy and intolerance to chemicals and certain buildings
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2017 (English)In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 59, no 1, 80-84 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: We tested the hypothesis of high comorbidity between asthma/allergy and chemical intolerance (CI) and between asthma/allergy and building intolerance (BI), and high multimorbidity between asthma/allergy, CI, and BI.

Methods: Population-based questionnaire data were used from 530 participants with asthma/allergy (allergic asthma, nonallergic asthma, allergic rhinitis, and/or atopic dermatitis), 414 with self-reported and 112 with physician-diagnosed CI, and 165 with self-reported and 47 with physician-diagnosed BI. Separate reference groups were formed for each of the five case groups.

Results: Adjusted odds ratios varied from 4.6 to 13.1 for comorbidity, and from 6.6 to 46.4 for multimorbidity.

Conclusion: The large comorbidity and multimorbidity between asthma/allergy, CI, and BI evokes the question as to whether there are similarities in underlying mechanisms between these conditions.

Keyword
Allergic asthma, non-allergic asthma, allergic rhinitis, atopic dermatitis, multiple chemical sensitivity, nonspecific building-related symptoms
National Category
Environmental Health and Occupational Health
Identifiers
urn:nbn:se:umu:diva-97469 (URN)10.1097/JOM.0000000000000930 (DOI)000391123100015 ()
Available from: 2014-12-18 Created: 2014-12-18 Last updated: 2017-12-05Bibliographically approved
2. Psychological distress in asthma and allergy: the Västerbotten Environmental Health Study
Open this publication in new window or tab >>Psychological distress in asthma and allergy: the Västerbotten Environmental Health Study
2014 (English)In: Psychology, Health & Medicine, ISSN 1354-8506, E-ISSN 1465-3966, Vol. 19, no 3, 316-323 p.Article in journal (Refereed) Published
Abstract [en]

With the aim to better understand the association between asthma/allergy and psychological distress, it was hypothesized that levels of stress, exhaustion, anxiety, depression, and health worries for environmental pollution would be higher in allergic asthma, allergic rhinitis, and atopic dermatitis than in non-allergic asthma and in referents without asthma or allergy. Taking part in the population-based Vasterbotten Environmental Health Study (aged 18-79years), 76 respondents reported a physician-based diagnosis of allergic asthma, 86 reported non-allergic asthma, 190 reported allergic rhinitis, and 46 reported atopic dermatitis as the only form of asthma/allergy. A group of 2876 respondents without an asthma/allergy diagnosis constituted as referents. The participants responded to the Perceived Stress Scale, the Shirom-Melamed Burnout Questionnaire, the Hospital Anxiety and Depression Scale, and the Environmental Pollution subscale of the Modern Health Worries Scale. Levels of stress, exhaustion, and anxiety were higher in allergic asthma and atopic dermatitis than in non-allergic asthma, allergic rhinitis, and among referents, and there was a strong tendency of such group differences for depression and health worries. The results imply that stress reduction and treatment of negative affect may in certain cases be fruitful interventions in patients with atopy.

Keyword
anxiety, burnout, depression, stress, worry
National Category
Psychology
Identifiers
urn:nbn:se:umu:diva-90071 (URN)10.1080/13548506.2013.806814 (DOI)000331864200008 ()
Available from: 2014-06-23 Created: 2014-06-17 Last updated: 2017-12-05Bibliographically approved
3. Coping and Social Support in Asthma and Allergy: The Västerbotten Environmental Health Study
Open this publication in new window or tab >>Coping and Social Support in Asthma and Allergy: The Västerbotten Environmental Health Study
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2015 (English)In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 52, no 6, 622-629 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: Asthma and allergy are stressful conditions that require coping strategies and social support to reduce stress and enhance health-promoting behavior. However, research is limited regarding coping and social support in asthma and allergy. The aim was to better understand use of different coping strategies and perceived social support in low and high severity (exacerbation frequency) of asthma and allergy. Methods: Population-based data were used to provide ratings of coping strategies (Study I) and social support (Study II) from 124 and 94 participants, respectively, with asthma and/or allergy, categorized as low or high in severity. Problem- and emotion-focused coping strategies were assessed as well as emotional, instrumental and informative social support from seven sources. Results: Study I showed that avoiding certain environments (problem-based coping) and trying to accept one’s situation (emotion-based) were the most commonly used coping strategies. These behaviors did not differ due to severity. Study II showed that more emotional than instrumental and informative support was perceived. The highest rated support sources were the partner, family members, and the healthcare system. More social support was reported in low compared to high asthma/allergy severity. Conclusion: The most commonly used coping strategies in the population of persons with these four types of asthma and allergy are avoiding certain environments and trying to accept one’s situation. More emotional support than instrumental and informative is perceived to be received, and most of the support is received from one’s partner and other family members, and least from authorities and patient associations/support groups.

Place, publisher, year, edition, pages
Taylor & Francis, 2015
Keyword
allergic rhinitis, atopic dermatitis, atopy, quality of life, epidemiology
National Category
Respiratory Medicine and Allergy Public Health, Global Health, Social Medicine and Epidemiology Psychology
Identifiers
urn:nbn:se:umu:diva-97461 (URN)10.3109/02770903.2014.991970 (DOI)000361339000015 ()
Available from: 2014-12-18 Created: 2014-12-18 Last updated: 2017-12-05Bibliographically approved

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