Quality of life in patients with chronic obstructive pulmonary disease: the predictive validity of the BODE index.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is currently the fourth cause of mortality and morbility in the developed world. Patients with COPD experience a progressive deterioration of health-related quality of life (HRQOL). A new model of severity classification, the body mass index, bronchial obstruction, dyspnoea, exercise (BODE) index, has recently been proposed. OBJECTIVE: To evaluate the relationship between HRQOL and the BODE index, and the predictive ability of BODE on HRQOL measurements. METHODS: Two HRQOL questionnaires were administered, namely the Nottingham Health Profile (NHP) and St George's Respiratory Questionnaire (SGRQ), in a sample of 67 patients with severe COPD. RESULTS: Pearsons correlation coefficient analysis shows a positive correlation between the BODE index and the total scores of the specific (P < 0.001), and general HRQOL (P < 0.001); the analysis shows a significant correlation between the BODE index and the subscales of symptoms, activity and impact of SGRQ (P < 0.001) and the subscales energy and physical mobility of the NHP (P < 0.001). The regression analysis shows that the BODE index is a significant predictor of HRQOL, explaining 46,1% of the total score of the SGRQ (P < 0.001) and 14.8% of the total score of the NHP (P < 0.001). CONCLUSIONS: The BODE index is good at predicting the worsening of HRQOL in patients with severe COPD.

[Functional health patterns and nursing diagnosis in intensive care units]. / Patrones funcionales de salud y diagnósticos de enfermería en las unidades de medicina intensiva.

The evaluation of the critically ill patient to develop a suitable care plan is one of the main objectives of the practices of Medico-Surgery for students of third year of the nursing degree. So as to be able to detect all the needs in the patients and settle priorities in their care we have carried out a physical evaluation and the 11 health functional patterns of Gordon (1982), which has allowed us to formulate the most frequent diagnosis of nursing in the patients hospitalized in the Intensive Care Units of the Hospital Son Dureta of Palma de Mallorca. The collection of data for the evaluation of the patterns of autoperception, adaptation to stress and to the family, has been scarce due to the critical situation of the patient and the tendency of nursing professionals to register the evaluation data which indicate alterations of the physical condition of the patient. The incapacity for self-care and the risk for infection have been the nursing diagnosis which all the patients of this study have shown.