Addressing Barriers to Chronic Obstructive Pulmonary Disease (COPD) Care: Three Innovative Evidence-Based Approaches: A Review.

Chronic obstructive pulmonary disease (COPD) is a preventable yet widespread and profoundly debilitating respiratory condition, exerting substantial personal and global health ramifications alongside significant economic implications. The first objective of this literature review was to identify reviews the barriers to optimal COPD care, categorizing them into personal patient factors, professional awareness and knowledge, patient-professional relationships, and healthcare service models, including access to care that significantly impacts the quality of COPD management. The second objective was to introduce three approaches for enhancing COPD care outcomes: Self-Management Educational Programs, Health Qigong, and Telehealth service provision, each demonstrating positive effects on COPD patients' health status. These evidence-based interventions offer promising avenues for enhancing COPD care and patient outcomes. Integrating these approaches into comprehensive COPD management strategies holds potential for improving the well-being and quality of life of individuals living with this chronic condition.

The Manchester Respiratory Activities of Daily Living Questionnaire: Reliability and Validity of the Chinese Version with Pictorial Enhancement.

BACKGROUND: The Manchester Respiratory Activities of Daily Living Questionnaire (MRADLQ) is a valid and reliable tool measuring the functional level of patients with COPD in multidimensional aspects. However, a local validation of the questionnaire is lacking in Hong Kong. OBJECTIVE: To develop a Chinese version of MRADLQ with pictorial enhancement (C-MRADLQ) and study its reliability and validity. PATIENTS AND METHODS: A total of 238 patients suffering from COPD were recruited from nine public hospitals and five Nurse and Allied Health Respiratory Clinics by convenient sampling. A total of 64 patients with normal spirometry results and no previous clinical diagnosis of COPD were invited to complete the C-MRADLQ for comparison and examination of its validity. Ten out of 302 patients were re-assessed with the C-MRADLQ after one week by the same rater for test-retest reliability. The C-MRADLQ was correlated with spirometry result, COPD classifications and groups by Global Initiative for Chronic Obstructive Lung Disease (GOLD), the modified Medical Research Council Dyspnea Scale (mMRC Dyspnea Scale), COPD Assessment Test (CAT), Chinese Version of the Shortness of Breath Questionnaire (C-SOBQ), number of admission and the ADO index. RESULTS: The C-MRADLQ shows good test-retest reliability as indicated by an intra-class correlation coefficient value of 0.975. It is significantly correlated with COPD stage, COPD group, SOBQ score, CAT score, mMRC, ADO index, spirometry results, and number of admissions. The SOBQ score, number of admissions, FEV1/FVC, and COPD group could significantly predict the total C-MRADLQ score. A total of 67.9% of participants' mMRC levels were correctly classified by using the C-MRADLQ total score. The agreement of the original and new versions of questions 20 and 21 of C-MRADLQ was 97.3% and 90.1%, respectively. CONCLUSION: The pictorial version of the C-MRADLQ is a validated and reliable functional assessment tool to measure functional status among patients with COPD in the Chinese population.

Computer products usage and prevalence of computer related musculoskeletal discomfort among adolescents.

The objective of this study was to investigate the pattern of computer related activities among Hong Kong adolescents and the prevalence of musculoskeletal discomfort by anatomic sites. This study used a questionnaire-based cross-sectional design. Students from Year 1 to 7 of six local high schools were invited to complete a Student Musculoskeletal Health Questionnaire and Computer Usage Questionnaire. Complete data for 3,191 questionnaires was obtained, giving an overall response rate of 95.5%. High prevalence (68.3%) of musculoskeletal discomfort related to using computer was reported among Hong Kong children and adolescents in the past 12 months. Shoulder (37.7%) and neck (35.0%) were the most frequently involved body parts for both genders, while female students reported higher rates of musculoskeletal discomfort in each of the specified anatomic site than male students. Students who reported musculoskeletal discomfort were significantly older and spent a longer time on computer related activities. The associations found in this cross-sectional study should be confirmed by subsequent longitudinal studies. An urgent need in healthy computing environment is demanded among Hong Kong adolescents.