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1.
Orv Hetil ; 162(1): 23-30, 2021 01 03.
Artigo em Húngaro | MEDLINE | ID: mdl-33388735

RESUMO

Összefoglaló. Bevezetés: Civilizált világunk, miközben látszólag túltáplált, ómega-3-hiányban szenved. A hosszú szénláncú, többszörösen telítetlen zsírsavak számos anyagcsere-megbetegedés (például elhízás, 2-es típusú diabetes mellitus, szív- és érrendszeri megbetegedések) kialakulásában játszhatnak szerepet. A halolajban lévo zsírsavak erosítik az immunrendszert, csökkentik a koleszterin- és trigliceridszintet, csökkentik a gyulladást. Célkituzés: Vizsgálatunk célja a többszörösen telítetlen zsírsavak bevitelének monitorozása, valamint a tüdofunkcióval és az életminoséggel való kapcsolatuk értékelése krónikus obstruktív tüdobetegségben (COPD). Módszer: Kérdoívünket az Országos Korányi Pulmonológiai Intézet Légzésrehabilitációs Osztályán, 2019. március 1. és 2020. március 1. között 40 év feletti COPD-s betegek körében vettük fel. Az életminoség mérésére a betegségspecifikus Szent György Légzési Kérdoívet alkalmaztuk, a légzésfunkciós és antropometriai adatokat az egészségügyi elektronikus nyilvántartási rendszerbol nyertük ki. Eredmények: A betegek medián életkora 66 (IQR 60-73) év volt, a nemek közötti megoszlást tekintve 47,5% férfi és 52,5% no. A medián BMI 26,0 (IQR 21,7-30,6) kg/m2, a FEV1 (ref%) 48,0 (IQR 38,1-55,3) volt. Az ómega-3 zsírsavakat a betegek 4,7%-a (n = 19) szedi rendszeresen, elsosorban kezeloorvosa javaslatára, a javasolt napi dózisban (0,25-0,50 g/nap). Esetükben jobb életminoséget tapasztaltunk (65,8 [52,4-79,7] vs. 72,2 [56,2-88,6]; p = 0,044), kevesebb társbetegséggel rendelkeztek (hypertonia: 10 [52,6%] vs. 275 [72,1%]; p = 0,066), kevesebb gyógyszert használtak (gyors hatású béta-2-agonista: 5 [25,3%] vs. 197 [51,7%]; p = 0,031), alacsonyabb volt a fellángolások száma (1 [1-3] vs. 2 [1-4]; p = 0,029), és nagyobb volt a 6 perces sétatávolság (300 [177-387] vs. 251 [150-345]; p = 0,121). Következtetés: Eredményeink arra utalnak, hogy a többszörösen telítetlen zsírsavak bevitele összefüggésben lehet az életminoséggel COPD-s betegekben. Vizsgálatunk szerint a betegek ómega-3-bevitele nem kielégíto - eredményeink alapján szeretnénk felhívni a figyelmet e zsírok fogyasztásának fontosságára. Orv Hetil. 2021; 162(1): 23-30. INTRODUCTION: Our civilized world, while seems to be overweight, suffers from omega-3 deficiency. Long-chain polyunsaturated fatty acids can play a role in the development of many metabolic diseases (e.g., obesity, type 2 diabetes mellitus, cardiovascular disease). Fatty acids in fish oil strengthen the immune system, reduce cholesterol and triglyceride levels, have been proven to be beneficial, reduce inflammation. OBJECTIVE: The aim of our study was to monitor the intake of polyunsaturated fatty acids and to evaluate their relationship with lung function and quality of life in patients with chronic obstructive pulmonary disease (COPD). METHOD: Our questionnaire was completed at the Department of Pulmonary Rehabilitation of the National Koranyi Institute for Pulmonology between March 1, 2019 and March 1, 2020 among COPD patients over 40 years of age. We used the disease-specific St. George's Respiratory Questionnaire to measure the quality of life; the respiratory function and anthropometric data were extracted from the electronic health record system. RESULTS: The median age of the patients was 66 (IQR 60-73) years, with a gender division of 47.5% male and 52.5% female. The median BMI was 26.0 (IQR 21.7-30.6) kg/m2, and the median FEV1 (%pred) was 48.0 (IQR 38.1-55.3). In the form of a dietary supplement, 4.7% (n = 19) of patients take omega-3 fatty acids regularly, mainly on the recommendation of their doctor, at the recommended daily dose (0.25-0.50 g/day). Among them, we detected a better quality of life (65.8 [52.4-79.7] vs. 72.2 [56.2-88.6]; p = 0.044), had fewer comorbidities (hypertension: 10 [52.6%] vs. 275 [72.1%]; p = 0.066), consumed fewer drugs (short-acting bronchodilators: 5 [25.3%] vs. 197 [51.7%]; p = 0.031), had fewer exacerbations (1 [1-3] vs. 2 [1-4]; p = 0.029), and higher six-minute walking distance (300 [177-387] vs. 251 [150-345]; p = 0.121). CONCLUSION: Our results suggest that the intake of polyunsaturated fatty acids may be related to the quality of life in COPD patients. According to our study, the intake of omega-3 in patients is unsatisfactory, and based on our results, we would like to draw attention to the importance of consuming these fats. Orv Hetil. 2021; 162(1): 23-30.


Assuntos
Ácidos Graxos Ômega-3/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Qualidade de Vida , Adulto , Idoso , Suplementos Nutricionais , Ácidos Graxos Ômega-3/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/psicologia , Resultado do Tratamento
2.
Ann Agric Environ Med ; 27(4): 689-694, 2020 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-33356079

RESUMO

INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD) is a condition that affects over 2 million adults in Poland. In recent years, increasing attention has been focused on improving the quality of life of patients with COPD, which includes alleviating their physical discomfort and relates to their mental health. It is therefore critically important to evaluate research tools that can accurately assess the relationship between the physical and mental health of patients with this disease. OBJECTIVE: This aim of the study is to evaluate the relationship between the COPD Assessment Test (CAT) and the Distress Thermometer and Problem List results in COPD patients. MATERIAL AND METHODS: The research evaluated 70 patients with COPD as defined by the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) criteria. Demographic data was obtained at baseline. Disease-specific quality of life was assessed using the CAT score, while overall distress was determined using the Distress Thermometer (DT) scale and a modified Problem List. The relationship between the CAT scores and the results of the Distress Thermometer and Problem List was statistically compared. The study was approved by the Bioethics Committee, and all patients provided written informed consent. RESULTS: The mean ± SD age was 69.6±9.05 (range 47-90) years. The average distress level was 4.09±1.95. A significant relationship was established between the CAT score and the results of the Distress Thermometer Scale (p<0.001); patients with higher CAT scores showed the highest level of distress. CONCLUSIONS: CAT was shown to be a simple, fast and clear measurement of disease-specific quality of life and was correlated with levels of distress in patients with COPD. Every patient with COPD should be evaluated using a scale such as the DT to measure their level of psychological distress.


Assuntos
Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida/psicologia , Termômetros/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Doença Pulmonar Obstrutiva Crônica/etiologia
3.
Rev Mal Respir ; 37(9): 699-709, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33071062

RESUMO

BACKGROUND: There is no validated Arabic version of the French questionnaire of quality of life, the VQ11. This study aimed to test the applicability of the Arabic version of the VQ11 in Tunisian patients with chronic obstructive pulmonary disease (COPD). METHODS: It was a prospective and cross-sectional study, spread over seven months, that included 40 stable COPD male patients. The Arabic version of VQ11, translated by a bilingual expert, was used. The functional, psychological, relational and total scores were calculated. Patients were divided into two groups according to the GOLD classification: "A-B" (n=25) and "C-D" (n=15). A significant correlation-coefficient (r) of≥0.51, between the VQ11 total score and the ADO index (age, dyspnoea, obstruction), and higher quality of life scores in GOLD "C-D" when compared to GOLD "A-B" would be in favour of application of the Arabic version of the VQ11. RESULTS: The mean±standard deviation of age, post-bronchodilator FEV1/FVC, ADO index and VQ11 total score were 64±8 years, 0.55±0.08, 4.8±1.7 and 2±10, respectively. A significant "r" (0.56) was identified between the ADO index and the total score. Psychological, relational and total scores of GOLD "A-B" patients were significantly lower than those in GOLD "C-D" patients: 10±4 vs. 12±3, 11±4 vs. 13±3 and 30±11 vs. 36±7, respectively. CONCLUSION: The Arabic version of VQ11 is applicable in Tunisian COPD patients with reliable results.


Assuntos
Comparação Transcultural , Idioma , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Inquéritos e Questionários , Idoso , Árabes/estatística & dados numéricos , Comorbidade , Jejum/fisiologia , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Religião e Medicina , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Fumar/epidemiologia , Fumar/psicologia , Inquéritos e Questionários/normas , Tradução , Tunísia/epidemiologia
4.
Chron Respir Dis ; 17: 1479973120962800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33000648

RESUMO

INTRODUCTION: The COVID pandemic has had a high psychological impact on healthy populations. Increased levels of perceived stress, depression, and insomnia are expected, especially in people with pre-existing medical conditions, such as asthma and chronic obstructive pulmonary disease (COPD), who seem to be particularly vulnerable. However, the difference in psychological distress frequency between asthma and COPD patients is unknown. OBJECTIVE: To compare the prevalence of depression, perceived stress related to COVID, post-traumatic stress, and insomnia in asthma and COPD patients at a pulmonology clinic in Santa Marta, Colombia. METHODS: A cross-sectional study was designed. The patients were contacted by telephone. An electronic link was sent to those who accepted. The questionnaire asked for perceived stress related to COVID-19, post-traumatic stress symptoms, depressive symptoms, and insomnia risk. RESULTS: 148 asthma patients and 144 COPD patients participated in, between 18 and 96 years. The prevalence of high COVID-19 perceived stress was 10.6% (n = 31); post-traumatic stress risk, 11.3% (n = 33); depression risk, 31.5% (n = 92); and insomnia risk, 57.7% (n = 169). No significant differences were found between asthma and COPD in indicators of psychological distress. CONCLUSIONS: Asthma and COPD patients present similar frequencies of depression risk, COVID-19 perceived stress, post-traumatic stress risk, and insomnia risk during the Colombian lockdown. It is essential to evaluate and manage psychological distress among asthma and COPD patients. It can reduce the risk of exacerbation and improve the quality of life.


Assuntos
Asma , Infecções por Coronavirus , Depressão , Pandemias , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono , Transtornos de Estresse Pós-Traumáticos , Asma/epidemiologia , Asma/psicologia , Betacoronavirus , Colômbia/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Depressão/diagnóstico , Depressão/etiologia , Depressão/psicologia , Autoavaliação Diagnóstica , Feminino , Indicadores Básicos de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Angústia Psicológica , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Pesquisa Qualitativa , Autoimagem , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
5.
Int J Chron Obstruct Pulmon Dis ; 15: 2621-2627, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33122900

RESUMO

Purpose: On March 16, 2020, the Spanish government declared a state of alarm due to the rapid spread of coronavirus disease 2019 (COVID-19). Patients with chronic obstructive pulmonary disease (COPD) were restricted to remain confined at home, and medical visits were cancelled for 3 months. The impact of this lockdown on the manifestations of COPD and the quality-of-life of these patients has not been explored. Patients and Methods: One hundred patients with COPD were interviewed by telephone from May 2-18, 2020. The interviews included questions about the lockdown, missed medical appointments, fears of the disease, possible COVID-19 infection, and exacerbations of COPD suffered during this period and their management. In addition, the COPD Assessment Test, the Hospital Anxiety and Depression, and the 5-Dimension Euro Quality-of-Life questionnaires were administered. Results: Sixty-four (64%) patients claimed to have strictly complied with the lockdown, and only 42 (42%) stated they had left home at least once during lockdown. Only one patient (1%) was hospitalized due to COVID-19, and 13 (13%) patients presented an exacerbation of COPD self-managed at home with no admissions due to exacerbation of COPD during this period. A medical consultation or complementary test was cancelled in 90% of the patients, but 61% had a medical telephone visit with a high degree of satisfaction (mean 9.3/10). Most patients declared that their feeling regarding lung disease and general health was similar or even better during lockdown (82% and 81%, respectively). Conclusion: Our results indicate that in general lockdown had a low impact on COPD patients. Only one patient was affected by COVID-19, but moderate exacerbations of COPD were not infrequent. Although many medical visits and test were cancelled, patients were very satisfied with the medical telephone visits.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Doença Pulmonar Obstrutiva Crônica/terapia , Qualidade de Vida , Isolamento Social , Idoso , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Doença Pulmonar Obstrutiva Crônica/complicações , Autogestão , Espanha , Inquéritos e Questionários
6.
Int J Chron Obstruct Pulmon Dis ; 15: 2127-2133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32982205

RESUMO

Pulmonary rehabilitation (PR) is an important, evidence-based treatment that improves outcomes for people with COPD. Individualized exercise programmes aim to improve exercise capacity; self-management education and psychological support are also provided. Translating increased exercise capacity into sustained behavioural change of increased physical activity is difficult. Other unresolved problems with PR programmes include improving uptake, completion, response and sustaining long-term benefit. We offer a different perspective drawn from clinical experience of PR, quantitative and qualitative studies of singing groups for people with COPD, and stroke rehabilitation research that gives psychological factors a more central role in determining outcomes after PR. We discuss Take Charge; a simple but effective psychological intervention promoting self-management--that could be used as part of a PR programme or in situations where PR was declined or unavailable. This may be particularly relevant now when traditional face-to-face group programmes have been disrupted by COVID-19 precautions.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus , Terapia por Exercício , Comportamentos Relacionados com a Saúde , Pandemias , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica , Pesquisa de Reabilitação , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Terapia por Exercício/métodos , Terapia por Exercício/organização & administração , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Sistemas de Apoio Psicossocial , Doença Pulmonar Obstrutiva Crônica/psicologia , Doença Pulmonar Obstrutiva Crônica/reabilitação , Projetos de Pesquisa , Autogestão/métodos , Autogestão/psicologia , Resultado do Tratamento
8.
Rev Mal Respir ; 37(6): 451-461, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32505369

RESUMO

INTRODUCTION: Numerous studies about poor communication and altered quality of life of patients with chronic obstuctive pulmonary disease (COPD) lead to the conclusion that overall palliative management of COPD remains to be improved. The aim of this study was to describe pulmonologists' practice of palliative care for COPD patients in order to identify obstacles to it. MATERIAL AND METHOD: A survey was sent to all pulmonologists whose email appeared in the 2017 French-language Respiratory Medicine Society's directory. RESULTS: A total of 294 responses were obtained, among which 287 were analysed. Overall, 81.6% of the pulmonologists said that they identify a distinct palliative phase from "sometimes to often" in the care of COPD patients. When not identified, the most common reason given (68.8%) was the difficulty of defining when to start palliative care. Aspects of the palliative approach, which were considered the most problematic for pulmonologists, were the discussion of end of life care, and the impression that COPD patients have a low demand for information. 31% of pulmonologists reported that they gathered information about patients' wishes to undergo resuscitation and endotracheal intubation in 61 % to 100% of patients who they judged to have the most severe disease. CONCLUSION: Uncertainty as to when to begin a palliative approach for COPD patients and perceptions around communication in chronic diseases appear to be the main obstacles to a palliative approach.


Assuntos
Cuidados Paliativos/psicologia , Cuidados Paliativos/estatística & dados numéricos , Percepção , Padrões de Prática Médica/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/terapia , Pneumologistas , Adulto , Diretivas Antecipadas/psicologia , Diretivas Antecipadas/estatística & dados numéricos , Idoso , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/normas , Relações Médico-Paciente , Padrões de Prática Médica/normas , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Pneumologia/normas , Pneumologia/estatística & dados numéricos , Pneumologistas/psicologia , Pneumologistas/estatística & dados numéricos , Qualidade de Vida , Assistência Terminal/métodos , Assistência Terminal/psicologia , Assistência Terminal/estatística & dados numéricos
9.
PLoS One ; 15(5): e0232587, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32365134

RESUMO

The 6-minute walk test is generally considered a standard test for the evaluation of short-term maximal physical performance. It has not been evaluated whether psychological factors, such as anxiety or depression, affect the performance or the results of the test. The main aim of this study was to investigate whether a correlation exists between psychological factors and the data from the 6-minute walking test. The study cohort consisted of 85 (♀ = 34 and ♂ = 51) 66 ± 10 (mean ± SD) year-old patients with chronic obstructive pulmonary disease (COPD) hospitalized for disease exacerbation. Forced Expiratory Volume in the first second (FEV1) (% predicted) as predictor for lung function, as well as anxiety and depression symptoms assessed using the Hospital Anxiety and Depression Scale (HADS) as psychological predictors were collected. Bivariate correlations and hierarchical linear regression models were used to analyse the correlations. Walking distance was on average 260m ± 107m and ranged from 64m to 480m. HADS was negatively correlated with 6-min walking distance (r = 0.441, p = .0009, r = -.523, p = 00006). Hierarchical linear regression showed that FEV1 alone explained 33%, and together with the psychological variables anxiety and depression explained 42% of the variance of results from the 6-minute walking test. These findings demonstrated that 11% of the data correlated with the psychological variables alone (p = .011). The effect size for lung function (f2 = .717) and psychological variables (f2 = .352) were high, whereas the socio-demographic variables sex, age, educational level and BMI could not explain any additional variance in our cohort. In conclusion, our study indicates that psychological factors such as symptoms of depression and anxiety are associated with lower physical functional performance in the 6-minute walking test. As such, these factors should also be assessed. Future research is needed to show if treatments of anxiety and depression can improve the walking distance in COPD patients.


Assuntos
Tolerância ao Exercício , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Testes de Função Respiratória , Teste de Caminhada , Idoso , Ansiedade/complicações , Ansiedade/fisiopatologia , Depressão/complicações , Depressão/fisiopatologia , Feminino , Volume Expiratório Forçado , Hospitalização , Humanos , Pacientes Internados , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Capacidade Vital
10.
PLoS One ; 15(5): e0233488, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469917

RESUMO

BACKGROUND: Health literacy (HL) and patient activation (PA) are necessary foundations to engage patients in self-management intervention. Each concept plays a unique role in improving access to the effective self-management of chronic disease. In this cross-sectional study, we examined the levels and determinants of HL and PA among the multi-morbid COPD patients in Nepal. METHODS: We conducted interviews with a simple random sample of 238 multi-morbid COPD people from July 2018 to January 2019. The questionnaire included sociodemographic profiles, five domains of the Health Literacy Questionnaire (HLQ), 13-item Patient Activation Measure (PAM) and patient's illness perception by Brief Illness Perception Questionnaire (BIPQ). Multivariable logistic regression was used to examine the associations. RESULTS: Most people with COPD had low health levels across each of the five domains of the HLQ. The proportion of people with low literacy level across each of the domains was: (i) feeling understood and supported by healthcare providers (79.0%), (ii) having sufficient information to manage my own health (76.5%), (iii) social support for health (77.3%), (iv) ability to find the good health information (75.2%), and (v) understand the health information well enough to know what to do (74.8%), respectively. The majority of patients also reported low levels of patient activation (level 1: 81.5%; level 2: 11.8%), with only 6.7% (level 3: 5%; level 4: 1.7%) reported higher patient activation level. We found significant associations between poor HL levels in the HLQ domains and having no education, being female or from Indigenous and Dalits communities, and having a monthly family income of less than USD176. Having no education and poor illness perception were significantly associated with poor activation level on PAM scale. CONCLUSION: A high proportion of multi-morbid COPD peoples had low levels of HL and were less activated than what would be required to self-manage COPD. These were in turn associated with socioeconomic factors and poor illness perception. The findings from this study are being used to design a COPD self-management program tailored to the low health literate population.


Assuntos
Letramento em Saúde , Participação do Paciente , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Adolescente , Adulto , Idoso , Comorbidade , Estudos Transversais , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/psicologia , Doença Pulmonar Obstrutiva Crônica/terapia , População Rural , Autogestão , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
12.
Thorax ; 75(5): 413-421, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32229541

RESUMO

RATIONALE: Pulmonary rehabilitation (PR) is an effective, key standard treatment for people with COPD. Nevertheless, low participant uptake, insufficient attendance and high drop-out rates are reported. Investigation is warranted of the benefits achieved through alternative approaches, such as pulmonary tele-rehabilitation (PTR). OBJECTIVE: To investigate whether PTR is superior to conventional PR on 6 min walk distance (6MWD) and secondarily on respiratory symptoms, quality of life, physical activity and lower limb muscle function in patients with COPD and FEV1 <50% eligible for routine hospital-based, outpatient PR. METHODS: In this single-blinded, multicentre, superiority randomised controlled trial, patients were assigned 1:1 to 10 weeks of groups-based PTR (60 min, three times weekly) or conventional PR (90 min, two times weekly). Assessments were performed by blinded assessors at baseline, end of intervention and at 22 weeks' follow-up from baseline. The primary analysis was based on the intention-to-treat principle. MEASUREMENTS AND MAIN RESULTS: The primary outcome was change in 6MWD from baseline to 10 weeks; 134 participants (74 females, mean±SD age 68±9 years, FEV1 33%±9% predicted, 6MWD 327±103 metres) were included and randomised. The analysis showed no between-group differences for changes in 6MWD after intervention (9.2 metres (95% CI: -6.6 to 24.9)) or at 22 weeks' follow-up (-5.3 metres (95% CI: -28.9 to 18.3)). More participants completed the PTR intervention (n=57) than conventional PR (n=43) (χ2 test p<0.01). CONCLUSION: PTR was not superior to conventional PR on the 6MWD and we found no differences between groups. As more participants completed PTR, supervised PTR would be relevant to compare with conventional PR in a non-inferiority design. Trial registration number ClinicalTrials.gov (NCT02667171), 28 January 2016.


Assuntos
Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/reabilitação , Telemedicina , Idoso , Ansiedade/etiologia , Depressão/etiologia , Exercício Físico , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida , Reabilitação/métodos , Método Simples-Cego , Avaliação de Sintomas , Teste de Caminhada
13.
J Phys Act Health ; 17(5): 519-524, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32234997

RESUMO

BACKGROUND: Growing evidence demonstrates the negative health impact of physical inactivity. Our aim was to examine the influence of previous-year physical activity (PA) on the cognition of chronic obstructive pulmonary disease (COPD) patients during exacerbation. METHODS: Observational study. One hundred and fifty-one patients with COPD exacerbation were recruited over a period of 3 years and divided in 2 groups according to their previous activity level. Sociodemographic, anthropometric, and clinical variables were collected. Our main outcome measures were previous-year PA level, measured using the Modified Baecke Physical Activity Questionnaire and cognitive status measured using the Montreal Cognitive Assessment. RESULTS: The cognitive variables that exhibited significant differences (P < .05) according to PA level were the visuoconstructional skills subscore, attention subscore, language subscore, orientation subscore, and Montreal Cognitive Assessment total score, with worse results in the sedentary group. Based on the relationships between total scores, the Baecke score was positively correlated with the Montreal Cognitive Assessment total score (r = .457). CONCLUSIONS: The cognitive status of COPD patients during an exacerbation is related to previous-year PA level. Previous-year PA level should be taken into consideration when patients with a COPD exacerbation are evaluated.


Assuntos
Cognição/fisiologia , Exercício Físico/fisiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Idoso , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino
14.
J Clin Nurs ; 29(13-14): 2638-2651, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32279357

RESUMO

AIM AND OBJECTIVES: To identify physiological, psychological and socioenvironmental factors that affect the health-related quality of life of Thai men living with chronic obstructive pulmonary disease. The vast majority of Thai persons living with chronic obstructive pulmonary disease are men. BACKGROUND: Little is known about the health-related quality of life of Thai people living with chronic obstructive pulmonary disease or about the physiological and psychosocial factors that most affect it. Applying a prevailing theoretical model of health-related quality of life, we explored how physiological, psychological and socioenvironmental factors simultaneously affect the health-related quality of life of Thai men with chronic obstructive pulmonary disease. DESIGN: A cross-sectional study design was used, together with the STROBE checklist. METHODS: In this study, 290 Thai male outpatients at a chronic obstructive pulmonary disease specialist clinic near Bangkok were recruited using purposive sampling. The participants completed the Satisfaction With Life Scale, the St. George Respiratory Questionnaire, the Center for Epidemiologic Studies Depression Scale, the Short Form Health Survey Version 2, the chronic obstructive pulmonary disease Self-Efficacy Scale and the Social Support Questionnaire. A structural equation model was used to examine the relationships between the assessed variables. RESULTS: Biological function (FEV-1, chronic obstructive pulmonary disease exacerbations), symptoms (chronic obstructive pulmonary disease and depression), functional status, general health perceptions and individual characteristics (age and self-efficacy to control dyspnoea) accounted for 56.9% of the variance in health-related quality of life. CONCLUSIONS: Symptoms of chronic obstructive pulmonary disease and depression were the main factors with statistically significant direct and indirect effects on the health-related quality of life of the Thai men in this study. The effects of both symptoms included an indirect effect on health-related quality of life through functional status and general health perceptions. RELEVANCE TO CLINICAL PRACTICE: The study findings may help nurses to better understand factors affecting health-related quality of life among men with chronic obstructive pulmonary disease. Preventing or minimising symptom exacerbations could be important in nursing practice. Cognitive-behavioural interventions addressing chronic obstructive pulmonary disease symptom management, depression screening and smoking cessation may improve health-related quality of life among Thai men with chronic obstructive pulmonary disease.


Assuntos
Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida , Idoso , Estudos Transversais , Depressão/complicações , Depressão/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Doença Pulmonar Obstrutiva Crônica/complicações , Inquéritos e Questionários , Tailândia
15.
J Clin Nurs ; 29(13-14): 2388-2396, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32221991

RESUMO

AIMS AND OBJECTIVES: To investigate the relationship between symptom burden, medication adherence and spiritual well-being in patients with chronic obstructive pulmonary disease (COPD). BACKGROUND: The relationship between spirituality and medication adherence has been investigated in different chronic conditions. However, the relationship between symptom burden, medication adherence and spiritual well-being in patients with COPD has not been explored. DESIGN: A descriptive correlational study design was adopted. METHODS: A total of 112 patients with COPD were included in the study. Data were collected using the COPD Assessment Test (CAT), the Adherence to Refills and Medications Scale-7 (ARMS-7) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp). The data were analysed using descriptive and correlational statistics. The Strengthening the Reporting of Observational studies in Epidemiology (STROBE) Checklist was used. RESULTS: The CAT score was significantly higher in patients on long-term oxygen therapy and those who had more than three comorbid conditions (p < .05). The mean score of ARMS-7 was significantly associated with age (p < .05). Current smokers had higher ARMS-7 and lower FACIT-Sp scores (p < .001). The FACIT-Sp score was negatively and moderately associated with the CAT and ARMS-7 scores (p < .001). CONCLUSION: This study concluded that individuals with higher spiritual well-being had lower symptom burden and higher medication adherence. The need for long-term oxygen therapy and a high number of comorbid conditions were associated with increased symptom burden. Current smokers had lower spiritual well-being and medication adherence. RELEVANCE TO CLINICAL PRACTICE: Spiritual well-being should be evaluated when assessing symptom burden and medication adherence in clinical practice. In addition, further studies examining the causal relationship between symptom burden, spiritual well-being and medication adherence in different populations are warranted.


Assuntos
Adesão à Medicação/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Índice de Gravidade de Doença , Espiritualidade , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/psicologia , Inquéritos e Questionários
16.
Medicine (Baltimore) ; 99(11): e19543, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176107

RESUMO

OBJECTIVE: To explore the effect of continuous nursing care based on the Information, Knowledge, Attitude, and Practice (IKAP) theory on the quality of life of patients with chronic obstructive pulmonary disease (COPD). METHODS: This study is a randomized control trial. COPD patients attending the Affiliated Hospital of Inner Mongolia Medical University, China between July 1 and October 31, 2017 were eligible. Following random assignment of participants to either the intervention group or control group, 70 patients (35 in each group) were included in the final sample. The intervention group received nursing care based on the Information, Knowledge, Attitude, and Practice theory, while the control group received standard nursing care. Data were collected before the intervention, 1 month after the intervention, and three months after the intervention. The St. George's Respiratory Questionnaire (SGRQ) was used to measure quality of life. RESULTS: Three months after the intervention, there were significant differences in the total SGRQ score (20.29 ±â€Š10.03 vs 30.14 ±â€Š12.52) and in the three SGRQ dimensions between the intervention group and the control group (P < .05). A repeated-measures analysis of variance showed that the total SGRQ score and the scores for impact and symptoms had a significant time effect (P < .001), that the total SGRQ score and the score for symptoms had a significant interaction effect (P < .05), and that the impact dimension had a significant group effect (P = .042). Pairwise comparisons of the data for the intervention group showed that there were significant differences between the pre-intervention and 1 month after intervention scores as well as between pre-intervention and three months after intervention, for the total SGRQ scores and the scores for impact and symptoms(P < .001). In terms of the impact dimension, there was a significant difference in the intervention group between 1 month after intervention and 3 months after intervention (P = .016). CONCLUSION: Continuous nursing care based on Information, Knowledge, Attitude, and Practice theory improved quality of scores at 3 months after intervention among COPD patients. Given limitations of the study, future large-scale studies are needed to validate our results.


Assuntos
Modelos de Enfermagem , Padrões de Prática em Enfermagem , Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida , Idoso , Feminino , Humanos , Masculino , Doença Pulmonar Obstrutiva Crônica/enfermagem , Resultado do Tratamento
17.
J Clin Nurs ; 29(13-14): 2410-2419, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32220091

RESUMO

AIMS AND OBJECTIVE: To investigate the effects on the quality of care of the Patient Report Informing Self-Management Support (PRISMS) form compared with usual care among patients with chronic obstructive pulmonary disease (COPD) consulting a COPD nurse in primary health care. BACKGROUND: Patients with COPD experience symptoms affecting their everyday lives, and there is a need for interventions in self-management support. The delivery of chronic care in an organised, structured and planned manner can lead to more productive relationships between professionals and patients. DESIGN: A multicentre randomised controlled trial with a post-test design, according to the CONSORT checklist, in one intervention group (n = 94) and one control group (n = 108). METHODS: In addition to usual care, the intervention group (n = 94) completed the PRISMS form to indicate areas where they wanted self-management support before the consultation with the COPD nurse. This form comprises 17 items that patients with COPD commonly experience as problems. The control group received usual care (n = 108). The primary outcome was patients' satisfaction with quality of care, assessed using the Quality from the Patient's Perspective (QPP) questionnaire. Means and (SD) are presented where applicable. Differences between the intervention and control group were analysed with Student's t test for independent groups for interval data, and the Mann-Whitney U test for ordinal data. RESULTS: Participants in the intervention group were more satisfied with the QPP domains "personal attention," regarding both "perceived reality" (p = .021) and "subjective importance" (p = .012). The PRISMS form revealed "shortness of breath" as the most commonly experienced problem and the issue most desired to discuss. CONCLUSION: The PRISMS form improved patient satisfaction with quality of care regarding personal attention, which is an important factor in patient participation and improving relationships and communication. RELEVANCE TO CLINICAL PRACTICE: The PRISMS form can be a useful tool in improving person-centred care when delivering self-management support. REGISTER ID: 192691 at http://www.researchweb.org/is/en/sverige/project/192691.


Assuntos
Doença Pulmonar Obstrutiva Crônica/enfermagem , Autogestão/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Doença Pulmonar Obstrutiva Crônica/psicologia , Melhoria de Qualidade/organização & administração , Qualidade da Assistência à Saúde/organização & administração , Qualidade de Vida , Autorrelato , Autogestão/psicologia , Inquéritos e Questionários
18.
Aten. prim. (Barc., Ed. impr.) ; 52(3): 142-150, mar. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-197216

RESUMO

OBJETIVO: Presentar el estudio piloto de la Escala de Convivencia con un proceso crónico (EC-PC) en pacientes con diabetes mellitus tipo 2, insuficiencia cardiaca crónica, enfermedad pulmonar obstructiva crónica y artrosis. DISEÑO: Estudio observacional, transversal y multicéntrico. Emplazamiento: Dos hospitales de atención especializada de Navarra y Madrid. PARTICIPANTES: 64 pacientes con diversos procesos crónicos, mayores de 18 años que acudan a centros de atención primaria y/o consultas externas. Los pacientes con deterioro cognitivo diagnosticado y/o trastornos psiquiátricos fueron excluidos. INTERVENCIONES: Las evaluaciones tuvieron una duración media de 15 minutos por paciente. Mediciones principales: Se evaluó la variable Convivencia con un proceso crónico, mediante la EC-PC. Se analizó la viabilidad/aceptabilidad, consistencia interna y validez de constructo. RESULTADOS: Para la muestra total, la EC-PC mostró una buena viabilidad y aceptabilidad, sin datos faltantes. El coeficiente alfa de Cronbach alcanzó valores entre 0,64 y 0,76, y el índice de homogeneidad fue superior a 0,30 en todos los dominios de la escala. Los valores de validez interna oscilaron entre 0,04 y 0,30. No se encontraron diferencias significativas en la puntuación total de la escala en función del sexo o las diferentes patologías. Los pacientes describieron la escala como sencilla y útil. CONCLUSIONES: El estudio piloto de la EC-PC en pacientes con diversos procesos crónicos indica que es una medida breve, de fácil uso, fiable y válida. La EC-PC servirá para conocer de manera individualizada cómo el paciente convive con su proceso crónico y prevenir posibles aspectos negativos del día a día con la enfermedad


OBJECTIVE: To present the pilot study of the Living with Chronic Illness Scale (EC-PC) in patients with diabetes mellitus type 2, chronic heart failure, chronic obstructive pulmonary disease and osteoarthritis. DESIGN: Observational, cross-sectional and multicenter study. LOCATION: Two specialized hospitals in Navarre and Madrid. PARTICIPANTS: 64 patients with several chronic diseases, older than 18 years old, that go to primary health centre and/or outpatients. Patients with cognitive deterioration and/or psychiatric disorders were excluded. INTERVENTIONS: Evaluations had an average duration of 15 minutes per patient. MAIN MEASUREMENTS: Patients completed the EC-PC and a questionnaire related to the scale. Feasibility/acceptability, internal consistency and construct validity was analyzed. RESULTS: For the total sample, the EC-PC showed a good viability and acceptability, without missing data and with almost 100% of the computable data. Cronbach's alpha coefficient reached values between 0.64 and 0.76, and the homogeneity index was higher than 0.30 in all domains of the scale. The values of internal validity ranged between 0.04 and 0.30. No significant differences were found (p> 0.05) in the total score of the scale according to gender or the different pathologies. The patients described the scale as simple and useful. CONCLUSIONS: The pilot study of the EC-PC in patients with different chronic illnesses showed that it is a brief, easy to use, reliable and valid measure. The EC-PC will serve to know in an individualized way, how the patient is living with his/her chronic process and to prevent possible negative aspects of the daily living with the disease


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doença Pulmonar Obstrutiva Crônica/psicologia , Diabetes Mellitus Tipo 2/psicologia , Insuficiência Cardíaca/psicologia , Inquéritos e Questionários , Artropatias/psicologia , Doença Crônica/psicologia , Estudos Transversais , Projetos Piloto , Psicometria
19.
Respir Res ; 21(1): 40, 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-32013976

RESUMO

BACKGROUND: Cognitive and motor-performance decline with age and the process is accelerated by decline in general health. In this study, we aimed to estimate the effects of COPD and HB levels on cognitive and motor performance in the general older population and assess potential interaction. METHODS: The English Longitudinal Study of Aging is a population-based cohort study including measurements of lung-function and HB levels together with cognitive and motor performance testing. Data were collected from 5709 participants including three measurement time over eight years. COPD was defined using lung-function-parameters and clinical symptoms. HB was assessed continuously and low HB was defined using clinical anemia cutoffs. Linear mixed-effects regression models were used to quantify the associations of COPD and HB with outcome measures, both individually and in combination. RESULTS: Participants with both low HB and COPD demonstrated worse motor performance compared to individuals with only one exposure, resulting in up to 1 s (95%CI, 0.04-1.8) longer time needed to complete the five times sit to stand task than what would be expected based on purely additive effects. Additionally in individuals with COPD, the time to complete the motor-performance task per unit decrease in continuous HB levels was longer than in participants without COPD after full adjustment for confounding (up to 1.38 s/unit HB level, 95% CI: 0.65-2.11). CONCLUSION: In persons with COPD low HB levels may contribute to low motor-performance in a supra additive fashion. Further studies should re-evaluate whether earlier treatment of lower HB in these individuals might be beneficial.


Assuntos
Envelhecimento/sangue , Anemia/sangue , Cognição/fisiologia , Vigilância da População , Desempenho Psicomotor/fisiologia , Doença Pulmonar Obstrutiva Crônica/sangue , Idoso , Envelhecimento/psicologia , Anemia/epidemiologia , Anemia/psicologia , Estudos de Coortes , Inglaterra/epidemiologia , Feminino , Volume Expiratório Forçado/fisiologia , Hemoglobinas/metabolismo , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia
20.
Respir Med ; 162: 105878, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32056676

RESUMO

BACKGROUND: Technology-based physical activity (PA) interventions have been shown to improve daily step counts and health-related quality of life, but their effect on long-term clinical outcomes like acute exacerbations (AEs) is unknown in persons with COPD. METHODS: U.S. Veterans with stable COPD were randomized (1:1) to either pedometer alone (control) or pedometer plus a website with feedback, goal-setting, disease education, and a community forum (intervention) for 3 months. AEs were assessed every 3 months over a follow-up period of approximately 15 months. Pedometer-assessed daily step counts, health-related quality-of-life (HRQL), and self-efficacy were assessed at baseline, end-of-intervention at 3 months, and during follow-up approximately 6 and 12 months after enrollment. Zero-inflated Poisson models assessed the effect of the intervention on risk for AEs, compared to controls. Generalized linear mixed-effects models for repeated measures examined between-group and within-group changes in daily step count, HRQL, and self-efficacy. RESULTS: There were no significant differences in age, FEV1% predicted, baseline daily step count, AEs the year prior to enrollment, or duration of follow-up between the intervention (n = 57) and control (n = 52) groups. The intervention group had a significantly reduced risk of AEs (rate ratio = 0.51, [95%CI 0.31-0.85]), compared to the control group. There were no significant between-group differences in change in average daily step count, HRQL, or self-efficacy at 6 and 12 months after enrollment. CONCLUSIONS: A 3-month internet-mediated, pedometer-based PA intervention was associated with reduced risk for AEs of COPD over 12-15 months of follow-up. ClinicalTrials.gov identifier: NCT01772082.


Assuntos
Actigrafia/métodos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Caminhada , Idoso , Progressão da Doença , Feminino , Seguimentos , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida , Risco , Autoeficácia , Fatores de Tempo
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