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Choate R, Holm KE, Sandhaus RA, Mannino DM, Strange C. Characteristics associated with SF-36 in alpha-1 antitrypsin deficiency-associated COPD: a cross-sectional analysis. BMC Pulm Med 2024; 24:138. [PMID: 38500152 PMCID: PMC10949668 DOI: 10.1186/s12890-024-02953-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Generic measures of health-related quality of life (HRQoL), such as the 36-Item Short Form Survey (SF-36), are widely used in assessing chronic conditions. These tools have an advantage over disease-specific instruments, as they allow comparisons across different health conditions and with the general population. In alpha-1 antitrypsin deficiency (AATD)-associated chronic obstructive pulmonary disease (COPD), HRQoL research remains scarce. This cross-sectional study evaluates the factors associated with HRQoL in a cohort of patients with AATD-associated COPD. METHODS Our study included participants of AlphaNet (2008-2019), a health management organization for people with AATD in the US who are prescribed augmentation therapy. Norm-based SF-36 scores for the mental and physical component summary scores (MCS and PCS, mean of 50 ± 10 in the general US population) and 8 individual scales were evaluated. Individuals with lung disease and data available on ≥1 measurement on any SF-36 scale and clinically relevant characteristics such as modified Medical Research Council (mMRC) scale, exacerbation frequency, productive cough, and use of oxygen were included in these analyses. Generalized linear regression models were fit to examine the association of baseline characteristics with MCS and PCS scores. Age, sex, regular use of oxygen, exacerbation frequency, mMRC, and productive cough were included in these models. RESULTS Participants (n=4398, mean age 57.6 [SD=10.6] years, 45.4% female) had a mean MCS score of 51.2 ± 10.8 and PCS of 36.3 ± 9.8. The average mMRC score was 2.4 ± 1.3, and 56.4% had 2 or more exacerbations per year. Overall, the physical component of SF-36 was more severely impacted compared to the mental component. In multivariable regression analyses, PCS scores were significantly associated with exacerbation frequency, mMRC, regular use of oxygen, and productive cough; MCS was associated with age, sex, exacerbation frequency, mMRC, and productive cough. CONCLUSIONS These findings demonstrate that patient-perceived physical health is significantly impaired in this cohort of people with AATD-associated COPD compared to mental health. Longitudinal studies are needed to evaluate the change in physical and mental health status over time in this population.
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Affiliation(s)
- Radmila Choate
- University of Kentucky College of Public Health, Lexington, Kentucky, United States.
| | - Kristen E Holm
- Department of Medicine, National Jewish Health, Denver, Colorado, United States
- AlphaNet, Inc, Coral Gables, Florida, United States
| | - Robert A Sandhaus
- Department of Medicine, National Jewish Health, Denver, Colorado, United States
- AlphaNet, Inc, Coral Gables, Florida, United States
| | - David M Mannino
- University of Kentucky College of Medicine, Lexington, Kentucky, United States
| | - Charlie Strange
- AlphaNet, Inc, Coral Gables, Florida, United States
- Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina, United States
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Wang D, Chen H, Chen J, Ye H, Chen X, Ye L, Yao K, Tu N, Dai H, Fan F. A comparative study of mental health status among left-behind, migrant, and local adolescents in China. J Affect Disord 2023; 324:521-528. [PMID: 36586615 DOI: 10.1016/j.jad.2022.12.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 09/13/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Influence of migration on mental impairments among adolescents has been well assessed. However, there lack empirical data on multiple mental health problems and comparisons of children who suffer from different parental migration. This study aims to compare the mental health status among left-behind adolescents (LBA), migrant adolescents (MA), and local adolescents (LA). METHODS A total of 67,532 adolescents were investigated on depression, anxiety, sleep disturbance, and psychotic-like experiences (PLEs). The LBA were registered in Shenzhen's hukou (household register system) and are living in Shenzhen while their parent(s) has/have migrated to work elsewhere for over 6 months. MA, defined as adolescents who immigrated with parents from other places, are living but not registered in Shenzhen hukou. LA referred to adolescents who were registered in Shenzhen hukou and are living with their parents. Social-demographics, family function, and school climate were also evaluated as influential factors. RESULTS The prevalence of overall mental health problems was 37.4 % for LBA, which was higher than that of MA (27.9 %) and LA (27.1 %). Females, adolescents with chronic physical illness, and with family history of mental disorders are all contributed to the increased occurrence of mental health issues. Poorer family function and school climate were also negatively associated with mental health among the three types of adolescents. CONCLUSION LBA is at a higher risk for poor mental health than other adolescents. Interventions that promoting family function and improving school climate may be helpful, especially for girls with chronic physical illness, or with family history of mental disorders.
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Affiliation(s)
- Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Huilin Chen
- Department of Psychiatry, University of Oxford, UK
| | - Jiaqiao Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Haoxian Ye
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Xinwen Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Liqun Ye
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Kun Yao
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Nanping Tu
- Shenzhen Bao'an Institute of Education Sciences, Shenzhen, China
| | - Huamei Dai
- Fenghuang School, Bao'an District, Shenzhen, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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Bamonti PM, Wiener CH, Weiskittle RE, Goodwin CL, Silberbogen AK, Finer EB, Moy ML. The Impact of Depression and Exercise Self-Efficacy on Benefits of Pulmonary Rehabilitation in Veterans with COPD. Behav Med 2023; 49:72-82. [PMID: 34743677 DOI: 10.1080/08964289.2021.1983755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Pulmonary rehabilitation (PR) improves health-related quality of life (HRQoL) and exercise capacity. Little is known about the impact of depression symptoms and exercise self-efficacy on improvements in these key PR outcomes. This study examined the impact of baseline depression status and change in depression symptoms (Beck Depression Inventory-II [BDI-II] score) over the course of PR on change in HRQoL assessed by the Chronic Respiratory Disease Questionnaire-Self Reported (CRQ-SR) and exercise capacity as measured by the 6-Minute Walk Test (6MWT). We also examined whether baseline exercise self-efficacy moderated the association between baseline depression symptoms and change in these key PR outcomes. We studied 112 US veterans (aged 70.38 ± 8.49 years) with chronic obstructive pulmonary disease (COPD) who completed PR consisting of twice-weekly 2-hour classes for 18 sessions. Depressed (BDI-II >13) and nondepressed (BDI-II ≤13) patients at baseline demonstrated comparable and significant improvement in CRQ-SR total score, subscales, and 6MWT. Greater reduction in depression over the course of treatment was significantly associated with greater improvement in CRQ-SR total score and the following subscales: fatigue, mastery, and emotional function. Change in depression did not predict change in 6MWT distance. Baseline exercise self-efficacy moderated the association between baseline depression symptoms and change in CRQ-SR fatigue. Specifically, when baseline exercise self-efficacy was <30.4, greater baseline depression was associated with less improvement in CRQ-SR fatigue. When baseline self-efficacy was >152.0, greater baseline depression was associated with greater improvement in CRQ-SR fatigue. PR programs should address mood and confidence to exercise given their impact on key PR outcomes.
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Affiliation(s)
- Patricia M Bamonti
- VA New England Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System.,Department of Psychiatry, Harvard Medical School
| | | | - Rachel E Weiskittle
- VA New England Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System
| | | | | | - Elizabeth B Finer
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System
| | - Marilyn L Moy
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System.,Department of Medicine, Harvard Medical School
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Wang D, Chen H, Chen Z, Liu W, Wu L, Chen Y, Sun M, Fan F. Current psychotic-like experiences among adolescents in China: Identifying risk and protective factors. Schizophr Res 2022; 244:111-117. [PMID: 35661996 DOI: 10.1016/j.schres.2022.05.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/22/2022] [Accepted: 05/21/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study aim to explore the prevalence of current PLEs over past month and relevant influential factors among adolescents. METHODS A total of 67,538 students completed one online survey between April 21st and May 12th, 2021. Current PLEs were assessed using the 8-item Positive Subscale of the Community Assessment of Psychic Experiences (CAPE-P8). Participants were defined as having frequent PLEs if they selected "often" or "nearly always" on one or more items of CAPE-P8. Family function, school climate and a series of socio-demographic were also evaluated. RESULTS In this sample, 49.3% adolescents reported having at least one PLE over the past month, while 15.4% experienced high frequent PLEs. Alcohol intake was positively associated with high frequent PLEs (OR = 2.61, 95% CI = 2.37-2.88). Adolescents with chronic physical illness (OR = 1.94, 95% CI = 1.73-2.18) or family history of psychiatric illness (OR = 2.61, 95% CI = 2.22-2.77) were more likely to suffer from high frequent PLEs. Dysfunction family function (OR moderate = 1.98, 95% CI = 1.98-2.09; OR severe = 6.98, 95% CI = 6.48-7.53) or poor school climate (OR = 3.14, 95% CI = 2.93-3.37) was associated with elevated high frequent PLEs. CONCLUSIONS Several factors of socio-demographics, unhealthy lifestyle, family and school environments are found to be related to frequent PLEs. These factors should also be taken into consideration for effective psychosocial intervention in adolescents.
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Affiliation(s)
- Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Huilin Chen
- Department of Psychology, University of Bath, UK
| | - Zihao Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Lili Wu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Yao Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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5
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Abstract
Background & objectives: Chronic obstructive pulmonary disease (COPD) adversely affects various functional and structural domains of the lungs, in addition to having an array of extra-pulmonary effects which affect overall well-being of a patient. This study was aimed at measuring the health-related quality of life (HRQOL) in COPD patients and relating the severity of disease and other factors with the degree of impairment of HRQOL. Methods: This cross-sectional study was conducted on 100 individuals with established COPD aged 45 yr or above. COPD severity was graded based on the Global Initiative for Obstructive Lung Disease (GOLD) staging system. Pulmonary function test was carried out as per the American Thoracic Society and European Respiratory Society task force standardised lung function testing guidelines. The quality of life was measured using the COPD-specific version of the St. George's Respiratory Questionnaire (SGRQ). The three component scores (activity, impact and symptoms) and the total score were compared across the various categories of age, gender and COPD grades. Using multivariable linear regression analysis, the relationship between COPD grades and various component scores, adjusting for age and gender, was determined. Results: The mean total SGRQ Classification score was found to be 48.5±17.1. There was a significant increase in the symptom, activity and impact component scores and the total scores of the participants with worsening of COPD grade. The activity, impact component scores and total score showed an increasing trend with age. However, the values of these three scores were lower in participants in the age group of 56-65 yr in comparison to those in the 45-55 yr age group. There was a significant increase in the symptom component score with increasing age across the study population. The difference in the various scores between males and females was not significant. Interpretation & conclusions: HRQOL is impaired in patients with COPD, and it deteriorates with increasing severity of the disease. The onset of COPD at a younger age has a much more significant deterioration of HRQOL, due to the early onset of symptoms and complications. These findings call for better early care and integration of pulmonary rehabilitation programmes into current health policies.
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Affiliation(s)
- Sidharth Kharbanda
- Department of Respiratory Medicine, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - R Anand
- Department of Respiratory Medicine, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Masror-Roudsary D, Fadaee Aghdam N, Rafii F, Baha R, Khajeh M, Mardani A. The Relationship between Experienced Respiratory Symptoms and Health-Related Quality of Life in the Elderly with Chronic Obstructive Pulmonary Disease. Crit Care Res Pract 2021; 2021:5564275. [PMID: 34094597 DOI: 10.1155/2021/5564275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/04/2021] [Indexed: 12/17/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is one of the diseases that usually present at an advanced age. Respiratory symptoms in patients with COPD are the most important for making treatment decisions and understanding the adverse effects on health-related quality of life (HRQoL). This study aimed to investigate HRQoL in elderly patients with COPD and examine the relationship between this in relation to respiratory symptoms experienced by them and their demographic characteristics. Methods This is a descriptive, correlational study of elderly patients with COPD who were hospitalized in five different hospitals in an urban area of Iran. A consecutive sampling method was used. Demographic data form, the respiratory symptoms component of St. George's Respiratory Questionnaire (SGRQ), and the Short Form 36 Health Survey Questionnaire (SF-36) were applied for data collection. Results The patients (n = 217) reported low HRQoL, and this impairment was more observed in the physical component. There was a significant inverse relationship between the experienced respiratory symptoms and physical (p=0.03) and mental (p < 0.001) components of HRQoL. Moreover, the female gender, the low level of education, the increased duration of the disease, the increased number of hospitalizations during the past year, and the use of two classes of drugs simultaneously were associated with the impaired HRQoL. Conclusion Our findings inform healthcare providers about the negative impacts of respiratory symptoms and other related factors on the HRQoL of elderly patients with COPD. Nurses and other healthcare providers should proactively identify respiratory symptoms and design appropriate caring strategies to improve HRQoL among this group.
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Abstract
Objectives: This study investigates whether the impact of Internet use on old adults' mental health problems differs across health conditions and income groups in Shanghai, China.Methods: This study uses data from a large-scale sample of 2117 respondents aged 60-80 years in Shanghai, China. This study measures mental health problems with the 10-item version of the Hopkins Symptom Checklist, assesses Internet use with a 4-item scale and chronic diseases with a 12-item scale. This study applies ordinary least square regression models to assess associations between Internet use and mental health problems across income groups and health conditions.Results: Elderly people using the Internet more frequently have substantially lower odds of having mental health problems. Further analyses find the moderating roles of chronic diseases and household income on mental health problems. Chronic diseases significantly increase the correlation of Internet use with mental health problems. Meanwhile, Internet use reduces more elders' mental health problems in the low-income group than in the high-income group.Conclusion: This study sheds evidence on the negative correlation of Internet use with mental health problems. It also indicates that Internet use may reduce more mental health problems in the low-income group and the unhealthy group. Therefore, increasing Internet use in the low-income group and the unhealthy group is suggested as a promising strategy to promote elders' mental health.
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Affiliation(s)
- Hao Yuan
- School of Sociology & Political Science, Shanghai University, Shanghai, China
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8
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Medrano-Ureña MDR, Ortega-Ruiz R, Benítez-Sillero JD. Physical Fitness, Exercise Self-Efficacy, and Quality of Life in Adulthood: A Systematic Review. Int J Environ Res Public Health 2020; 17:E6343. [PMID: 32878182 DOI: 10.3390/ijerph17176343] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/23/2020] [Accepted: 08/26/2020] [Indexed: 12/03/2022]
Abstract
Background: The aim of the present work is the elaboration of a systematic review of existing research on physical fitness, self-efficacy for physical exercise, and quality of life in adulthood. Method: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines, and based on the findings in 493 articles, the final sample was composed of 37 articles, which were reviewed to show whether self-efficacy has previously been studied as a mediator in the relationship between physical fitness and quality of life in adulthood. Results: The results indicate that little research exists in relation to healthy, populations with the majority being people with pathology. Physical fitness should be considered as a fundamental aspect in determining the functional capacity of the person. Aerobic capacity was the most evaluated and the 6-min walk test was the most used. Only one article shows the joint relationship between the three variables. Conclusions: We discuss the need to investigate the mediation of self-efficacy in relation to the value of physical activity on quality of life and well-being in the healthy adult population in adult life.
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9
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Kaptain RJ, Helle T, Patomella AH, Weinreich UM, Kottorp A. Association Between Everyday Technology Use, Activities of Daily Living and Health-Related Quality of Life in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2020; 15:89-98. [PMID: 32021147 PMCID: PMC6957009 DOI: 10.2147/copd.s229630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/17/2019] [Indexed: 01/05/2023] Open
Abstract
Purpose A decline in the ability to perform activities of daily living (ADL) and ability to use everyday technology can pose threats to independent living, healthcare management and quality of life (QOL) of patients suffering from chronic obstructive pulmonary disease (COPD). Evidence of the relationship between these variables remains limited. The dual aim of this study was, first, to investigate if health-related QOL (HRQOL) was associated with quality in ADL performance and everyday technology use; second, to examine whether lung function, years with COPD diagnosis, living status or educational level affected physical and mental domains of HRQOL. Methods This cross-sectional study included (N=80) participants aged 46-87 years recruited at healthcare centres in the Northern Region of Denmark using a convenience sampling procedure. Data were gathered through standardized assessments and analysed using multiple regression analysis. Results The regression model explained 50.6% (R2=0.506) of the variation in HRQOL-physical. The following four variables were statistically significantly associated with HRQOL - physical: years since COPD diagnosis (p=0.023), ability to use everyday technology (p=0.006), amount of relevant everyday technologies (p=0.015) and ADL motor ability (p<0.01). The regression model explained 22.80% (R2=0.228) of HRQOL - mental. Only the variable ability to use everyday technology was statistically significantly associated with HRQOL - mental (p=0.009). Conclusion Quality of ADL performance and everyday technology use seem to be associated with HRQOL in people living with COPD. The only demographic variable associated with HRQOL was years with COPD. This indicates that healthcare professionals should enhance their attention also to ADL-performance and everyday technology use when striving to increase the HRQOL of persons living with COPD.
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Affiliation(s)
- Rina Juel Kaptain
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Tina Helle
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Ann-Helen Patomella
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Ulla Møller Weinreich
- Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark
- The Clinical Institute, Aalborg University, Aalborg, Denmark
| | - Anders Kottorp
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
- Faculty of Health and Society, Malmö University, Malmö, Sweden
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10
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Wu M, Zan T, Zhao Q, Ge S, Li K, Li J. Symptom Clusters and Health-related Quality of Life in Chinese patients with Chronic Obstructive Pulmonary Disease. West J Nurs Res 2019; 42:437-445. [PMID: 31342864 DOI: 10.1177/0193945919866475] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to identify symptom clusters of chronic obstructive pulmonary disease (COPD) and to examine the relationship between symptom clusters and health-related quality of life (HRQoL). It included 154 hospitalized patients with COPD. The majority of the participants (88.6%) were aged 60 years and above, and the numbers of men and women were approximately equal (men: 55.2%). The Charlson Comorbidity Index (CCI), the Memorial Symptom Assessment Scale (MSAS), and the Chinese version of the Clinical COPD Questionnaire (CCQ) were used to evaluate comorbidity, participant's symptoms, and HRQoL, respectively. Five symptom clusters were identified using exploratory factor analysis, and symptom clusters, especially the Psychological, Pain and Fatigue, GI, and Dyspnea-Sweat symptom clusters, had negative effects on HRQoL in patients with COPD. Understanding the patterns and occurrences of symptom clusters could be essential for developing effective interventions to manage COPD symptoms and improve the patients' HRQoL.
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Affiliation(s)
- Maochun Wu
- School of Nursing, Jilin University, Changchun, Jilin province, China.,Equal contributors
| | - Tao Zan
- Intensive Care Unit, The First Hospital of Jilin University, Changchun, China.,Equal contributors
| | - Qiheng Zhao
- Orthopedics Department, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Song Ge
- Department of natural sciences and Nursing, University of Houston-Downtown, Houston, TX, USA
| | - Kun Li
- School of Nursing, Jilin University, Changchun, China
| | - Junxin Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
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11
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Shah AM, Shah RB, Kachoria S. Health-related quality of life and associated factors in patients with chronic obstructive pulmonary disease. Drugs Ther Perspect 2019. [DOI: 10.1007/s40267-019-00617-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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12
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Tabar NA, Alshraideh JA. Correlates and Predictors of Health-Related Quality of Life among Patients with COPD: An Integrative Review. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojn.2019.912088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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13
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Kovelis D, Cruz PL, Silva LI, Sierra JR, Sandoval PRDM, Valderramas S. Characteristics of long-term home oxygen therapy users in the municipality of Curitiba, Brazil. Fisioter mov 2019. [DOI: 10.1590/1980-5918.032.ao04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Long-term home oxygen therapy (LTOT) can be successfully used in the treatment and prevention of chronic lung diseases, as it improves quality of life, increases survival, and reduces the lenght of hospital stays. However, to the authors’ knowledge there are no descriptive studies with details of the clinical and social profile of patients using LTOT in the state of Paraná. Objective: To analyze the profile of LTOT users in the state of Paraná. Method: All patients registered in the LTOT program of the Curitiba Municipal Department of Health were recruited to the study. Participants answered a questionnaire with questions about their education level, family income, main diagnosis, comorbidities, hours/day of O2 use, and hospitalizations in the previous year. Results: 386 patients (67 ± 20.4 years; 66% females) were interviewed. Chronic obstructive pulmonary disease (COPD) was the most common disease (58.5%); 60.6% were former smokers and 84.5% did not practice any kind of physical activity; dyspnea was the most common symptom (81.3%) and immobility was the most commonly reported inconvenience (33%); 55.7% used O2 24 hours a day; 53.6% had been hospitalized in the previous year; 33.9% had not completed primary school; 31.4% had an income of one minimum monthly wage or less. Conclusion: LTOT users in Curitiba are primarily elderly women with COPD, with low family income and limited schooling. It is extremely important that health professionals provide educational and preventive measures for this population, to minimize the impact of COPD in the community.
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Affiliation(s)
- Demetria Kovelis
- Universidade Federal do Paraná, Brazil; Centro Universitário UniDomBosco, Brazil
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14
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Holm KE, Mannino DM, Choate R, Sandhaus RA. Genotype is associated with smoking and other key health behaviors among individuals with alpha-1 antitrypsin deficiency-associated lung disease. Respir Med 2018; 143:48-55. [PMID: 30261992 DOI: 10.1016/j.rmed.2018.08.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/21/2018] [Accepted: 08/31/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine the association of genotype with smoking and other key health behaviors among individuals with alpha-1 antitrypsin deficiency (AATD) associated lung disease. METHODS Self-reported data were analyzed from 3506 individuals with AATD-associated lung disease. All data were collected upon enrollment in a disease management program designed for individuals who have been prescribed augmentation therapy. Multivariate logistic regression was utilized to examine the extent to which genotype was associated with smoking and other key health behaviors (i.e., getting a pneumonia vaccine, getting a flu vaccine, exercising, and maintaining a healthy weight). We hypothesized that MZs and SZs are more likely than ZZs to be current smokers, and that genotype is associated with additional health behaviors. RESULTS MZs and SZs had higher odds of being a current smoker than ZZs (MZ versus ZZ OR = 2.73, p < .001; SZ versus ZZ OR = 4.34, p < .001). For every additional health behavior examined, MZs had higher odds of unhealthy behavior than ZZs (ORs ranged from 1.35 to 1.98, p < .05). SZs had higher odds of unhealthy behavior than ZZs with regard to lack of exercise (OR = 1.52, p = .003) and failure to maintain a healthy weight (underweight OR = 1.93, p = .028; overweight OR = 1.43, p = .015). CONCLUSIONS Among individuals who have been prescribed augmentation therapy for lung disease due to AATD, genotype is associated with smoking and additional health behaviors that are central to managing lung disease.
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Farag TS, Sobh ESM, Elsawy SB, Fahmy BM. Evaluation of health-related quality of life in patients with chronic obstructive pulmonary disease. Egypt J Bronchol 2018. [DOI: 10.4103/ejb.ejb_11_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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16
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Jang SM, Kim KU, Na HJ, Song SE, Lee SH, Lee H, Kim YS, Lee MK, Park HK. Depression is a major determinant of both disease-specific and generic health-related quality of life in people with severe COPD. Chron Respir Dis 2018; 16:1479972318775422. [PMID: 29742914 PMCID: PMC6302962 DOI: 10.1177/1479972318775422] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The quality of life of patients with chronic obstructive pulmonary disease (COPD)
decreases significantly as the disease progresses; those with severe COPD are
affected most. This article investigates predictors of the disease-specific and
generic health-related quality of life (HRQL) in patients with severe COPD. This
multicentre prospective cross-sectional study enrolled 80 patients with severe
COPD. At enrolment, all patients completed a disease-specific instrument, the St
George’s Respiratory Questionnaire (SGRQ), and a generic instrument, the Short
Form 36 Health Survey Questionnaire (SF-36). The data were analyzed by Pearson’s
correlation and multiple linear regression. The mean age of the patients was 66
± 8 years; 93% were males. The SGRQ and SF-36 scores were not influenced by age
or sex. Depression, dyspnea, the number of exacerbations, and exercise capacity
significantly predicted the total SGRQ score (p < 0.05).
Depression was the strongest determinant of the total SGRQ score. The SF-36
physical component summary scores were related to depression, dyspnea, and the
number of exacerbations (p < 0.05). In comparison, the SF-36
mental component summary scores were related to depression and anxiety
(p < 0.05). Depression is a significant determinant of
both the disease-specific and generic HRQL in patients with severe COPD.
Screening and early intervention for depression in patients with severe COPD
could improve the HRQL.
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Affiliation(s)
- Sun Mi Jang
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Ki Uk Kim
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hae Jung Na
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Seung Eun Song
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Sang Hee Lee
- 3 Department of Internal Medicine, Sanbon Hospital, Wonkwang University, Gunpo, Republic of Korea
| | - Haejung Lee
- 4 Department of Nursing, College of Nursing, Pusan National University, Yangsan, Republic of Korea
| | - Yun Seong Kim
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Min Ki Lee
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Hye-Kyung Park
- 1 Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.,2 Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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Brandl M, Böhmer MM, Brandstetter S, Finger T, Fischer W, Pfeifer M, Apfelbacher C. Factors associated with generic health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD): a cross-sectional study. J Thorac Dis 2018; 10:766-775. [PMID: 29607147 DOI: 10.21037/jtd.2018.01.122] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Health-related quality of life (HRQOL) is impaired in chronic obstructive pulmonary disease (COPD) patients, but determining factors for HRQOL are still not unequivocal. This study measures HRQOL among patients with COPD and aims to determine factors associated with HRQOL. Methods Data for cross-sectional analyses were obtained from the baseline of a cohort study. The study population includes adult COPD patients (disease duration ≥3 months), recruited from primary and secondary care settings in Germany, without acute psychiatric/neurologic disease (exception: affective/ anxiety disorders). HRQOL was assessed using the Short-Form 12 (SF-12) Health Survey Questionnaire, comprising a physical and mental component. Independent variables encompass socio-demographic, disease-specific, treatment-related and psychological factors. Multivariable linear regression analyses were conducted. Results In total, 206 COPD patients (60.7% male; mean age: 65.3 years) took part in the study. In multivariable analysis, the physical component score showed a significant negative association with the COPD Assessment Test (CAT) (P<0.001) and a higher total number of prescribed medications (P=0.001). A higher forced expiratory volume in 1 second (FEV1) value in percent predicted was significantly related to the physical component score in a positive manner (P=0.006). The mental component score was significantly associated with elevated patient-reported symptoms of anxiety (P=0.002) or depression (P<0.001), measured by the hospital anxiety and depression scale (HADS) in a negative way. Like for the physical component score (P<0.001), a worse CAT score was significantly associated with a lower mental component score (P=0.033). Conclusions Focusing on patient reported outcomes and screening for depression and anxiety with potential successive treatment might be promising approaches to improve HRQOL in patients with COPD.
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Affiliation(s)
- Magdalena Brandl
- Medical Sociology, Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Merle M Böhmer
- Bavarian Health and Food Safety Authority, Munich, Germany
| | - Susanne Brandstetter
- Medical Sociology, Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Tamara Finger
- Medical Sociology, Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Wiebke Fischer
- Medical Sociology, Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | | | - Christian Apfelbacher
- Medical Sociology, Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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Levy AR, Matata B, Pilsworth S, Mcgonigle A, Wigelsworth L, Jones L, Pott N, Bettany M, Midgley AW. An intervention for pulmonary rehabilitators to develop a social identity for patients attending exercise rehabilitation: a feasibility and pilot randomised control trial protocol. Pilot Feasibility Stud 2018; 4:40. [PMID: 29423258 PMCID: PMC5787301 DOI: 10.1186/s40814-018-0238-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a degenerative condition that can impair health-related quality of life (HRQoL). A number of self-management interventions, employing a variety of behavioural change techniques (BCTs), have been adopted to improve HRQoL for COPD patients. However, a lack of attention has been given to group management interventions with an emphasis on incorporating BCTs into rehabilitators' practice. This study aims to pilot and feasibly explore a social identity group management intervention, delivered by COPD rehabilitation staff to patients attending exercise pulmonary rehabilitation. Doing so will help inform the plausibility of the intervention before conducting a full trial to evaluate its effectiveness to improve HRQoL. METHODS This is a two-centre, randomised cross-over controlled trial. Two pulmonary rehabilitation centres based in the UK will be randomly allocated to two treatment arms (standard care and intervention). Outcome measurements relating to HRQoL and social identity will be completed pre- and post-exercise rehabilitation. Focus group interviews will be conducted at the end of exercise rehabilitation to capture participants' contextualised experiences of the intervention. COPD rehabilitators will undertake semi-structured interviews at the end of the trial to garner their holistic perspectives of intervention fidelity and implementation. DISCUSSION This is the first study to adopt a social identity approach to develop a rehabilitator-led, group management intervention for COPD patients attending exercise pulmonary rehabilitation. The results of this study will provide evidence for the feasibility and sample size requirements to inform a larger study, which can ascertain the intervention's effectiveness for improving HRQoL for COPD patients. TRIAL REGISTRATION ClinicalTrials.gov NCT02288039. Date 31 October 2014.
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Affiliation(s)
- Andrew R. Levy
- Department of Psychology, Edge Hill University, Ormskirk, L39 4QP UK
| | - Bashir Matata
- Clinical Trials Unit, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool, L14 3PE UK
| | - Sam Pilsworth
- Knowsley Community Respiratory Service, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool, L14 3PE UK
| | - Adrian Mcgonigle
- Knowsley Community Respiratory Service, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool, L14 3PE UK
| | - Lyndsey Wigelsworth
- Knowsley Community Respiratory Service, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool, L14 3PE UK
| | - Linda Jones
- Knowsley Community Respiratory Service, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool, L14 3PE UK
| | - Nicola Pott
- Knowsley Community Respiratory Service, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool, L14 3PE UK
| | - Max Bettany
- Knowsley Community Respiratory Service, Liverpool Heart and Chest Hospital, Thomas Drive, Liverpool, L14 3PE UK
| | - Adrian W. Midgley
- Department of Sport and Physical Activity, Edge Hill University, Ormskirk, L39 4QP UK
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Brien SB, Stuart B, Dickens AP, Kendrick T, Jordan RE, Adab P, Thomas M. Independent determinants of disease-related quality of life in COPD - scope for nonpharmacologic interventions? Int J Chron Obstruct Pulmon Dis 2018; 13:247-256. [PMID: 29386893 PMCID: PMC5765972 DOI: 10.2147/copd.s152955] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose Quality-of-life (QoL) scores in chronic obstructive pulmonary disease (COPD) have a weak relationship with physiologic impairment. We investigated factors associated with poor QoL, focusing on psychological measures potentially amenable to intervention. Patients and methods We utilized a pre-existing Birmingham (UK) COPD cohort to assess factors associated with QoL impairment (COPD Assessment Test [CAT] scores). Univariate and multivariate regression models were constructed from three categories of variables: demographic, lung function/COPD-related symptoms, and psychosocial/behavioral factors. Results Analyses were based on self-report questionnaire data from 735 participants. The multivariate model of variables independently associated with CAT included depression, dysfunctional breathing symptoms (Nijmegen score), and illness perception, in addition to COPD symptoms (wheeze, cough), exercise capacity, breathlessness, exacerbations, and deprivation; this model explained 72% of CAT score variation. In a dominance analysis assessing the relative contribution of variables, similar contributions were made by breathlessness (20.2%), illness perception (19.8%), dysfunctional breathing symptoms (17.5%), and depression (12.5%) with other variables contributing <5%. Conclusion Psychological factors significantly contribute to disease-specific QoL impairment in COPD, and potentially explain the mismatch between objective physiologic impairment and patients’ experience of their disease. Interventions targeting psychological factors, illness perception, and dysfunctional breathing should be assessed.
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Affiliation(s)
- Sarah B Brien
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, Hampshire
| | - Beth Stuart
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, Hampshire
| | - Andrew P Dickens
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, Warwickshire, UK
| | - Tony Kendrick
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, Hampshire
| | - Rachel E Jordan
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, Warwickshire, UK
| | - Paymane Adab
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, Warwickshire, UK
| | - Mike Thomas
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, Hampshire
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Mallouli M, Dardouri M, Ajmi T, Mtiraoui A, Ben Dhiab M, Zedini C. Factors Determining the Quality of Life of Patients With COPD: A Review. ACTA ACUST UNITED AC 2017; 24:227-31. [DOI: 10.1097/cpm.0000000000000222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Graney BA, Wamboldt FS, Baird S, Churney T, Fier K, Korn M, Mccormick M, Vierzba T, Swigris JJ. Looking ahead and behind at supplemental oxygen: A qualitative study of patients with pulmonary fibrosis. Heart Lung 2017; 46:387-93. [DOI: 10.1016/j.hrtlng.2017.07.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/02/2017] [Accepted: 07/05/2017] [Indexed: 11/22/2022]
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Ahmed MS, Neyaz A, Aslami AN. Health-related quality of life of chronic obstructive pulmonary disease patients: Results from a community based cross-sectional study in Aligarh, Uttar Pradesh, India. Lung India 2016; 33:148-53. [PMID: 27051101 PMCID: PMC4797432 DOI: 10.4103/0970-2113.177438] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. It is an incurable disease with improvement in quality of life (QOL) as a major focus area for management. This study assesses the QOL of COPD patients and the factors affecting it. Materials and Methods: All 124 patients diagnosed with COPD in a larger cross-sectional study to determine the prevalence of COPD were assessed for their QOL using St. George's respiratory questionnaire for COPD patients (SGRQ-C). Spirometry was performed to assess lung function and diagnose COPD. Chronic lung disease (CLD) severity index was used to assess the severity of symptoms and the Medical Research Council questionnaire was used to assess the severity of dyspnea. Sociodemographic data regarding the patients were also recorded. Results: Patients with COPD showed significantly reduced health-related quality of life (HRQOL). CLD estimate for severity of lung disease and the Medical Research Council assessment for dyspnea and the duration of illness showed a highly significant positive correlation with HRQOL. There was a statistically significant negative correlation between lung function and SGRQ-C score. Increasing age, increased quantum of smoking, and lower socioeconomic status were correlated with poorer HRQOL. No association between QOL and education, body mass index (BMI), and gender was observed. Conclusion: This study showed that Indian patients with COPD had reduced HRQOL. Poor lung function, increased disease duration and smoking, and worsening symptoms impacted HRQOL negatively.
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Affiliation(s)
| | - Arslan Neyaz
- Department of Community Medicine, NIMS Medical College, Jaipur, Rajasthan, India
| | - Ahmad Nadeem Aslami
- Department of Community Medicine, Travancore Medical College, Kollam, Kerala, India
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24
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Borge CR, Moum T, Puline Lein M, Austegard EL, Wahl AK. Illness perception in people with chronic obstructive pulmonary disease. Scand J Psychol 2014; 55:456-63. [DOI: 10.1111/sjop.12150] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 05/21/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Christine Råheim Borge
- Department of Health Sciences; University of Oslo; Norway
- Department of Medicine; Lovisenberg Diaconale Hospital; Oslo Norway
| | - Torbjørn Moum
- Department of Behavioral Sciences in Medicine; University of Oslo; Norway
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da Costa CC, de Azeredo Lermen C, Colombo C, Canterle DB, Machado MLL, Kessler A, Teixeira PJZ. Effect of a Pulmonary Rehabilitation Program on the levels of anxiety and depression and on the quality of life of patients with chronic obstructive pulmonary disease. Rev Port Pneumol 2014; 20:299-304. [PMID: 24874610 DOI: 10.1016/j.rppneu.2014.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 02/27/2014] [Accepted: 03/21/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To analyze the effect of a Pulmonary Rehabilitation Program (PRP) on the levels of anxiety and depression and the quality of life of patients with chronic obstructive pulmonary disease. METHOD Patients with chronic obstructive pulmonary disease (COPD) who completed the PRP of 3 weekly sessions of 60 min duration for 12 weeks, a total of 36 sessions, were assessed using Beck Inventory (BAI and BDI) and Saint George's Respiratory Questionnaire (SGRQ). RESULTS A total of 125 individuals, with an average age of 63.7 ± 8.8 years, FEV1: 1.17 ± 0.57L (43.18 ± 18.79% predicted), 61.6% male and 38.4% female, were analyzed. The BAI and BDI before and after PRP were, respectively, 10.15 ± 6.32 vs. 7.67 ± 7.21; p=0.0041 and 12.60 ± 7.99 vs. 8.96 ± 7.29; p=0.00016. The results of the SGRQ domains were, respectively, Before and After symptoms (48.53 ± 20.41 vs. 32.58 ± 18.95), Activity (69.15 ± 20.79 vs. 52.42 ± 23.70), Impact (32.92 ± 18.29 vs. 20.27 ± 16.70), Total (46.69 ± 16.90 vs. 32.07 ± 16.96). When correlating the BDI to the domains of the SGRQ, weak correlations were observed (Symptoms r=0.22; p=0.01; Activity r=0.28; p=0.001; Impact r=0.52; p=2.72; Total r=0.44; p=0.17). In the same way, weak correlations were observed when correlating the BAI to the SGRQ (Symptoms r=0.28; p=0.0009; Activity r=0.32; p=0.0005; Impact r=0.42; p=7.33; Total r=0.43; p=0.74). CONCLUSION Although the PRP improves levels of depression and anxiety as well as the quality of life in patients with COPD, no significant correlation of these analyzed variables was observed.
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Affiliation(s)
- C C da Costa
- Universidade Federal do Rio Grande do Sul, Center for Health Sciences and Coordinator of the Pulmonary Rehabilitation Project, Universidade Feevale, Flores da Cunha, 111 ap. 504, CEP: 93410-110, Novo Hamburgo, RS, Brazil.
| | - C de Azeredo Lermen
- Universidade Feevale, Maurício Cardoso, 980 ap. 206, Novo Hamburgo, RS, Brazil.
| | - C Colombo
- Universidade Feevale, R. Silveira Martins, 655 ap. 905, Novo Hamburgo, RS, Brazil.
| | - D B Canterle
- Universidade Federal do Rio Grande do Sul, Center for Health Sciences, Universidade Feevale, Rua Caeté, 200 ap. 34, Novo Hamburgo, RS, Brazil.
| | - M L L Machado
- Universidade do Vale do Sinos, Center for Health Sciences, Universidade Feevale, Rua Adolfo Jaeger, 44 ap. 201, Novo Hamburgo, RS, Brazil.
| | - A Kessler
- Universidade Federal do Rio Grande do Sul, Center for Health Sciences, Universidade Feevale, RS, Brazil; Department of Physiotherapy, Universidade Federal de Ciências da Saúde de Porto Alegre, Av. Itajaí, 368 ap. 301, Porto Alegre, RS, Brazil.
| | - P J Z Teixeira
- Universidade Federal do Rio Grande do Sul, Center for Health Sciences, Universidade Feevale, RS, Brazil; Department of Medical Clinic, Pulmonology, Universidade Federal de Ciências da Saúde de Porto Alegre, ERS 239, 2755, Novo Hamburgo, RS, Brazil.
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Martinez CH, St Jean BL, Plauschinat CA, Rogers B, Beresford J, Martinez FJ, Richardson CR, Han MK. Internet access and use by COPD patients in the National Emphysema/COPD Association Survey. BMC Pulm Med 2014; 14:66. [PMID: 24755090 PMCID: PMC4021217 DOI: 10.1186/1471-2466-14-66] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 03/26/2014] [Indexed: 12/20/2022] Open
Abstract
Background Technology offers opportunities to improve healthcare, but little is known about Internet use by COPD patients. We tested two hypotheses: Internet access is associated with socio-demographic disparities and frequency of use is related to perceived needs. Methods We analyzed data from a 2007–2008 national convenience sample survey of COPD patients to determine the relationship between Internet access and frequency of use with demographics, socio-economic status, COPD severity, and satisfaction with healthcare. Results Among survey respondents (response rate 7.2%; n = 914, 59.1% women, mean age 71.2 years), 34.2% reported lack of Internet access, and an additional 49% had access but used the Internet less than weekly. Multivariate models showed association between lack of access and older age (OR 1.10, 95% CI 1.07, 1.13), lower income (income below $30,000 OR 2.47, 95% CI 1.63, 3.73), less education (high school highest attainment OR 2.30, 95% CI 1.54, 3.45), comorbid arthritis or mobility-related disease (OR 1.56, 95% CI 1.05, 2.34). More frequent use (at least weekly) was associated with younger age (OR 0.95, 95% CI 0.93, 0.98), absence of cardiovascular disease (OR 0.48, 95% CI 0.29, 0.78), but with perception of needs insufficiently met by the healthcare system, including diagnostic delay (OR 1.72, 95% CI 1.06, 2.78), feeling treated poorly (OR 2.46, 95% CI 1.15, 5.24), insufficient physician time (OR 2.29, 95% CI 1.02, 5.13), and feeling their physician did not listen (OR 3.14, 95% CI 1.42, 6.95). Conclusions An analysis of the characteristics associated with Internet access and use among COPD patients identified two different patient populations. Lack of Internet access was a marker of socioeconomic disparity and mobility-associated diseases, while frequent Internet use was associated with less somatic disease but dissatisfaction with care.
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Affiliation(s)
- Carlos H Martinez
- Division of Pulmonary and Critical Care, University of Michigan Health System, 3916 Tubman Center, 1500 E, Medical Center Drive, Box 0360, Ann Arbor, USA.
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Villar Balboa I, Carrillo Muñoz R, Regí Bosque M, Marzo Castillejo M, Arcusa Villacampa N, Segundo Yagüe M. [Factors associated with the quality of life in patients with chronic obstructive pulmonary disease]. Aten Primaria 2014; 46:179-87. [PMID: 24262284 PMCID: PMC6983611 DOI: 10.1016/j.aprim.2013.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 09/05/2013] [Accepted: 09/14/2013] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To describe the relationship between individual or combined prognostic factors in the multidimensional classifications (BODE and ADO), and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD). DESIGN Cross-sectional descriptive study. SETTING Primary care. PARTICIPANTS Systematic random sample of 102 patients diagnosed with COPD, excluding those patients with acute exacerbation, dementia, terminal illness or those who receive home care. MAIN MEASUREMENTS Demographics variables, smoking habits, body mass index and number of exacerbations. Comorbidity. Degree of dyspnea. Respiratory function tests. Exercise capacity. The BODE index and the ADO index. The EuroQol-5D questionnaire (EQ-5D), and visual analogue scale (VAS). RESULTS EQ-5D: mobility: 43.9%; personal care: 13.3%; daily-life activities: 29.6%; pain/discomfort: 55.1%; anxiety/depression: 37.8%, and 34.7% VAS ≤ 60%. Exacerbations: Mobility, OR: 1.85 (95%CI: 1.08-3.20); personal care, OR: 2.12 (95%CI: 1.3-4.76); daily-life activities, OR: 2.35 (95%CI: 1.17-4.71); VAS, regression coefficient: -3.50 (95%CI: 6.31- -0.70). Dyspnea: mobility, OR: 4.47 (95%CI: 1.39-14.42); daily-life activities, OR: 7.71 (95%CI: 2.03-12.34); VAS, regression coefficient: -7.15 (95%CI: 11.71- -2.59). BODE: mobility, OR: 1.53 (95%CI: 1.15-2.02); personal care, OR: 2.08 (95%CI: 1.40-3.11); daily-life activities, OR: 1.97 (95%CI: 1.38-2.80); VAS, regression coefficient: -3.96 (95%CI: -5.51- -2.42). ADO: mobility, OR: 2.42 (95%CI: 1.39-4.20); personal care, OR: 3.21 (95%CI: 1.67-6.18); daily-life activities, OR: 3.17 (95%CI: 1.69-5.93); VAS, regression coefficient: -3.53 (95%CI: -5.57- -1.49). CONCLUSIONS The BODE index and the ADO index showed a significant association with HRQOL. Exacerbations and dyspnea were the best individual factors related to HRQoL.
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Affiliation(s)
- Iván Villar Balboa
- Medicina de Familia y Comunitaria, Equipo de Atención Primaria Florida Sud, Unitat Docent Multiprofessional d'Atenció Familiar i Comunitària Costa de Ponent, Institut Català de la Salut, L'Hospitalet de Llobregat, Barcelona, España.
| | - Ricard Carrillo Muñoz
- Medicina de Familia y Comunitaria, Equipo de Atención Primaria Florida Sud, Unitat Docent Multiprofessional d'Atenció Familiar i Comunitària Costa de Ponent, Institut Català de la Salut, L'Hospitalet de Llobregat, Barcelona, España
| | - Meritxell Regí Bosque
- Medicina de Familia y Comunitaria, Equipo de Atención Primaria Can Serra, Unitat Docent Multiprofessional d'Atenció Familiar i Comunitària Costa de Ponent, Institut Català de la Salut, L'Hospitalet de Llobregat, Barcelona, España
| | - Mercè Marzo Castillejo
- Medicina de Familia y Comunitaria, Salud Pública y Medicina Preventiva, Unitat de Suport a la Recerca de Costa de Ponent-Institut d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Direcció d'Atenció Primària Costa de Ponent, Institut Català de la Salut, Barcelona, España
| | - Núria Arcusa Villacampa
- Medicina de Familia y Comunitaria, Equipo de Atención Primaria Florida Sud, Unitat Docent Multiprofessional d'Atenció Familiar i Comunitària Costa de Ponent, Institut Català de la Salut, L'Hospitalet de Llobregat, Barcelona, España
| | - Marta Segundo Yagüe
- Medicina de Familia y Comunitaria, Equipo de Atención Primaria Molí Nou, Unitat Docent Multiprofessional d'Atenció Familiar i Comunitària Costa de Ponent, Institut Català de la Salut, Sant Boi de Llobregat, Barcelona, España
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Zohal MA, Yazdi Z, Kazemifar AM, Mahjoob P, Ziaeeha M. Sleep Quality and Quality of Life in COPD Patients with and without Suspected Obstructive Sleep Apnea. Sleep Disord 2014; 2014:508372. [PMID: 24587911 DOI: 10.1155/2014/508372] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/03/2013] [Accepted: 11/05/2013] [Indexed: 11/29/2022]
Abstract
Present study was designed to obtain association between sleep apnea with sleep quality and quality of life in COPD patients. This cross-sectional descriptive study was conducted on 139 patients with COPD in a chest clinic of a university hospital. All patients were evaluated by pulmonary function test for determination of severity of their disease. Also, Berlin questionnaire, Epworth sleepiness scale, Pittsburgh Sleep Quality Index, and St. George Respiratory questionnaires (SGRQ) were employed for assessment of patients. Analysis of data showed that quality of sleep was significantly correlated with quality of life (P < 0.001). About half of the patients were at high risk for sleep apnea. The patients were divided into two groups according to the result of Berlin questionnaire. Significant differences were found between the groups for total score and each of three subscores of SGRQ suggesting worse quality of life in overlap syndrome (P < 0.001). Also, patients with overlap syndrome had worse quality of sleep compared to patients without it (8.1 ± 1.7 versus 6.2 ± 2.3; P < 0.001). Stepwise multiple regression analysis showed that severity of COPD, coexisting obstructive sleep apnea, and sleep quality accounted for the SGRQ significantly (r2 (coefficient of determination) = 0.08, 0.21, and 0.18, resp.). It is recommended that patient with COPD be evaluated for sleep apnea and sleep disorders during routine examinations and followups.
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Abstract
AIM The purpose of this concept analysis is to examine the health-related quality of life in patients with moderate to severe chronic obstructive pulmonary disease (COPD). BACKGROUND COPD is the third leading cause of death in the United States. Health-related quality of life (HRQoL) in patients with moderate to severe COPD has not been clearly defined. DESIGN Walker and Avant's concept analysis methodology was employed. REVIEW METHODS The author examined articles focusing on QoL, HRQoL, and HRQoL in COPD. RESULTS The concept analysis explores the negative consequences related to COPD while defining HRQoL and the characteristics of positive HRQoL. CONCLUSION Patients living with COPD should be assessed for HRQoL status.
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Affiliation(s)
- April L Mouser
- School of Nursing, Indiana University Kokomo, Kokomo, Indiana
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31
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Weldam SWM, Lammers JWJ, Decates RL, Schuurmans MJ. Daily activities and health-related quality of life in patients with chronic obstructive pulmonary disease: psychological determinants: a cross-sectional study. Health Qual Life Outcomes 2013; 11:190. [PMID: 24192270 PMCID: PMC4228311 DOI: 10.1186/1477-7525-11-190] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 10/31/2013] [Indexed: 02/07/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) patients are confronted with reduced daily activities (DA) and reduced health-related quality of life (HRQoL) caused by dyspnea and systemic effects such as skeletal muscle dysfunction and co-morbidities. To understand the complexity of living with COPD, it is important to understand which factors, in addition to physical functioning, are associated with DA and HRQoL. In this study, we explored the extent to which the combination of illness perceptions, proactive coping, and depressive symptoms contribute to DA and HRQoL in COPD patients. Method In a cross-sectional study in primary care, 90 COPD patients (GOLD I-III) completed questionnaires: the Brief Illness Perception Questionnaire, the Utrecht Proactive Coping Competence scale, the Centers for Epidemiologic Studies Depression scale, the Medical Research Council dyspnea scale, the Functional Performance Inventory (FPI), and the Clinical COPD Questionnaire (CCQ). The analyses were performed with multiple linear regression analyses. Results More adequate and positive illness perceptions (β = .61, p < .001) and less depressive symptoms (β = .21, p = .010) were associated with better HRQoL (CCQ). Significant relations between psychological factors and DA were not found. Conclusion The results of this study demonstrate that psychological factors are related to HRQoL, but not to DA. These results contribute to understanding the complexity of living with COPD and provide starting points for the development of interventions focusing on psychological factors to support COPD patients in disease management.
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Affiliation(s)
- Saskia W M Weldam
- Department of Respiratory Diseases, Division Heart & Lungs, University Medical Center Utrecht, HP E03,511, PO Box 85500, Utrecht 3508 GA, the Netherlands.
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Holm KE, Plaufcan MR, Ford DW, Sandhaus RA, Strand M, Strange C, Wamboldt FS. The impact of age on outcomes in chronic obstructive pulmonary disease differs by relationship status. J Behav Med 2014; 37:654-63. [PMID: 23645147 DOI: 10.1007/s10865-013-9516-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 04/25/2013] [Indexed: 01/11/2023]
Abstract
Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that can lead to early-onset chronic obstructive pulmonary disease (COPD). The objective of this study was to examine the impact of age on psychological and clinical outcomes among individuals with AATD-associated COPD. 468 individuals with AATD-associated COPD (age 32-84 at baseline) completed questionnaires at baseline, 1- and 2-year follow-up. Age was examined as a predictor of depression, anxiety, health-related quality of life, and breathlessness at all three time points using linear mixed models. Age was associated with anxiety (b = -0.09, SE = 0.02, p < 0.001) and health-related quality of life (b = -0.29, SE = 0.09, p < 0.001). Age also had a statistically significant interaction with relationship status when predicting depression, health-related quality of life, and breathlessness. Among individuals who were single, younger age was associated with more symptoms of depression (b = -0.08, SE = 0.03, p < 0.01), worse health-related quality of life (b = -0.61, SE = 0.16, p < 0.001), and more breathlessness (b = -0.023, SE = 0.009, p < 0.01) throughout the 2-year study. Age was not associated with these three outcomes among individuals who were married/part of an unmarried couple. Results suggest that individuals who develop a chronic illness at a young age, particularly those who are single, may be more likely to have worse psychological and clinical outcomes.
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Burgel PR, Escamilla R, Perez T, Carré P, Caillaud D, Chanez P, Pinet C, Jebrak G, Brinchault G, Court-Fortune I, Paillasseur JL, Roche N. Impact of comorbidities on COPD-specific health-related quality of life. Respir Med 2013; 107:233-41. [DOI: 10.1016/j.rmed.2012.10.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 09/26/2012] [Accepted: 10/03/2012] [Indexed: 01/31/2023]
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Berry CE, Drummond MB, Han MK, Li D, Fuller C, Limper AH, Martinez FJ, Schwarz MI, Sciurba FC, Wise RA. Relationship between lung function impairment and health-related quality of life in COPD and interstitial lung disease. Chest 2013; 142:704-711. [PMID: 22576634 DOI: 10.1378/chest.11-1332] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Health-related quality-of-life (HRQL) measures have been correlated with lung function in patients with COPD and interstitial lung disease (ILD). However, different pathophysiologic mechanisms may influence how these distinct diseases affect HRQL, resulting in differing HRQL by pulmonary diagnosis among patients with similar severity of ventilatory impairment. METHODS The National Heart, Lung, and Blood Institute Lung Tissue Research Consortium provided data on well-characterized participants with COPD (n = 576) and ILD (n = 405) at four clinical sites. Using multiple linear regression, we examined the effects of FEV₁ (% predicted) and diagnosis (ILD vs COPD) on HRQL scores, including total St. George Respiratory Questionnaire (SGRQ) scores and Short Form-12 (SF-12) physical component summary (PCS) and mental component summary (MCS) scores. RESULTS Participants with ILD had, on average, higher SGRQ scores (15.33 points; 95% CI, 12.46-18.19; P <.001) and lower SF-12 PCS scores (-4.73 points; 95% CI, -6.31 to -3.14; P <.001) compared with patients with COPD with similar FEV₁ % predicted values, indicating worse HRQL. The specific diagnosis also modified the effect of FEV₁ on the total SGRQ score (P = .003) and the SF-12 PCS score (P = .03). There was no relationship between lung function and SF-12 MCS scores. CONCLUSIONS HRQL scores were worse for patients with ILD compared with patients with COPD with similar degrees of ventilatory impairment. Differences in dyspnea mechanism or in the rate of disease progression may account for these differences in HRQL.
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Affiliation(s)
- Cristine E Berry
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - M Bradley Drummond
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - MeiLan K Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI
| | - Daner Li
- C-TASC Clinical Trials and Surveys Corporation, Owings Mills, MD
| | - Cathy Fuller
- C-TASC Clinical Trials and Surveys Corporation, Owings Mills, MD
| | - Andrew H Limper
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN
| | - Fernando J Martinez
- Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI
| | - Marvin I Schwarz
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Denver School of Medicine, Aurora, CO
| | - Frank C Sciurba
- Division of Pulmonary and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Robert A Wise
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
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Mroz RM, Minarowski L, Chyczewska E. Indacaterol add-on therapy improves lung function, exercise capacity and life quality of COPD patients. Adv Exp Med Biol 2012; 756:23-8. [PMID: 22836615 DOI: 10.1007/978-94-007-4549-0_4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a progressive, inflammatory condition, involving airways and lung parenchyma. The disease leads to airflow limitation, and pulmonary hyperinflation, resulting in dyspnea, decreased exercise tolerance, and impaired quality of life. COPD pharmacotherapy guidelines are based on a combination of long-acting beta2-agonists (LABA), long-acting antimuscarinic agents (LAMA) and methyloxantins. Recently, indacaterol, ultralong acting beta2-agonist, has been introduced. The aim of our study was to assess the impact of indacaterol add-on therapy on lung function, exercise tolerance and quality of life of COPD patients. Thirty four COPD patients, receiving stable bronchodilator therapy were randomly allocated into two arms of add-on treatment (1:1 - indacaterol:placebo) for 3 months. Indacaterol replaced LABA in all patients receiving LABA. Spirometry, lung volumes, DLCO, St George's Respiratory Questionnaire (SGRQ) and 6 min Walk Distance (6MWD) were performed before and after therapy. We found that in the indacaterol group FEV1 did not changed significantly. However, there were significant improvements in ERV, 6MWD, and 6MWD-related dyspnea score. We also found that the degree of desaturation before and after 6MWD, and fatigue levels significantly improved in the indacaterol group. The patients' quality of life also changed favorably in the indacaterol treatment arm. We conclude that the add-on therapy with indacaterol exerts positive effects in COPD patients.
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Affiliation(s)
- R M Mroz
- Department of Lung Diseases, Medical University of Bialystok, Zurawia 14, Bialystok, Poland.
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Cedano S, Belasco AGS, Traldi F, Machado MCLO, Bettencourt ARDC. Influence that sociodemographic variables, clinical characteristics, and level of dependence have on quality of life in COPD patients on long-term home oxygen therapy. J Bras Pneumol 2012; 38:331-8. [PMID: 22782603 DOI: 10.1590/s1806-37132012000300008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 03/08/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate and correlate the quality of life (QoL) of COPD patients on long-term home oxygen therapy (LTOT) with their sociodemographic/clinical characteristics and level of dependence. METHODS This was a cross-sectional analytical study involving COPD patients on LTOT followed at the Oxygen Therapy Outpatient Clinic of the Federal University of São Paulo Hospital São Paulo, in the city of São Paulo, Brazil. Sociodemographic, clinical, and biochemical data were collected. We assessed QoL and level of dependence using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and the Katz index, respectively. Multiple linear regression models were constructed in order to determine the influence of these variables on QoL. RESULTS We included 80 patients in the study. The mean age was 69.6 ± 9.1 years, and 51.3% were female. The lowest SF-36 scores were for the physical functioning and role-physical domains. All sociodemographic characteristics (except gender) were found to correlate significantly with the SF-36 domains mental health, vitality, role-physical, and social functioning. We also found that body mass index, PaO2, post-bronchodilator FEV1, hemoglobin, and Katz index correlated significantly with the physical functioning, mental health, role-physical, and bodily pain domains. In addition, oxygen flows were found to correlate negatively with the physical functioning, mental health, vitality, and role-emotional domains. CONCLUSIONS Low scores for SF-36 domains, as well as the variables that negatively influence them, should be considered and analyzed during the development and implementation of strategies for improving the QoL of COPD patients on LTOT.
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Affiliation(s)
- Simone Cedano
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
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Deslee G, Barbe C, Bourdin A, Durand-Zaleski I, Dutau H, Jolly D, Jounieaux V, Kessler R, Mal H, Pison C, Thiberville L, Vergnon JM, Marquette CH. [Cost-effectiveness of lung volume reduction coil treatment in emphysema. STIC REVOLENS]. Rev Mal Respir 2012. [PMID: 23200592 DOI: 10.1016/j.rmr.2012.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Medical therapeutic options for the treatment of emphysema remain limited. Lung volume reduction surgery is infrequently used because of its high morbi-mortality. Endobronchial lung volume reduction coil (LVRC(®), PneumRx, Mountain View, CA) treatment has been recently developed and has been shown to be feasible and associated with an acceptable safety profile, while resulting in improvements in dyspnea, exercise capacity and lung function. The objective of this study is to analyze the cost effectiveness of LVRC treatment in severe emphysema. METHODS This prospective, multicenter study, randomized with a 1:1 ratio (LVRC vs conventional treatment) will include 100 patients who will be followed up for 1year. The primary outcome measure is the 6-month improvement of the 6-minute walk test: the percentage of patients showing an improvement of at least 54m will be compared between groups. A cost-effectiveness study will estimate the cost of LVRC treatment, the global cost of this therapeutic option and will compare the cost between patients treated by LVRC and by medical treatment alone. EXPECTED RESULTS This study should allow validating the clinical efficacy of LVRC in severe emphysema. The cost-effectiveness study will assess the medical-economic impact of the LVRC therapeutic option.
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Affiliation(s)
- G Deslee
- Service de pneumologie, hôpital Maison-Blanche, CHU de Reims, 45 rue Cognacq-Jay, Reims, France.
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Mapel DW, Roberts MH. New clinical insights into chronic obstructive pulmonary disease and their implications for pharmacoeconomic analyses. Pharmacoeconomics 2012; 30:869-85. [PMID: 22852587 PMCID: PMC3625413 DOI: 10.2165/11633330-000000000-00000] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death and disability worldwide, but before the development of several new pharmacological treatments little could be done for COPD patients. Recognition that these new treatments could significantly improve the prognosis for COPD patients has radically changed clinical management guidelines from a palliative philosophy to an aggressive approach intended to reduce chronic symptoms, improve quality of life and prolong survival. These new treatments have also sparked interest in COPD cost-effectiveness research. Most COPD cost-effectiveness studies have been based on clinical trial populations, limited to direct medical costs, and used standard analysis methods such as Markov modelling, and they have usually found that newer therapies have favourable cost effectiveness. However, new insights into the clinical progression of COPD bring into question some of the assumptions underlying older analyses. In this review, we examine clinical factors unique to COPD and recent changes in clinical perspectives that have important implications for pharmacoeconomic analyses. The main parameters explored include (i) the high indirect medical costs for COPD and their relevance in assessing the societal benefits of new therapy; (ii) the importance of acute deteriorations in COPD, known as exacerbations, and approaches to modelling the cost benefit of exacerbation reduction; (iii) quality/utility instruments for COPD; (iv) the prevalence of co-morbid conditions and confounding between COPD and co-morbid disease utilization; (v) the limitations of Markov modelling; and (vi) the problem of outliers.
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Affiliation(s)
- Douglas W Mapel
- Lovelace Clinic Foundation, Albuquerque, MN 87106-4264, USA.
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Jacobsen R, Frølich A, Godtfredsen NS. Impact of exercise capacity on dyspnea and health-related quality of life in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil Prev 2012; 32:92-100. [PMID: 22193931 DOI: 10.1097/HCR.0b013e31823be107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the impact of the amount of exercise training during pulmonary rehabilitation (PR) program for improvements in dyspnea and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD). METHODS Data on COPD patient health, exercise capacity, dyspnea, and HRQOL were collected at the start and at the end of PR, which was provided in the ambulatory section of the hospital and lasted for 7 weeks. Pulmonary rehabilitation program included exercise training, education, smoking cessation, and diet consultation sessions. Data were analyzed using multivariable linear regression. RESULTS Baseline data were obtained from a total of 143 patients with followup data in 108 patients available at the end of PR. The majority of the patient population had severe disease progression of COPD as exhibited by spirometry test results. Results of multivariable analyses showed that after adjustment for sociodemographic characteristics and baseline patient characteristics, changes in dyspnea and exercise capacity were directly and linearly predicted by the number of exercise training sessions attended. Changes in disease-specific and general HRQOL outcomes were not predicted by the amount of exercise training received during PR. CONCLUSIONS Quality of life in patients with COPD is predicted by dyspnea. Thus, to further investigate the influence of exercise training on quality of life in patients with CODP, simultaneous assessment of dyspnea should be considered.
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Kamal AH, Miriovsky BJ, Currow DC, Abernethy AP. Improving the management of dyspnea in the community using rapid learning approaches. Chron Respir Dis 2012; 9:51-61. [PMID: 22308555 DOI: 10.1177/1479972311433576] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patients with chronic pulmonary disease often suffer from breathlessness or dyspnea. Traditional evidence generation techniques to expand upon current treatment paradigms are limited by the significant delay between study initiation and clinical implementation of findings. Rapid learning health care is a novel approach to health care delivery that relies on intelligent and continuous integration of clinical and research data sets to deliver personalized medicine using the most current evidence available. Results of important studies in the management of chronic respiratory disease are presented in brief; however, the focus of this review is on evidence supporting the implementation of a rapid learning model for symptom management. Recent findings suggest that a rapid learning system is feasible and acceptable to patients with advanced illness, helps monitor symptoms overtime, facilitates study of the impact of novel interventions, and can identify unrecognized needs and concerns. A rapid learning model improves comprehensive assessment, timeliness of intervention, and accrual of contemporaneous data to support best practice that tailors care specific to the needs of patients as their disease and lifestyle change overtime. Using the rapid learning health care model, data collected in the process of routine care can simultaneously function both as clinical information and as a resource for research on patient-centered experiences and outcomes.
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Affiliation(s)
- Arif H Kamal
- Division of Medical Oncology, Department of Medicine, Duke Cancer Care Research Program, Duke Cancer Institute, Duke University Medical Center, NC 27710, USA
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Tsiligianni I, Kocks J, Tzanakis N, Siafakas N, van der Molen T. Factors that influence disease-specific quality of life or health status in patients with COPD: a review and meta-analysis of Pearson correlations. Prim Care Respir J 2012; 20:257-68. [PMID: 21472192 DOI: 10.4104/pcrj.2011.00029] [Citation(s) in RCA: 157] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND A major goal in the management of chronic obstructive pulmonary disease (COPD) is to ensure that the burden of the disease for patients with COPD is limited and that patients will have the best possible quality of life. AIMS To explore all the possible factors that could influence disease-specific quality of life and health status in patients with COPD. METHODS A systematic review of the literature and a meta-analysis were performed to explore the factors that could have a positive or negative effect on quality of life and/or health status in patients with COPD. RESULTS Quality of life and health status are determined by certain factors included gender, disease severity indices, lung function parameters, body mass index, smoking, symptoms, co-morbidity, depression, anxiety, and exacerbations. Factors such as dyspnoea, depression, anxiety and exercise tolerance were found to be more correlated with health status than the widely used spirometric values. Forced expiratory volume in one second had a weak to modest Pearson weighted correlation coefficient which ranged from -0.110 to -0.510 depending on the questionnaire used. CONCLUSIONS The broad range of determining factors suggests that, in order to reach the management goals, health status should be measured in addition to lung function in patients with COPD.
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Affiliation(s)
- Ioanna Tsiligianni
- University Medical Center, University of Groningen, Groningen, The Netherlands.
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Kamal AH, Maguire JM, Wheeler JL, Currow DC, Abernethy AP. Dyspnea review for the palliative care professional: assessment, burdens, and etiologies. J Palliat Med 2011; 14:1167-72. [PMID: 21895451 PMCID: PMC3189385 DOI: 10.1089/jpm.2011.0109] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2011] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dyspnea is a common symptom experienced by many patients with chronic, life-threatening, and/or life-limiting illnesses. Although it can be defined and measured in several ways, dyspnea is best described directly by patients through regular assessment, as its burdens exert a strong influence on the patient's experience throughout the trajectory of serious illness. Its significance is amplified due to its impact on family and caregivers. DISCUSSION Anatomic and physiologic changes associated with dyspnea, and cognitive perceptions related to patients and the underlying disease, provide insights into how to shape interventions targeting this oppressive symptom. Additionally, as described in the concept of "total dyspnea," the complex etiology and manifestation of this symptom require multidisciplinary treatment plans that focus on psychological, social, and spiritual distress as well as physical components. Several validated assessment tools are available for clinical and research use, and choice of method should be tailored to the individual patient, disease, and care setting in the context of patient-centered care. CONCLUSION This article, the first in a two-part series, reviews the identification and assessment of dyspnea, the burden it entails, and the underlying respiratory and nonrespiratory etiologies that may cause or exacerbate it.
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Affiliation(s)
- Arif H. Kamal
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina
| | - Jennifer M. Maguire
- Department of Medicine, Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Jane L. Wheeler
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina
| | - David C. Currow
- Department of Palliative and Supportive Services, Division of Medicine, Flinders University, Bedford Park, South Australia, Australia
| | - Amy P. Abernethy
- Department of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina
- Department of Palliative and Supportive Services, Division of Medicine, Flinders University, Bedford Park, South Australia, Australia
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Current world literature. Curr Opin Pulm Med 2011; 17:126-30. [PMID: 21285709 DOI: 10.1097/MCP.0b013e3283440e26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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