Resilience Factors Important in Health-Related Quality of Life of Subjects With COPD

Depression and comorbid chronic physical health diseases in the Australian population: A scoping review

OBJECTIVE

Chronic diseases are a major challenge in Australia, contributing to disability, premature mortality, and a significant healthcare burden. This burden is intensified when depression, a common mental health issue, co-occurs with chronic diseases. This scoping review aimed to investigate the relationship between depression and comorbid chronic diseases, namely cardiovascular disease (CVD), diabetes, asthma, and chronic obstructive pulmonary disease (COPD) in the Australian population.

METHODS

Following Joanna Briggs Institute (JBI) methodology, this scoping review searched for English-language articles published between January 2013 and December 2023. The review targeted studies examining depression and selected comorbid chronic diseases within the Australian population. Two independent reviewers conducted data screening and extraction, with results synthesised into tables and summarised narratively.

RESULTS

The search yielded 31 quantitative studies, highlighting a high prevalence of depression co-occurring with chronic diseases. Key findings included the worsening of chronic disease severity by depression, compounded by gender and age disparities, and the impact of socioeconomic factors impairing the quality of life. The review also identified significant challenges in the provision of care, particularly in rural areas, emphasising the need for integrated care models, and enhanced healthcare training.

CONCLUSION

This review revealed critical research gaps in understanding the relationship between depression and chronic diseases, particularly regarding underrepresented groups such as younger adults and rural populations. It highlights the need for improved diagnostic criteria, treatment approaches, and professional training, advocating for targeted research and policy interventions to improve outcomes and quality of life for individuals with depression and selected comorbid chronic diseases.

Factors associated with the core dimensions of spiritual health among older adults with chronic obstructive pulmonary disease: A cross-sectional study

AIMS

To investigate the level of spiritual health in older patients with chronic obstructive pulmonary disease (COPD) from the core dimensions and to explore its associated factors.

DESIGN

A cross-sectional study.

METHODS

Participants were recruited from four hospitals between September 2020 and June 2021, using a convenience sampling. Older patients with COPD (n = 162) completed the demographic and disease-related information questionnaires, Function Assessment of Chronic Illness Therapy Spiritual Scale, 10-item Connor-Davidson Resilience Scale, General Self-efficacy Scale, Social Support Rating Scale, COPD Assessment Test, 15-item Geriatric Depression Scale and modified Medical Research Council Dyspnea Scale. Descriptive statistics, Pearson and Spearman correlation analyses, t-tests, one-way ANOVA and multiple linear regression models were used.

RESULTS

Older patients with COPD have a moderate level of spiritual health. The multiple linear regression analysis showed that psychological resilience, general self-efficacy, social support, symptom burden and monthly income were associated with the core dimensions of spiritual health.

CONCLUSION

Chinese older patients with COPD have a moderate level of spiritual health. Psychological resilience, general self-efficacy, social support, monthly income and symptom burden were associated with the core dimensions of spiritual health.

IMPACT

This study is the first to investigate the level of spiritual health in older patients with COPD from the core dimensions and to explore its associated factors, providing a basis for developing spiritual intervention programs. Our findings can help us realize that intervention strategies of psychological resilience, general self-efficacy and social support can all be used to enhance spiritual health. Nurses should focus on the spiritual health of older COPD patients with high symptom burden and low monthly income.

PATIENT OR PUBLIC CONTRIBUTION

Although we did not directly involve patients and the public because of the COVID-19 pandemic, the results of the study will be disseminated to patients and the public through WeChat and seminars.

The relationship between mental health continuum and care dependency in individuals with chronic obstructive pulmonary disease: A cross-sectional study

AIM

To examine the relationship between mental health continuum and care dependence of hospitalized patients, who were diagnosed with chronic obstructive pulmonary disease (COPD).

DESIGN

Descriptive, cross-sectional study.

METHODS

The data were obtained from 448 inpatients diagnosed with COPD, who were treated in clinics, by utilizing questionnaires and face-to-face interviews between November 2021 and February 2022. The Mental Health Continuum Short Form and Care Dependency Scale were used by the researchers with the sociodemographic and clinical characteristics form created in line with the literature. The data were analysed using the SPSS 23.0 software.

RESULTS

It was determined that a moderately significant positive relationship between mental health continuum and care dependency. In addition, the patient's perception of own health, disease stage and severity of dyspnoea were also found to be associated with mental health and care dependency. Gender, marital status, employment status and income level were found to be associated with mental health continuum, but not with care dependency. Advanced age, low educational level, alcohol consumption, antidepressant use and comorbidities were found to be associated with both care dependency and mental health continuum.

CONCLUSION

Individuals with COPD who have low mental health, poor health perception, high disease stage and dyspnoea severity have high care dependency.

IMPACT

In this study, it was revealed that the level of mental health continuum was significantly associated with care dependency in individuals with COPD; in addition, the individual's perception of poor health, disease stage and dyspnoea severity were other factors associated with care dependency. It is important for nurses working with individuals with COPD to evaluate the mental health of individuals with poor health perception, high disease stage and dyspnoea severity and to plan appropriate interventions to reduce care dependency.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution was required in the design, conduct, analysis or interpretation of this study. Patients/public members only contributed to data collection. Data were obtained from patients hospitalized in the chest diseases clinic of a training and research hospital.

The association of resilience with self-care and quality of life in people with chronic obstructive pulmonary disease: A cross-sectional study

AIM

To investigate the association of resilience with self-care and quality of life in people with chronic obstructive pulmonary disease.

DESIGN

Cross-sectional study.

METHODS

Data were collected between February and May 2021. Self-care was measured with the self-care of chronic illness inventory, quality of life was measured with the clinical chronic obstructive pulmonary disease questionnaire and resilience was measured with the resilience evaluation scale. Possible confounders were included (sex, age, smoking, time since diagnosis of chronic obstructive pulmonary disease, educational level, social support and pulmonary function). Multiple regression analysis was performed among the determinants, confounders and both outcomes.

RESULTS

Participants scored fairly well on resilience (mean 22.5). Self-care scored reasonably well (mean maintenance 65.9, mean monitoring 70.9, mean management 59.9 and mean confidence 71.5). Quality of life scored mediocre (mean 2.6). The results of the linear multiple regression were resilience, which is associated with self-care confidence and quality of life when adjusted for possible confounders. This means people with chronic obstructive pulmonary disease with higher resilience have better self-care confidence and higher quality of life. The outcome contributes to strengthening nursing care and further developing nurses' knowledge. The results can contribute to increasing awareness for healthcare professionals that resilience can potentially increase self-care and quality of life.

Higher Lifetime Stress and Symptom Burden Contribute to the Occurrence of Shortness of Breath

OBJECTIVES

Among four classes of patients with distinct shortness of breath profiles, evaluate for differences in levels of global, cancer-specific, and cumulative life stress, as well as resilience; evaluate for differences in the occurrence rates for various stressful life events, and evaluate for differences in the severity of common co-occurring symptoms.

DATA SOURCES

Outpatients (N = 1338) completed questionnaires six times over two cycles of chemotherapy. The occurrence of shortness of breath was assessed using the Memorial Symptom Assessment Scale. Latent class analysis was used to identify subgroups of patients with distinct shortness of breath profiles. Differences among the classes were evaluated using parametric and nonparametric tests.

CONCLUSION

Shortness of breath classes were labeled based on their distinct occurrence trajectories: None (70.5%), Decreasing (8.2%), Increasing (7.8%), and High (13.5%). Compared to None class, Decreasing and High classes had higher global and cancer-specific stress scores. The High class reported higher occurrence rates for several adverse childhood experiences. Compared to None class, Decreasing and High classes had higher depression, anxiety, and morning fatigue scores and lower morning energy and cognitive function scores.

IMPLICATIONS FOR NURSING PRACTICE

Given the additive or synergistic relationships between stress, co-occurring symptoms, and shortness of breath, multimodal interventions that include stress management, exercise training, and/or symptom management may decrease shortness of breath in oncology patients.

Development and applicability of a dignity-centred palliative care programme for people with idiopathic pulmonary fibrosis: A qualitative-driven mixed methods study

AIMS

This study evaluated the acceptability of a dignity-centred palliative care programme for people with idiopathic pulmonary fibrosis by converging perceptions of living with idiopathic pulmonary fibrosis qualitative data and quantitative data.

DESIGN

The qualitative-driven mixed methods research addressed the study aim by using a convergent design. This single arm, non-randomized study used purposive sampling.

METHODS

Interviews with 12 stable outpatients with IPF provided qualitative data. Their quantitative data were from six scales: self-esteem, health-related quality of life, anxiety, depression, dyspnoea, cough and programme satisfaction. Intervention was three educational modules: symptom management, enhancing daily activities and life reviews.

RESULTS

Semi-structured interviews yielded eight categories. Self-esteem was not statistically significantly changed. Dyspnoea symptoms improved significantly. Participants (n = 9) holding positive attitudes for living with idiopathic pulmonary fibrosis, had improved lifestyle behaviour and improved or maintained self-esteem. The meta-inference regarding idiopathic pulmonary fibrosis perceptions were related to changes in self-esteem.

Quantifying Physical Resilience in Ageing Using Measurement Instruments: A Scoping Review

Purpose: The capacity to recover motor function with pathology or age-related decline is termed physical resilience. It is unknown what outcome domains are captured with existing measurement instruments. Thus, this scoping review aimed to identify measurement instruments for physical resilience, identify research gaps, and make recommendations for future research. Methods: Articles were included from the search when their subject matter included the term resilience in relation to the physical health of older adults. Data on physical resilience measurement instruments were extracted using the outcome domains: body function or structure, activity and participation, and societal impact. Results: The majority of the 33 included articles involved older adults with fractures, cardiac conditions, and cancer. Many measurement instruments quantified body function or structure, and some instruments captured activity and participation, and societal impact of physical resilience. Measurement instruments were pooled into 4 categories: psychological, physiological, motor function, and psychosocial scales. No studies combined all areas of measurement. Conclusions: A potential gap of a measurement instrument capturing social aspects of physical resilience was identified. Comprehensive measurement could identify which outcome domains could be targeted to foster resilience. This knowledge might be useful across many health disciplines and contribute to therapeutic decision-making and rehabilitation strategies.

Resilience as a Mediator of the Association between Spirituality and Self-Management among Older People with Chronic Obstructive Pulmonary Disease

This study examined the mediating effect of resilience in the relationship between spirituality and self-management among older people with chronic obstructive pulmonary disease (COPD). The participants were 151 older people with COPD in four general hospitals in Jiangsu Province, China. Data were collected from September 2020 to May 2021 using a questionnaire developed by the investigator, the Function Assessment of Chronic Illness Therapy-Spiritual Scale (FACIT-SP-12), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and COPD Self-Management Scale (CSMS). One-way ANOVA and t-test were used to compare the level of self-management in patients with different sociodemographic and clinical characteristics. Partial correlation analysis was used to explore the correlation between spirituality, resilience, and self-management. Hierarchical multiple regression analyses were performed to examine the contribution of spirituality and resilience to the prediction of self-management. A bootstrapping test was implemented using the SPSS PROCESS macro to test the statistical significance of the mediating effect. There was a pairwise positive correlation between spirituality, resilience, and self-management. Resilience mediated the relationship between spirituality and self-management. These findings suggested that resilience interventions could be incorporated into future COPD self-management interventions to better improve self-management and health outcomes. Moreover, resilience should be an important component of healthy aging initiatives.

Interrelated Factors for Return to Work of Sick-Listed Employees in Sweden

Purpose:

Long-term sickness absence is a significant human and economic cost in many countries, including Sweden making research on factors which impact on return to work (RTW) relevant. This study has two aims: (1) provide an overview of factors that impact RTW expectations in a national sample of Swedish workers on long-term sickness absence; and (2) gain an understanding of the interrelationships among these factors using a socioecological framework and decision tree analysis.

Method:

A survey, designed to capture information about demographic variables, health and work ability, workplace contact, supervisor support and expectations of return to work, was mailed to 1,112 randomly selected sick-listed people in Sweden and completed by 534, representing a response rate of 48%.

Results:

The most important factors affecting RTW expectations were work ability and burnout. Employees reporting high levels of work ability were more likely to expect to RTW compared to those reporting low levels, and this was dependent on their relative burnout score. Those with a high burnout score were less likely to expect to RTW, while for those with a low burnout score RTW expectations were dependent on age, country of birth, and supervisor support. For young employees reporting low work ability and low burnout score, RTW expectations were lower.

Conclusions:

Our results suggest a more nuanced approach to delivery of RTW services is required, whereby practitioners need to understand the socioecology of the range of factors that impact RTW expectations. The use of decision tree analysis facilitates this understanding by describing the interrelationships between these factors.