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Xie W, Liu M, Okoli CTC, Zeng L, Huang S, Ye X, Liu F, Wang J. Construction and evaluation of a predictive model for compassion fatigue among emergency department nurses: A cross-sectional study. Int J Nurs Stud 2023; 148:104613. [PMID: 37839306 DOI: 10.1016/j.ijnurstu.2023.104613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Compassion fatigue is a syndrome resulting from long-term work-related traumatic event stress exposure of medical staff. The emergency department is considered to be a high-risk, high-intensity and high-stress work environment, with a high prevalence of trauma and violence. Nurses in the emergency department are more prone to compassion fatigue than nurses in other departments. Compassion fatigue not only affects the physical and mental health, and job satisfaction of emergency department nurses, but also causes serious consequences for patients, such as poor patient outcome, medical errors, and increased patient mortality during hospitalization. OBJECTIVES Our study aims to develop and evaluate a predictive model for compassion fatigue among emergency department nurses. DESIGN A cross-sectional study. DATA SOURCES The emergency department nurses (N = 1014) were recruited from 21 tertiary hospitals (from Chengdu, Chongqing, Guiyang, Guangzhou and Shanghai) in central, southwestern, southern, and eastern China from July 25, 2022 to October 30, 2022. METHODS Univariate and multiple logistic regression analyses were used to determine the potential predictive factors associated with compassion fatigue in emergency department nurses. A nomogram was built based on the predictive factors and internally evaluated using a bootstrap resampling method (1000 bootstrap resamples). The performance of the predictive model was evaluated by measuring the Hosmer-Lemeshow goodness of fit test and calibration curve. RESULTS The prevalence of compassion fatigue among emergency department nurses was 75.9 %. The multiple logistic regression analysis revealed that the independent predictive factors for compassion fatigue among emergency department nurses were working position, job satisfaction, diet habit, sleep hours per day, occupational stress, physical harassment and the level of workplace violence, all of which were identified to create the nomogram. The Hosmer-Lemeshow goodness of fit test indicated that the predictive model was well calibrated (χ2 = 11.520, P = 0.174). The bootstrap-corrected concordance index of nomogram was 0.821 (95 % CI: 0.791-0.851). The calibration curve of the nomogram showed good consistency between the predicted and actual probabilities. CONCLUSIONS A predictive model of compassion fatigue among emergency department nurses has been developed, based on the general demographic, work-related and lifestyle characteristics, occupational stress, and workplace violence, with satisfactory predictive ability. This model can identify emergency department nurses who are at high risk of compassion fatigue. Our study provides an empirical basis for early detection, early diagnosis and early intervention of emergency department nurses at high risk of compassion fatigue.
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Affiliation(s)
- Wanqing Xie
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Manli Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Chizimuzo T C Okoli
- University of Kentucky College of Nursing, 517 College of Nursing Building, Lexington, KY 40536, USA.
| | - Li Zeng
- Sichuan Nursing Vocational College, No. 173 Longdu South Road, Longquanyi District, Chengdu City, Sichuan province 610100, China.
| | - Shuqi Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xin Ye
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Fan Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Nursing Key Laboratory of Sichuan Province, West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Jialin Wang
- School of Nursing, Chengdu University of Traditional Chinese Medicine, No. 1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province 611137, China.
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Yayan J, Rasche K. Risk Factors for Depression in Patients with Chronic Obstructive Pulmonary Disease. Respir Physiol Neurobiol 2023:104110. [PMID: 37393968 DOI: 10.1016/j.resp.2023.104110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/15/2023] [Accepted: 06/29/2023] [Indexed: 07/04/2023]
Abstract
Depression, anxiety, and panic disorders are common in chronic obstructive pulmonary disease (COPD) and important for the further course of the disease, as they are associated with increased hospital admissions, longer hospital stays, more frequent doctor visits, and a worsened quality of life. There are also indications of premature death in affected patients. Therefore, knowledge of the risk factors for depression in COPD patients is all the more important for early detection and treatment. Hence, Embase, the Cochrane Library, and the MEDLINE/PubMed databases were analyzed for studies on these risk factors. The main factors are as follows: female gender; older/younger age; living alone; higher education; unemployment; retirement; a low quality of life; social isolation; high/low income; high cigarette and alcohol consumption; poor physical fitness; severe respiratory symptoms; high/low body mass index, airway obstruction, dyspnea, exercise capacity index scores; and comorbidities (mainly heart disease, cancer, diabetes, and stroke). This article presents the analyzed medical literature.
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Affiliation(s)
- Josef Yayan
- Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Witten, Germany.
| | - Kurt Rasche
- Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Witten, Germany
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National Trends in Prevalence of Depression in Men and Women with Chronic Obstructive Pulmonary Disease Hospitalized in Spain, 2016–2020. J Clin Med 2022; 11:jcm11216337. [PMID: 36362570 PMCID: PMC9655616 DOI: 10.3390/jcm11216337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/23/2022] Open
Abstract
(1) Background: To describe trends in the prevalence of depression in men and women with COPD hospitalized in Spain (2016–2020). (2) Methods: We used a nationwide discharge database to select all patients ≥35 years with COPD. (3) Results: The prevalence of depression was 3.54-times higher in women with COPD than in men (OR 3.54; 95%CI 3.48–3.6). It decreased significantly between 2016 and 2020, although the reduction was only significant in women (12.27% in 2016 vs. 10.56% in 2020). Older age, comorbidity and the most recent years of hospital admission were associated with lower prevalence of depression in both men and women, while obesity, obstructive sleep apnea (OSA) and use of oxygen prior to admission were risk factors. In-hospital mortality (IHM) increased significantly over time. Older age, comorbidity, the use of oxygen prior to admission and having been hospitalized in 2020 increased the risk of IHM. Female sex was associated with a lower IHM in patients with depression and COPD. (4) Conclusions: The prevalence of depression has decreased over time in women with COPD while it has not changed significantly in men with this disease. IHM increased over time both in men and women with COPD and depression, with higher prevalence in the former.
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Barrueco-Otero E, Refoyo Matellán B, Martín Puente J, Viñado Mañes C, León Subias E, Olivera Pueyo J, Sancho Sanchez C. [Prevalence of Depressive Symptoms, Predictive Factors, and Diagnosis of Suspicion of Depression in Patients with COPD]. Aten Primaria 2022; 54:102236. [PMID: 35144117 PMCID: PMC8841611 DOI: 10.1016/j.aprim.2021.102236] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/27/2021] [Accepted: 09/26/2021] [Indexed: 11/26/2022] Open
Abstract
Objetivo Conocer la prevalencia y factores predictores de depresión en pacientes diagnosticados de enfermedad pulmonar obstructiva crónica (EPOC) y remitidos desde Atención Primaria a consultas de Neumología, servicios que comparten la atención al proceso EPOC. Diseño Estudio observacional, multicéntrico, prospectivo con muestreo no probabilístico, transversal. Emplazamiento Dos consultas de neumología de dos hospitales de diferente nivel asistencial. Participantes Se diagnosticaron 293 pacientes de EPOC en fase estable de la enfermedad. Intervenciones Aplicación de cuestionarios clínicos habituales en la EPOC y test HADS (Hospital Anxiety and Depression Scale). Variables Variables demográficas, clínicas y funcionales de la EPOC y escala de depresión del test HADS (Hospital Anxiety and Depression Scale). Resultados Se incluyeron 229 hombres (78,16%) y 64 mujeres (21,8%), con una edad media de 68,2 ± 10,3 años, de los que 93 (31,7%) eran fumadores activos y 200 (68,3%) exfumadores. El 19,45% de los pacientes tenía diagnóstico clínico previo de depresión, pero mediante el test HADS se estableció el diagnóstico de sospecha en el 32,6%. Las variables predictoras fueron: ser mujer, vivir solo y variables relacionadas con la gravedad de la enfermedad (volumen espiratorio forzado en 1 segundo [FEV1] postbroncodilatador, ser paciente de riesgo y fenotipo agudizador según criterios de la Guía Española de la EPOC [GesEPOC] y grados C y D de criterios Global Initiative for Chronic Obstructive Lung Disease [GOLD]). Conclusiones La prevalencia de la depresión en pacientes con EPOC es alta y está infradiagnosticada. El test diagnóstico HADS es útil para establecer el diagnóstico de sospecha en las consultas de Atención Primaria y Neumología. Existen factores personales y clínicos que pueden considerar predictores y servir de orientación para determinar en qué pacientes realizar el test HADS y, en función de los resultados, derivar al paciente a una Unidad de Salud Mental para confirmar o descartar el diagnóstico.
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Affiliation(s)
| | | | - Javier Martín Puente
- Servicio de Neumología, Hospital Universitario de Salamanca e IBSAL, Salamanca, España
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de la Cruz SP, Cebrino J. Common Mental Disorders, Functional Limitation and Diet Quality Trends and Related Factors among COPD Patients in Spain, 2006-2017: Evidence from Spanish National Health Surveys. J Clin Med 2021; 10:jcm10112291. [PMID: 34070391 PMCID: PMC8197509 DOI: 10.3390/jcm10112291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 12/11/2022] Open
Abstract
Certain conditions such as common mental disorders (CMDs), functional limitation (FL) and poor diet quality may affect the lives of individuals who suffer from chronic obstructive pulmonary disease (COPD). This study sought to examine time trends in the prevalence of CMDs, FL and diet quality among male and female COPD patients living in Spain from 2006 to 2017 and to identify which factors were related to CMDs, FL and a poor/improvable diet quality in these patients. We performed a cross-sectional study among COPD patients aged ≥ 40 years old using data from the Spanish National Health Surveys conducted in 2006, 2011 and 2017, identifying a total of 2572 COPD patients. Binary logistic regressions were performed to determine the characteristics related to CMDs, FL and poor/improvable diet quality. Over the years of the study, the prevalence of FL among female COPD patients increased (p for trend <0.001). In addition, CMDs were associated to body mass index (BMI), educational level, physical activity, smoking status, occupation, chronic conditions and alcohol consumption; FL was related to age, living with a partner, educational level, physical activity and chronic conditions; and poor/improvable diet quality was associated to age, smoking status, BMI and physical activity.
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Affiliation(s)
- Silvia Portero de la Cruz
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba, Avda. Menéndez Pidal, S/N, 14071 Córdoba, Spain;
| | - Jesús Cebrino
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Seville, Avda. Doctor Fedriani, S/N, 41009 Seville, Spain
- Correspondence: ; Tel.: +34-954-551-771
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Zhang L, Zhao S, Lin Q, Song M, Wu S, Zheng H. Algorithms to Predict Anxiety and Depression Among University Students in China After Analyzing Lifestyles and Sport Habits. Neuropsychiatr Dis Treat 2021; 17:2011-2025. [PMID: 34188472 PMCID: PMC8232847 DOI: 10.2147/ndt.s315148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/05/2021] [Indexed: 01/22/2023] Open
Abstract
PURPOSE This study aims to identify potential risk factors associated with anxiety or depression and propose algorithms to predict anxiety and depression especially among university students. METHODS We included and analyzed 881 university students from eight colleges in China in November 2020. Student's basic information, lifestyles, sport habits, comorbidities, and mental health conditions were collected. Anxiety and depression were measured using the generalized anxiety disorder 7 (GAD-7) and the patient health questionnaire 9 (PHQ-9), respectively. A multiple linear regression analysis was used to assess the ability of 25 potential risk factors for predicting anxiety and depression, and significant risk factors were included in the algorithms. RESULTS Of all the included students, 44.27% lived with mild or above anxious symptoms and 50.62% had mild or above depressive symptoms. According to the multiple linear regression model, grade levels (P<0.01), member of college sports dance team (P=0.05), sedentary time (P=0.02), exercise frequency (P<0.01), only child status (P=0.05), addiction of drinking (P<0.01), and prefer eating vegetable (P<0.01) were significantly associated with anxiety; grade levels (P<0.01), member of college sports dance team (P<0.01), sedentary time (P<0.01), exercise frequency (P<0.01), academic study period during free time (P=0.03), only child status (P<0.01), addiction of drinking (P<0.01), prefer eating vegetables (P<0.01), and main types of drinking water (P<0.01) were significantly associated with depression. Based on these significant factors, two algorithms were successfully developed, and two risk groups were created according to the algorithms. CONCLUSION The study proposed two algorithms to calculate anxiety and depression, respectively, which can be useful tools to identify students with different risk of anxiety or depression. Effective measures are warranted to improve student's sport habits and healthy lifestyles in order to mitigate anxiety and depression, especially among students in the high risk group.
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Affiliation(s)
- Lirong Zhang
- Department of Physical Education, Xiamen University of Technology, Xiamen, Fujian, People's Republic of China
| | - Shaocong Zhao
- Department of Physical Education, Xiamen University of Technology, Xiamen, Fujian, People's Republic of China
| | - Qiong Lin
- Department of Physical Education, JiMei University, Xiamen, Fujian, People's Republic of China
| | - Minmin Song
- Department of Physical Education, Fujian Agriculture and Forestry University, Fuzhou, Fujian, People's Republic of China
| | - Shouren Wu
- Department of Physical Education, JiMei University, Xiamen, Fujian, People's Republic of China
| | - Hua Zheng
- College of Physical Education and Health Sciences, Chongqing Normal University, Chongqing, People's Republic of China
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Barbolla Benito P, Peces-Barba Romero G. Self-reported walking and associated factors in the Spanish population with chronic obstructive pulmonary disease. BMC Pulm Med 2018; 18:166. [PMID: 30404632 PMCID: PMC6222980 DOI: 10.1186/s12890-018-0731-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 10/25/2018] [Indexed: 11/24/2022] Open
Abstract
Background The level of physical activity among individuals with chronic obstructive pulmonary disease (COPD) is associated with the disease severity and prognosis. The aim of this study was to describe the prevalence of self-reported walking at least 150 min per week and the associated factors among the Spanish population with COPD. Methods Analyses were based on data drawn from the 2009 European Health Interview Survey in Spain (2009 EHIS). Twenty-two thousand one hundred eighty-eight subjects participated in the survey (response rate of 96.5%). Participants were classified according to international physical activity recommendations. The prevalence of walking among participants with and without COPD (≥40 years old) was described. Univariate and multivariate logistic regression models were used to study the association of walking with socio-demographic and health outcome variables. Results Of the participants with COPD, 55.0% reached the minimum walking recommendations compared to 59.9% of the general population. The level of walking physical activity of the participants with COPD differed according to sex, age, educational level, area of residence, living as a couple, self-rated health status, mental health, body mass index and hospital admissions. In the multivariate analysis, being male, < 65 years old, living in an area with ≥50,000 inhabitants, no diagnosed depression or anxiety and self-reported good to very good health were factors significantly associated with walking ≥150 min per week. Conclusions Sex, age, area of residence, mental disorders and self-rated health are associated with weekly walking time in the Spanish population with COPD.
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Affiliation(s)
- Pedro Barbolla Benito
- Autonomous University of Madrid, Ciudad Universitaria de Cantoblanco, Madrid, 28049, Spain.
| | - Germán Peces-Barba Romero
- Department of Pneumology IIS-Fundación Jiménez Díaz, Center for Biomedical Research in the Network, Respiratory Diseases (Spanish acronym CIBERES), Calle de Melchor Fernández Almagro, 3, Madrid, 28029, Spain
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Montserrat-Capdevila J, Godoy P, Marsal JR, Ortega M, Pifarré J, Alsedà M, Castañ MT, Barbé F. Mental disorders in chronic obstructive pulmonary diseases. Perspect Psychiatr Care 2018; 54:398-404. [PMID: 29577318 DOI: 10.1111/ppc.12274] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 02/22/2018] [Accepted: 02/24/2018] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Anxiety and depression are underdiagnosed in chronic obstructive pulmonary disease (COPD) patients. Few studies have tried to identify their association with hospitalization (severe exacerbation). The objective of this study was to determine whether the anxiety/depression was associated with severe exacerbation. DESIGN AND METHODS A prospective cohort study, based on a sample of 512 patients diagnosed with COPD originating from primary care in a rural area in Lleida (Spain) and monitored between November 1, 2012 and October 31, 2014. For each patient, variables of interest were recorded; they were administered the HADS (Hospital Anxiety and Depression Scale) test to determine the possible presence of anxiety/depression, and its association with severe exacerbation was analyzed using a logistic regression model. FINDINGS Initially, the prevalence of anxiety/depression was 15.6%. The incidence of global hospitalization in the first year was 8.2% and 11.3% in the second year. In patients with anxiety/depression, it increased to 17.5% in the first year and 18.8% in the second year. In the multivariate regression model, the diagnosis of anxiety/depression almost doubled the risk of hospitalization (OR = 1.94) (p < .041). PRACTICE IMPLICATIONS Anxiety and depression are associated with an increased risk of hospitalization. Intervention studies are needed to evaluate the effects of anxiety/depression in the hospitalization.
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Affiliation(s)
- Josep Montserrat-Capdevila
- Biomedical Research Institute (IRB) of Lleida, Catalan Institute of Health (ICS), UGA Terres de l'Urgell (Consultori Local de Bellvís-Els Arcs), Lleida, Catalonia, Spain
| | - Pere Godoy
- Public Health Agency of Catalonia, Health Department, Biomedical Research Institute (IRB) of Lleida, University of Lleida, Faculty of Medicine, Lleida, Catalonia, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Josep Ramon Marsal
- Primary Care Research Institute (IDIAP) Jordi Gol, Universitat Autònoma of Barcelona, University Hospital Vall d'Hebron, Cardiovascular Department, Epidemiology Unit, Lleida, Catalonia, Spain
| | - Marta Ortega
- Primary Care Research Institute (IDIAP) Jordi Gol, Universitat Autònoma of Barcelona, Catalan Institute of Health (ICS), Lleida, Catalonia, Spain
| | - Josep Pifarré
- University Hospital Santa Maria, Psychiatry Department, Biomedical Research Institute (IRB) of Lleida, University of Lleida, Faculty of Medicine, Lleida, Catalonia, Spain
| | - Miquel Alsedà
- Public Health Agency of Catalonia, Health Department, Biomedical Research Institute (IRB) of Lleida, University of Lleida, Faculty of Medicine, Lleida, Catalonia, Spain
| | - Maria Teresa Castañ
- Biomedical Research Institute (IRB) of Lleida, Catalan Institute of Health (ICS), ABS Balaguer, Lleida, Catalonia, Spain
| | - Ferran Barbé
- University Hospital Arnau de Vilanova, Biomedical Research Institute (IRB) of Lleida, Respiratory Diseases Group, Biomedical Research Centre/Respiratory Diseases Network (CIBERES), Madrid, Spain
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Anxiety and depression in patients with chronic obstructive pulmonary disease and their relation to serum vitamin D levels. MARMARA MEDICAL JOURNAL 2018. [DOI: 10.5472/marumj.398936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Crespo-Lessmann A, Plaza V, González-Barcala FJ, Fernández-Sánchez T, Sastre J. Concordance of opinions between patients and physicians and their relationship with symptomatic control and future risk in patients with moderate-severe asthma. BMJ Open Respir Res 2017; 4:e000189. [PMID: 29018525 PMCID: PMC5604707 DOI: 10.1136/bmjresp-2017-000189] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 07/26/2017] [Accepted: 08/09/2017] [Indexed: 11/23/2022] Open
Abstract
Introduction Differences between the opinions of patients and physicians on the impact of asthma are common. We hypothesised that patient–physician discordance may negatively affect asthma outcome. Methods A total of 2902 patients (61% women, mean age 47 years) with moderate–severe asthma and 231 physicians participated in a prospective study. At the baseline visit, data on demographics, clinical variables, degree of asthma control according to the Asthma Control Test (ACT), basic spirometry and the Hospital Anxiety and Depression Scale (HADS) were collected and an ad hoc questionnaire was completed that allowed the degree of concordance between doctors and patients to be assessed. A scheduled telephone call after 3 months was used to elicit the ACT score and the future risk of asthma. At the final visit at 6 months, the following data were recorded: ACT score, spirometry, HADS score and an ad hoc questionnaire to assess the agreement between the doctor and the patient. Changes in study variables according to patient–physician concordance or discordance were analysed. Results The rate of patient–physician discordance was 27.2%, with overestimation of disease impact by the physician in 12.3% and underestimation in 14.9%. Patient–physician opinion discordance, particularly in the case of physicians underestimating the impact of asthma, showed worse results with statistically significant differences in ACT score, a higher percentage of patients with poor asthma control and lower HADS scores. The need for hospital and emergency department admissions was also higher. Conclusion Patient–physician opinion discordance may be contributing to lower symptomatic control and increased future risk, with a higher impact when physicians underestimate the impact of asthma on their patients.
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Affiliation(s)
- Astrid Crespo-Lessmann
- Service of Pneumology, Hospital de la Santa Ceu i Sant Pau, Institute of Sant Pau & Biomedical Research (IBB Sant Pau), Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Vicente Plaza
- Service of Pneumology, Hospital de la Santa Ceu i Sant Pau, Institute of Sant Pau & Biomedical Research (IBB Sant Pau), Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
| | - Francisco-Javier González-Barcala
- Service of Pneumology, Complejo Hospitalario Universitario de Santiago de Compostela. Department of Medicine, University of Santiago de Compostela. Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
| | | | - Joaquín Sastre
- Department of Allergy, Hospital Universitario Fundación Jiménez Díaz. Centro deInvestigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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Gea J, Casadevall C, Pascual S, Orozco-Levi M, Barreiro E. Clinical management of chronic obstructive pulmonary disease patients with muscle dysfunction. J Thorac Dis 2016; 8:3379-3400. [PMID: 28066619 DOI: 10.21037/jtd.2016.11.105] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Muscle dysfunction is frequently observed in chronic obstructive pulmonary disease (COPD) patients, contributing to their exercise limitation and a worsening prognosis. The main factor leading to limb muscle dysfunction is deconditioning, whereas respiratory muscle dysfunction is mostly the result of pulmonary hyperinflation. However, both limb and respiratory muscles are also influenced by other negative factors, including smoking, systemic inflammation, nutritional abnormalities, exacerbations and some drugs. Limb muscle weakness is generally diagnosed through voluntary isometric maneuvers such as handgrip or quadriceps muscle contraction (dynamometry); while respiratory muscle loss of strength is usually recognized through a decrease in maximal static pressures measured at the mouth. Both types of measurements have validated reference values. Respiratory muscle strength can also be evaluated determining esophageal, gastric and transdiaphragmatic maximal pressures although there is a lack of widely accepted reference equations. Non-volitional maneuvers, obtained through electrical or magnetic stimulation, can be employed in patients unable to cooperate. Muscle endurance can also be assessed, generally using repeated submaximal maneuvers until exhaustion, but no validated reference values are available yet. The treatment of muscle dysfunction is multidimensional and includes improvement in lifestyle habits (smoking abstinence, healthy diet and a good level of physical activity, preferably outside), nutritional measures (diet supplements and occasionally, anabolic drugs), and different modalities of general and muscle training.
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Affiliation(s)
- Joaquim Gea
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Carme Casadevall
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Sergi Pascual
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Mauricio Orozco-Levi
- Department of Respiratory, Cardiovascular Foundation from Colombia Floridablanca, Santander, Colombia, CIBERES, ISC III, Barcelona, Catalonia, Spain
| | - Esther Barreiro
- Servei de Pneumologia, Hospital del Mar - IMIM, Experimental Sciences and Health Department (DCEXS), Universitat Pompeu Fabra, CIBERES, ISC III, Barcelona, Catalonia, Spain
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