Reliability and Validity of the Chinese Version of the Chronic Respiratory Questionnaire (CCRQ) in Patients with COPD

Survival prediction in patients with chronic obstructive pulmonary disease following a pulmonary rehabilitation programme in Hong Kong

Background and objective

Pulmonary rehabilitation programme (PRP) is an important component in the management of chronic obstructive pulmonary disease (COPD). However, to date so far there has been limited literature on the survival outcomes of patients with COPD after a PRP in Hong Kong. This study aimed to investigate the outcomes of a pulmonary rehabilitation programme on the survival rates of a retrospective cohort of patients with COPD.

Methods

This was a retrospective study that included subjects who participated in the PRP in a rehabilitation hospital from the year 2003 to 2015. A total of 431 patients with chronic obstructive pulmonary disease were identified from the electronic record system of the hospital. The dataset were split into two age groups for reporting and analysis using the mean age of 72 as the cut-off. Their median survival times were calculated using Kaplan-Meier analysis. Cox-proportional regression model was used to explore factors that predicted better survival. The most significant predictors were used as strata, and their respective effects on survival functions were analysed with Kaplan-Meier analysis again.

Results

The overall median survival of the cohort was 4.3 years. The median survival times of the younger patient group (aged <72) and the older patient group (aged ≥72) were 5.3 and 3.6 years, respectively. For the patients, aged <72 years old, Moser's Activities of Daily Living class and the pulmonary rehabilitation programme completion rate were the most significant survival predictors. For the patients aged ≥72 years old, Monitored Functional Task Evaluation score was the most significant survival predictor.

Conclusion

Moser's Activities of Daily Living class ≥2 and non-completion of PRP for younger group, low exercise capacity with Monitored Functional Task Evaluation score <17 for older group were identified as significant predictors of poor survival. The findings of this study helped identifying those patients with COPD who have the needs to be more intensively treated and closely monitored.

Multitask protocols to evaluate activities of daily living performance in people with COPD: a systematic review

INTRODUCTION

People with chronic obstructive pulmonary disease (COPD) present symptoms such as dyspnea and fatigue, which hinder their performance in activities of daily living (ADL). A few multitask protocols have been developed to assess ADL performance in this population, although measurement properties of such protocols were not yet systematically reviewed. Areas covered: Studies were included if an assessment of the ability to perform ADL was conducted in people with COPD using a (objective) performance-based protocol. The search was conducted in the following databases: Pubmed, EMBASE, Cochrane Library, PEDro, CINAHL and LILACS. Furthermore, hand searches were conducted. Expert commentary: Up to this moment, only three protocols had measurement properties described: the Glittre ADL Test, the Monitored Functional Task Evaluation and the Londrina ADL Protocol were shown to be valid and reliable whereas only the Glittre ADL Test was shown to be responsive to change after pulmonary rehabilitation. These protocols can be used in laboratory settings and clinical practice to evaluate ADL performance in people with COPD, although there is need for more in-depth information on their validity, reliability and especially responsiveness due to the growing interest in the accurate assessment of ADL performance in this population.

Reliability and Validity of the Self-administered Chinese Version of the Shortness of Breath Questionnaire (C-SOBQ) in Patients with Chronic Obstructive Pulmonary Disease

Background

Dyspnoea is crucial in evaluating patients with chronic obstructive pulmonary disease (COPD). The San Diego Shortness of Breath Questionnaire (UCSD SOBQ) assesses shortness of breath in activities of daily living (ADL). It has been translated into Chinese and used clinically in Hong Kong for many years.

Objective

To investigate the reliability and validity of a self-administered Chinese version of the Shortness of Breath Questionnaire (C-SOBQ) with pictorial enhancement in patients with COPD in Hong Kong.

Methods

A total of 119 patients with COPD were recruited by convenience sampling from seven public clinical settings and two community self-help groups. The C-SOBQ score for each patient was correlated with a set of criterion parameters including age, body mass index (BMI), 6-minute walking distance (6MWD) test, lung function physiological parameters, BODE index, the Modified Medical Research Council Dyspnoea Scale (MMRC Dyspnoea Scale), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPD classifications. For test–retest reliability, 22 out of 119 patients were selected and assessed using the C-SOBQ followed by a reassessment within 1 week by the same rater.

Results

The C-SOBQ shows good test–retest reliability with an intra-class correlation coefficient of 0.915 (p ≤ .05). It demonstrates significant correlations with the MMRC Dyspnoea Scale, GOLD COPD classifications, BODE index, BMI, and 6MWD. The BODE index, MMRC Dyspnoea Scale, and 6MWD were valid predictors of C-SOBQ total score. A total of 50.4% of patients could be correctly grouped in quartiles of the BODE index using the C-SOBQ.

Conclusion

The C-SOBQ with pictorial enhancement is a valid and reliable instrument which gives precise information about the impact of dyspnoea on functional activities for patients with COPD.

Therapeutic Effects of Qigong in Patients with COPD: A Randomized Controlled Trial

Objective

This study was conducted to compare the therapeutic effects of health qigong (HQG) with conventional pulmonary rehabilitation (PR) exercise among patients with chronic obstructive pulmonary disease (COPD).

Methods

A total of 132 patients with confirmed diagnosis of COPD but no serious comorbidities were randomly allocated to the HQG group (n = 51), PR group (n = 32), or medical treatment group (n = 35). The HQG group received 1 week of HQG training under the supervision of professional coaches, and were then encouraged to participate in a peer-led weekly practice group thrice a week, lasting 1 hour each time, for 6 months. The conventional PR group received the same amount of professional coaching on breathing and aerobic exercises, and peer-led walking or ball game groups. The medical treatment group only received health education on self-exercise. Baseline data were taken before randomization, and outcomes were ascertained at the 6-month follow-up by blinded assessors.

Results

Overall, 118 patients with complete data were recruited into the final analysis. Irrespective of disease stages, both HQG and PR groups showed improving trends across 6-minute walk test and quality of life scores, while the medical treatment group demonstrated either no improvements or some deteriorations. When comparing HQG with PR, HQG appeared to have better effects on decreasing the frequency of exacerbation for patients with GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage I and maintaining a stable tumor necrosis factor-alpha level for patients of GOLD stage II.

Conclusion

This study solidifies the concept that both HQG and PR produce positive effects on subjective symptoms and functions among COPD patients, and also provided evidence that HQG can induce additional effects compared to conventional PR.

Air quality influence on chronic obstructive pulmonary disease (COPD) patients' quality of life

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death. The relationship between urban air pollution and its short-term health effects on patients suffering from COPD is confirmed. However, information about the impact of air pollutants upon the quality of life (QOL) in patients with COPD is lacking. Through a cross-sectional survey, this study investigates such impact in terms of the scores of the (Chinese) chronic respiratory questionnaire (CCRQ) and the measurements of indoor air quality (IAQ), lung function and Moser's activities of daily living (ADL). Using Yule's Q statistic with a cutoff |Q|>0.7 to identify the strong relationships between environmental parameters and CRQ sub-scores, this study reveals that patient emotion is strongly associated with indoor environmental quality although the evidence of a causal relationship between them needs further research.

PRACTICAL IMPLICATIONS

As QOL in patients with COPD and indoor environmental parameters are strongly associated, indoor air pollutants must be monitored for related studies in the future.