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Bamonti PM, Rose GA, Park S, Silberbogen AK, Moye J, Moy ML. Emotional Distress and Physical Activity Engagement in U.S. Veterans With Chronic Obstructive Pulmonary Disease: A Qualitative Study. Ann Behav Med 2024; 58:539-551. [PMID: 38847496 DOI: 10.1093/abm/kaae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Physical activity is recommended as part of guideline-based care for managing chronic obstructive pulmonary disease (COPD) at all stages of the disease. However, physical activity interventions are less effective in individuals with co-occurring emotional distress (i.e., depression and/or anxiety symptoms). Interventions that dually promote improved physical and mental health in COPD are needed. The first step for intervention development is understanding individuals' experience of these factors. PURPOSE To understand the experience of emotional distress in U.S. Veterans diagnosed with COPD and to explore how emotional distress impacts physical activity engagement. METHODS Structured interviews informed by the cognitive and behavioral models of psychopathology were conducted with 29 United States Veterans with COPD (89.66% male, age 67.72 ± 6.55 years, 93.10% White) at the VA Boston Healthcare System. Interviews were audio recorded, transcribed, and underwent thematic analysis. RESULTS Three major themes encapsulating 17 codes emerged through thematic analysis: (i) the experience of emotional distress in Veterans with COPD; (ii) the complex relationship between emotional distress, physical activity engagement, and COPD; (iii) contextual and personal factors. CONCLUSIONS Veterans' interpretation of their COPD symptoms as unpredictable and uncontrollable and COPD-related physical limitations influenced their experience of emotional distress, while the experience of emotional distress both promoted and deterred physical activity engagement. Veterans were motivated to engage in physical activity despite experiencing emotional distress when they faced a responsibility in daily life. They identified motivational strategies and self-regulation techniques to manage emotional distress and to foster physical activity.
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Affiliation(s)
- Patricia M Bamonti
- Research & Development Service, VA Boston Healthcare System, Boston MA, USA
- Department of Psychiatry, Havard Medical School, Boston, MA, USA
| | - Grace A Rose
- Research & Development Service, VA Boston Healthcare System, Boston MA, USA
| | - Stella Park
- New England Geriatric Research Education & Clinical Center, VA Boston Healthcare System, Boston, MA, USA
| | - Amy K Silberbogen
- VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Jennifer Moye
- Department of Psychiatry, Havard Medical School, Boston, MA, USA
- New England Geriatric Research Education & Clinical Center, VA Boston Healthcare System, Boston, MA, USA
| | - Marilyn L Moy
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
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Efil S, Kalkan Ugurlu Y, Akça Doğan D, Budak D. Perceived Spousal Support and Activities of Daily Living in Individuals With COPD. West J Nurs Res 2024; 46:436-444. [PMID: 38655927 DOI: 10.1177/01939459241248218] [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] [Indexed: 04/26/2024]
Abstract
BACKGROUND The relationship between perceived spousal support and activities of daily living in patients with chronic obstructive pulmonary disease (COPD) is unclear. PURPOSE The aim of this study was to explore the relationship between spousal support perceived by those with COPD and their activities of daily living. METHODS This study was a cross-sectional and descriptive study. Data collection was conducted between September 2022 and April 2023. A Data Gathering Form, the Spousal Support Scale, and the London Chest Activity of Daily Living Scale were used to collect data. A total of 132 adults were included in this study. RESULTS The mean (SD) scores of individuals with COPD for perceived spousal support and activities of daily living were 62.40 (14.66) and 32.91 (15.72), respectively. Levels of perceived spousal support and activities of daily living varied according to sex, employment status, admission to the emergency service or hospitalization, use of antidepressants, and the severity of the illness (P < .05). Those with better spousal support felt less dyspnea when performing the activities of daily living (r = -0.205, P < .05). CONCLUSIONS Knowing the potential factors affecting perceived spousal support and activities of daily living can provide an opportunity to determine appropriate strategies to increase the level of independence of individuals with COPD. Educational interventions to help spouses understand COPD may help increase spousal support.
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Affiliation(s)
- Sevda Efil
- Department of Nursing, Faculty of Health Sciences, Canakkale Onsekiz Mart University, Canakkale, Turkey
| | - Yasemin Kalkan Ugurlu
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Ordu University, Ordu, Turkey
| | - Derya Akça Doğan
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Bursa Uludag University, Bursa, Turkey
| | - Dilek Budak
- Pulmonology Department, Canakkale Onsekiz Mart University Hospital, Canakkale, Turkey
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Bamonti PM, Fischer I, Moye J, Poghosyan H, Pietrzak RH. Obstructive respiratory disease in U.S. veterans: Prevalence, characteristics, and health burden. J Psychiatr Res 2024; 176:140-147. [PMID: 38857555 DOI: 10.1016/j.jpsychires.2024.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/15/2024] [Accepted: 05/29/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVE To examine the psychiatric and physical health burden of obstructive respiratory disease in a nationally representative sample of U.S. Veterans. METHODS Secondary data analyses were conducted using data from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of U.S. Veterans. Participants self-reported health professional-diagnosed obstructive respiratory disease (i.e., asthma, chronic bronchitis or chronic obstructive pulmonary disease). Veterans who reported obstructive respiratory disease (n = 502) were compared to veterans without this disease but with at least one or more other medical conditions-controls (n = 3169) on measures of sociodemographic, trauma, psychiatric, and physical health characteristics. Multivariable regression analyses examined independent associations between obstructive respiratory disease and psychiatric conditions and physical characteristics. RESULTS A total 12.5% of the sample reported a diagnosis of obstructive respiratory disease. Compared to controls, veterans with obstructive respiratory disease were more likely to be female, unmarried/partnered, lower income, residing in the Midwest, receiving VA healthcare, and had greater lifetime and childhood trauma burden. In adjusted analyses, veterans with respiratory disease had 47-91% greater odds of screening positive for current posttraumatic stress, major depressive, and generalized anxiety disorders, and had 48% greater odds of current suicide ideation. They were also more likely to have lifetime nicotine use disorder and had more medical comorbidities and more severe somatic symptoms. CONCLUSIONS Obstructive respiratory disease is prevalent among U.S. veterans and associated with significant mental and physical health burden. Results highlight the need for timely screening and treatment for psychiatric and medical conditions that are highly comorbid with obstructive respiratory disease in this population.
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Affiliation(s)
- Patricia M Bamonti
- Research & Development, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA, 02215, USA.
| | - Ian Fischer
- National Center for PTSD, VA Connecticut Healthcare System, 950 Campbell Avenue, Connecticut, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street Ste 901, New Haven, CT, 06510, USA
| | - Jennifer Moye
- Department of Psychiatry, Harvard Medical School, 2 West, Room 305, 401 Park Drive, Boston, MA, 02215, USA; New England Geriatric Research Education & Clinical Center, VA Boston Healthcare System, 150 S. Huntington Avenue, Boston, MA, 02130, USA
| | - Hermine Poghosyan
- Yale School of Nursing, Orange, CT, 06477, USA; Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Robert H Pietrzak
- National Center for PTSD, VA Connecticut Healthcare System, 950 Campbell Avenue, Connecticut, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street Ste 901, New Haven, CT, 06510, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06510, USA
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Rochester CL. Barriers to Pulmonary Rehabilitation. Respir Care 2024; 69:713-723. [PMID: 38806224 PMCID: PMC11147625 DOI: 10.4187/respcare.11656] [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] [Indexed: 05/30/2024]
Abstract
Pulmonary rehabilitation (PR) is one of the most effective therapies for chronic respiratory diseases, yet it is significantly underutilized. There are several patient-related, geographic, societal, and health system-related barriers to PR. People with chronic respiratory disease face a collectively high burden of treatments including health care provider visits, medications, oxygen and other durable medical equipment, and providers' recommendation to undertake PR may be considered an added burden more than a likely benefit. Transportation difficulties, lack of insurance coverage, competing time priorities, low knowledge of PR, lack of perceived likely benefit, comorbidities, and other factors also pose obstacles to participation in PR for patients. Geographic availability of PR is heterogenous; in the United States, out-patient center-based PR programs are often not available within close proximity to patients' residence, posing barriers to patients' access to it. PR programs are lacking altogether in many areas; rural areas are particularly affected. Existing PR programs are often poorly funded and underresourced. Socioeconomic and racial disparities also influence patients' likelihood of receiving PR. Also, health care professionals (HCPs) often do not refer their patients with chronic respiratory disease to PR, owing to a lack of knowledge and awareness of its content and benefits, patient candidacy, or of the referral process. A limited number of multidisciplinary HCPs trained in PR likely also contributes to limited access to PR for patients. Collectively, these multifaceted barriers to PR create unacceptable health care disparities. Strategies to address barriers to PR are urgently needed in order to enable individuals who need to receive it.
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Affiliation(s)
- Carolyn L Rochester
- Section of Pulmonary, Critical Care and Sleep Medicine and Yale COPD Program, Yale University School of Medicine, New Haven, Connecticut; and Pulmonary Rehabilitation, VA Connecticut Healthcare System, West Haven, Connecticut.
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Pendoni R, Albanesi B, Clari M, Pecorari G, Matarese M. Contributing to self-care of a person with chronic obstructive pulmonary disease: A qualitative study of the experiences of family caregivers. J Adv Nurs 2024; 80:1927-1942. [PMID: 37949838 DOI: 10.1111/jan.15939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/02/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023]
Abstract
AIM To explore family caregivers' experiences of contributing to self-care of patients with chronic obstructive pulmonary disease (COPD). DESIGN A qualitative description study. METHODS Individual semi-structured interviews were conducted face-to face, by telephone or video calls in a purposive sample of 17 family caregivers of patients with COPD recruited in Italy, and analysed through content analysis. The consolidated criteria for reporting qualitative studies (COREQ) checklist was used for study reporting. RESULTS Ten subcategories were derived from 106 codes grouped into three main categories: family caregiver contributions to maintaining disease stable and ensuring a normal life for patients; family caregiver contributions to disease monitoring; and family caregiver contributions to coping with disease exacerbations. Family caregivers provided practical and emotional support, and their contribution was essential to improve treatment adherence, to enable the patient to continue living a normal life, and to have access to the healthcare services. Family caregivers were constantly vigilant and monitored patients daily to detect worsening conditions, and they managed exacerbations especially when patients were unable to do it due to their critical conditions. CONCLUSION This study broadens knowledge of family caregivers' contributions to patients' self-care in COPD, describing the different ways family members provide daily care to patients and the many responsibilities they take on. IMPACT Family caregivers perform a variety of behaviours when supporting patients with COPD in self-care, especially when patients are more dependent and the disease more severe. Nurses should acknowledge the various contributions provided by family caregivers and develop educational interventions aiming to support them in patient care and improve patient outcomes. PATIENT OR PUBLIC CONTRIBUTION Researchers shared the draft study report with participants for validation and feedback. This helped to strengthen the study design and results.
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Affiliation(s)
- Roberta Pendoni
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Beatrice Albanesi
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | - Marco Clari
- Department of Public Health and Pediatrics, University of Torino, Turin, Italy
| | | | - Maria Matarese
- Research Unit of Nursing Sciences, Faculty of Medicine and Surgery, Campus Bio-Medico University of Rome, Rome, Italy
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Stoustrup AL, Janssen DJA, Nakken N, Wouters EFM, Marques A, Weinreich UM, Spruit MA. Association of inadequate social support and clinical outcomes in patients with chronic obstructive pulmonary disease - A cross-sectional study. Respir Med 2024; 226:107625. [PMID: 38570144 DOI: 10.1016/j.rmed.2024.107625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/27/2024] [Accepted: 04/01/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION In patients with chronic obstructive pulmonary disease (COPD), loneliness and social isolation are associated with increased morbidity and decreased mobility, self-reliance, and health-related quality of life. Social support has been shown to improve these outcomes. AIMS This cross-sectional study aimed to investigate the level of experienced social support and the clinical outcomes associated with inadequate social support among patients with COPD with a resident loved one. METHODS Level of social support was assessed with the Medical Outcomes Study - Social Support Survey (MOS-SSS) in patients with COPD with a resident loved one. Patients were sub-grouped into adequate or inadequate social support. Multiple clinical outcomes were assessed, including lung function, degree of dyspnoea, health status, symptoms of anxiety and depression, the degree of care dependency, functional status, and mobility. RESULTS The study included 191 Dutch patients with COPD (53.4% men, age: 65.6 ± 8.9 years, FEV1: 47.3 ± 17.7% predicted). Eighteen percent of the patients reported inadequate social support. Patients with inadequate social support reported a significantly symptom severity of COPD (p = 0.004), a higher care dependency level (p = 0.04) and a higher level of depression (p = 0.004) compared to patients with adequate social support. Other traits were comparable for both groups. CONCLUSION Patients with COPD with a resident loved one who perceive an inadequate level of social support are more likely to report a higher impact of COPD, a higher care dependency and symptoms of depression. Other characteristics are comparable with patients who perceive adequate social support.
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Affiliation(s)
- Anna L Stoustrup
- Department of Respiratory Diseases, Aalborg University Hospital, Denmark.
| | - Daisy J A Janssen
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Health Services Research and Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Nienke Nakken
- Department of Research and Development, Ciro, Horn, the Netherlands.
| | - Emiel F M Wouters
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
| | | | - Martijn A Spruit
- Department of Research and Development, Ciro, Horn, the Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre+ (MUMC+), Maastricht, the Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
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Pan D, Diaz JL, Weidman K, Graham J, Goyal P, Rajan M, Lau J, Pinheiro L, Rachid L, Simmons W, Schenck EJ, Safford MM, Lief L. Social Networks as a Key Health Determinant in Acute Illness Recovery: A Lesson from the COVID-19 Pandemic. Am J Med 2024:S0002-9343(24)00236-5. [PMID: 38677397 DOI: 10.1016/j.amjmed.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND The COVID-19 pandemic highlighted the importance of considering social determinants of health in health outcomes. Within this spectrum of determinants, social networks garnered attention as the pandemic highlighted the negative effects of social isolation in the context of social distancing measures. Postpandemic, examining the role social networks play in COVID-19 recovery can help guide patient care and shape future health policies. This study aimed to investigate the relationship between social networks and self-rated health change, as well as physical function, in patients recovering from COVID-19 pneumonia. METHODS This was a retrospective cohort study utilizing clinical data from 2 New York City hospitals and a 9-month follow-up survey of COVID-19 pneumonia survivors. We evaluated a composite Social Network Score from the 6-item Lubben Social Network Scale and its association with 2 outcomes: 1) self-rated health change and 2) physical function. RESULTS A total of 208 patients were included in this study. A 1-point increase in the Social Network Score was associated with greater odds of both same or improved self-rated health change (odds ratio [OR] 1.07, 95% CI 1.02-1.12, P = .01), as well as unimpaired physical function (OR 1.08, 95% CI 1.03-1.14, P < .01). CONCLUSION This study emphasized the importance of social networks as a social determinant of health among patients recovering from COVID-19 hospitalization. Targeted interventions to enhance social networks may benefit not only COVID-19 patients but also individuals recovering from other acute illnesses.
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Affiliation(s)
- Di Pan
- Division of Pulmonary and Critical Care, Department of Medicine, Weill Cornell Medical College, New York, N.Y..
| | - Jihui L Diaz
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Penn
| | - Karissa Weidman
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, N.Y
| | - Julia Graham
- Division of Pulmonary and Critical Care, Department of Medicine, Weill Cornell Medical College, New York, N.Y
| | - Parag Goyal
- Division of Cardiology, Department of Medicine, Weill Cornell Medical College, New York, N.Y
| | - Mangala Rajan
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, N.Y
| | - Jennifer Lau
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, N.Y
| | - Laura Pinheiro
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, N.Y
| | - Leena Rachid
- Stritch School of Medicine at Loyola University Chicago, Maywood, Ill
| | - Will Simmons
- Department of Population Health Sciences, Weill Cornell Medical College, New York, N.Y
| | - Edward J Schenck
- Division of Pulmonary and Critical Care, Department of Medicine, Weill Cornell Medical College, New York, N.Y
| | - Monika M Safford
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, New York, N.Y
| | - Lindsay Lief
- Division of Pulmonary and Critical Care, Department of Medicine, Weill Cornell Medical College, New York, N.Y
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Bouloukaki I, Christodoulakis A, Margetaki K, Aravantinou Karlatou A, Tsiligianni I. Exploring the Link between Social Support and Patient-Reported Outcomes in Chronic Obstructive Pulmonary Disease Patients: A Cross-Sectional Study in Primary Care. Healthcare (Basel) 2024; 12:544. [PMID: 38470655 PMCID: PMC10930953 DOI: 10.3390/healthcare12050544] [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: 01/31/2024] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
We aimed to explore the link between social support and various patient-reported outcome measures (PROMs) in primary care patients with COPD. This was a cross-sectional study with 168 patients with COPD from six primary care centers in Crete, Greece. We collected data on sociodemographic characteristics, medical history, disease-specific quality of life, the COPD Assessment Test (CAT), fatigue, the Fatigue Severity Scale (FSS), phycological parameters, Patient Health Questionnaire-9, General Anxiety Disorder-7, sleep complaints, the Pittsburg Sleep Quality Index, the Athens Insomnia scale (AIS), and the Epworth Sleepiness Scale. Social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS). Out of 168 patients with COPD, 114 (68.9%) exhibited low levels of social support. Low social support (MSPSS total ≤ 5) was positively associated with COPD symptoms (CAT score ≥ 10) (OR = 3.97, 95%CI:1.86-8.44; p < 0.01), fatigue (FSS ≥ 36) (OR = 2.74, 95%CI:1.31-5.74; p = 0.01), and insomnia symptoms (AIS ≥ 6) (OR = 5.17 95%CI:2.23-12.01; p < 0.01), while the association with depressive symptoms (PHQ-9 ≥ 10) was marginally significant (OR = 3.1, 95%CI:0.93-10.36; p = 0.07). Our results suggest that lower levels of social support are positively associated with PROMs in patients with COPD. Therefore, our findings show an additional way to improve the overall health of patients with COPD in primary care by putting social support at the epicenter of actions.
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Affiliation(s)
- Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
| | - Antonios Christodoulakis
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Katerina Margetaki
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
| | - Antonia Aravantinou Karlatou
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece; (A.C.); (K.M.); (A.A.K.); (I.T.)
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Zhao J, Zhang X, Li X, Zhang R, Chang Y, Li Y, Lu H. Unraveling the mediation role of frailty and depression in the relationship between social support and self-management among Chinese elderly COPD patients: a cross-sectional study. BMC Pulm Med 2024; 24:66. [PMID: 38302898 PMCID: PMC10835951 DOI: 10.1186/s12890-024-02889-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/28/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Self-management (SM) is the key factor in controlling the progression of chronic obstructive pulmonary disease (COPD). Previous studies have reported that majority of COPD patients later presented with frailty and mental health diseases, which affect self-management. This study attempted to explore the mediation role of depression and frailty between social support and self-management in elderly COPD population. METHODS Six hundred twenty-seven stable elderly COPD patients admitted to 5 public hospitals in Ningxia, China were selected as study subjects by convenience sampling method. Self-management, frailty, depression and social support were assessed using the COPD Self-management Scale (COPD-SMS), Frail Scale (FS), 15-item Geriatric Depression Scale (GDS-15), and Social Support Rating Scale (SSRS) respectively. The Pearson correlation analysis was used to assess the correlation between variables. Additionally, SPSS25.0 PROCESS plugin Model 6 was used to explore the mediating effects of frailty and depression in the relationship between social support and self-management. RESULTS The mean participant age was 72.87 ± 7.03 years, 60.4% of participants were male. The mean total score of the COPD-SMS was 156.99 ± 25.15. Scores for the SSRS, FS, and GDS-15 were significantly correlated with COPD-SMS (p < 0.05). The analysis of the mediation effect demonstrated that social support has a direct predictive effect on self- management (β = 1.687, 95%CI: 1.359 to 2.318). Additionally, social support can also predict self- management indirectly through the mediation of depression (β = 0.290, 95%CI: 0.161 to 0.436) and frailty-depression (β = 0.040, 95%CI: 0.010 to 0.081). However, the mediation effect of frailty alone was not found to be statistically significant (β =-0.010, 95%CI: -0.061 to 0.036). The direct effect accounted for 84.06% of the total effect, while the indirect effect accounted for 15.94% of the total effect. CONCLUSION Self-management among elderly COPD patients was relatively moderate to low. Furthermore, frailty and depression were found to have a partially mediation role in the relationship between social support and self-management. Therefore, healthcare professionals need to comprehensively consider the frailty and depression status of patients, and implement targeted intervention measures as part of their care, which can improve the self-management of elderly COPD patients.
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Affiliation(s)
- Jie Zhao
- Department of Master's Training Station, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Xiaona Zhang
- Department of Nursing, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Xindan Li
- Department of Master's Training Station, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Rui Zhang
- Department of Nursing, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Yan Chang
- Department of Nursing, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Yongju Li
- Department of Nursing, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Hongyan Lu
- Department of Nursing, General Hospital of Ningxia Medical University, Yinchuan, 750004, China.
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Aravantinou-Karlatou A, Bouloukaki I, Christodoulakis A, Tsiligianni I. The Influence of Social Support in PROMs of Patients with COPD in Primary Care: A Scoping Review. Healthcare (Basel) 2023; 11:3141. [PMID: 38132031 PMCID: PMC10742576 DOI: 10.3390/healthcare11243141] [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: 11/14/2023] [Revised: 12/05/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a prevalent and multidimensional disease with symptoms that greatly influence patients' health. Healthcare professionals utilize patient-reported outcome measures (PROMs) to classify and better manage the disease. Despite the value of PROMs, they inadequately represent some important dimensions of COPD, like social support and healthcare access/utilization. This is important, especially for social support, since it can positively influence PROMs results and the overall health of patients with COPD. Therefore, a scoping review was conducted to determine how social support affects PROMs of patients with COPD in primary care. The PRISMA-Scoping approach was adopted, and we sought articles published in MEDLINE and COHRANE. We screened 2038 articles for inclusion and finally included a total of 10 articles. Most of the articles were conducted in the U.S. and Norway. Social support had a strong positive impact on PROMs. Additionally, different types of social support were observed. Moreover, higher levels of social support were linked to better quality of life, mental health, self-care behaviors, self-management, functionality, and less severe COPD. Consequently, this scoping review highlights the value of social support in patients with COPD and its underrepresentation and misrepresentation in PROMs literature.
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Affiliation(s)
- Antonia Aravantinou-Karlatou
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
| | - Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
| | - Antonios Christodoulakis
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, Voutes-Stavrakia, 71003 Heraklion, Greece; (I.B.); (A.C.); (I.T.)
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Delaney S, Cronin P, Huntley-Moore S. Conceptualisations of COPD self-management: A narrative review of the research literature. Chronic Illn 2023; 19:514-528. [PMID: 35876320 DOI: 10.1177/17423953221115441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM To examine how self-management is conceptualised in the research literature on chronic obstructive pulmonary disease (COPD). METHODS A narrative review was undertaken to search the research literature on COPD self-management. Ten databases (2000-2021) were searched for published texts. Sixty-two articles met the inclusion criteria. A thematic analysis was conducted of the literature. RESULTS Three conceptualisations of COPD self-management were identified: 1) a dominant medicocentric conceptualisation which represented self-management as medical in focus; 2) a less dominant experiential conceptualisation that viewed it as arising from the experiences of people living with COPD; and 3) a smaller body of literature that attempted to integrate medicocentric and experiential conceptualisations of self-management. DISCUSSION The dominance of the medicocentric conceptualisation of self-management and the polarisation of medicocentric and experiential perspectives were striking. An integrated conceptualisation of self-management has the potential to unite these competing perspectives and promote collaborative relationships between individuals and professionals, so long as the underlying values informing it are made explicit. However, there is a dearth of literature on this approach and it would benefit from more attention. Methods such as Co-production and the Personal Outcomes Approach offer the potential to support an integrated perspective in clinical practice.
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Affiliation(s)
- Sarah Delaney
- Health Research Charities Ireland, Digital Office Centre, 12 Camden Row, Dublin, Ireland
| | - Patricia Cronin
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland
| | - Sylvia Huntley-Moore
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland
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12
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Sloth MMB, Neble Larsen E, Godtfredsen NS, Osler M, Jørgensen TSH. Impact of offspring and their educational level on readmission and death among older adults with chronic obstructive pulmonary disease: a nationwide cohort study using multistate survival models. J Epidemiol Community Health 2023; 77:558-564. [PMID: 37311624 DOI: 10.1136/jech-2022-220243] [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: 12/19/2022] [Accepted: 06/05/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND It is well described that there is social inequality in the disease course of chronic obstructive pulmonary disease (COPD), but the impact of social relations is less explored. We aimed to investigate the impact of adult offspring and their educational level on readmission and death among older adults with COPD. METHODS In total, 71 084 older adults born 1935-53 with COPD diagnosed at age ≥65 years in 2000-2018 were included. Multistate survival models were performed to estimate the impact of adult offspring (offspring (reference) vs no offspring) and their educational level (low, medium or high (reference)) on the transition intensities between three states: COPD diagnosis, readmission and all-cause death. RESULTS During follow-up, 29 828 (42.0%) had a readmission and 18 504 (26.0%) died with or without readmission. Not having offspring was associated with higher hazards of death without readmission (HRwomen: 1.52 (95% CI: 1.39 to 1.67), HRmen: 1.29 (95% CI: 1.20 to 1.39)) and a higher hazard of death after readmission for women only (HRwomen: 1.19 (95% CI: 1.08 to 1.30). Having offspring with low educational level was associated with higher hazards of readmission (HRwomen: 1.12 (95% CI: 1.06 to 1.19)), (HRmen: 1.06 (95%CI: 1.002 to 1.12)), death without readmission (HRwomen: 1.24 (95% CI: 1.11 to 1.39)), HRmen: 1.16 (95% CI: 1.05 to 1.29) and death after readmission for men only (HRmen: 1.15 (95% CI: 1.05 to 1.25)). Having offspring with medium educational level was associated with a higher hazard of death without readmission for women (HRwomen: 1.11 (95% CI: 1.02 to 1.21)). CONCLUSION Adult offspring and their educational level were associated with higher risk of readmission and death among older adults with COPD.
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Affiliation(s)
- Mathilde Marie Brünnich Sloth
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Emma Neble Larsen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Nina Skavlan Godtfredsen
- Department of Respiratory Diseases, Hvidovre Hospital, Hvidovre, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Terese Sara Høj Jørgensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Copenhagen University Hospital, Frederiksberg, Denmark
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13
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Clark LA, Klinedinst NJ, Zhu S, Seong H, Reed R, Renn C, Corazzini KN. Factors Related to Fatigue and Physical Function in COPD: A Secondary Analysis Using National Survey Data. West J Nurs Res 2023; 45:653-664. [PMID: 37114849 DOI: 10.1177/01939459231170710] [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] [Indexed: 04/29/2023]
Abstract
Fatigue in chronic obstructive pulmonary disease (COPD) is debilitating and associated with considerable morbidity. The aim of this study is to present a model based on the Theory of Unpleasant Symptoms of physiologic, psychologic, and situational factors with COPD-related fatigue and the relationship with physical functioning. This study used data collected from Wave 2 (2010-2011) of the National Social, Health, and Aging Project (NSHAP). A total of 518 adults with self-reported COPD were included in this study. Path analysis was used for hypothesis testing. Depression was the only psychologic factor found to have a direct relation to both fatigue (β = 0.158, p < .001) and physical function (β = -0.131, p = .001). Factors related to physical function included fatigue, depression, sleep, loneliness, and pain. Additionally, fatigue was indirectly associated with physical function via depression (β = -0.064, p = .012). These findings suggest avenues for future research on predictors of COPD-related fatigue in relation to physical functioning.
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Affiliation(s)
- Lindsey A Clark
- University of Maryland School of Nursing, Baltimore, MD, USA
| | | | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Hohyun Seong
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Robert Reed
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Cynthia Renn
- University of Maryland School of Nursing, Baltimore, MD, USA
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14
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Silva J, Hipólito N, Machado P, Flora S, Cruz J. Technological features of smartphone apps for physical activity promotion in patients with COPD: A systematic review. Pulmonology 2023:S2531-0437(23)00124-1. [PMID: 37394341 DOI: 10.1016/j.pulmoe.2023.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION Low physical activity (PA) levels have a negative impact on the health status of patients with Chronic Obstructive Pulmonary Disease (COPD). Smartphone applications (apps) focused on PA promotion may mitigate this problem; however, their effectiveness depends on patient adherence, which can be influenced by the technological features of the apps. This systematic review identified the technological features of smartphone apps aiming to promote PA in patients with COPD. METHODS A literature search was performed in the databases ACM Digital Library, IEEE Xplore, PubMed, Scopus and Web of Science. Papers including the description of a smartphone app for PA promotion in patients with COPD were included. Two researchers independently selected studies and scored the apps features based on a previously developed framework (38 possible features). RESULTS Twenty-three studies were included and 19 apps identified, with an average of 10 technological features implemented. Eight apps could be connected to wearables to collect data. The categories 'Measuring and monitoring' and 'Support and Feedback' were present in all apps. Overall, the most implemented features were 'progress in visual format' (n = 13), 'advice on PA' (n = 14) and 'data in visual format' (n = 10). Only three apps included social features, and two included a web-based version of the app. CONCLUSIONS The existing smartphone apps include a relatively small number of features to promote PA, which are mostly related to monitoring and providing feedback. Further research is warranted to explore the relationship between the presence/absence of specific features and the impact of interventions on patients' PA levels.
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Affiliation(s)
- J Silva
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Portugal
| | - N Hipólito
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal; Health Data Science of the Department of Community Medicine, Information and Health Decision Sciences of the Faculty of Medicine of the University of Porto, Porto, Portugal
| | - P Machado
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal
| | - S Flora
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal
| | - J Cruz
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Portugal; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal.
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15
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Barradell AC, Gerlis C, Houchen-Wolloff L, Bekker HL, Robertson N, Singh SJ. Systematic review of shared decision-making interventions for people living with chronic respiratory diseases. BMJ Open 2023; 13:e069461. [PMID: 37130669 PMCID: PMC10163462 DOI: 10.1136/bmjopen-2022-069461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE Shared decision-making (SDM) supports patients to make informed and value-based decisions about their care. We are developing an intervention to enable healthcare professionals to support patients' pulmonary rehabilitation (PR) decision-making. To identify intervention components we needed to evaluate others carried out in chronic respiratory diseases (CRDs). We aimed to evaluate the impact of SDM interventions on patient decision-making (primary outcome) and downstream health-related outcomes (secondary outcome). DESIGN We conducted a systematic review using the risk of bias (Cochrane ROB2, ROBINS-I) and certainty of evidence (Grading of Recommendations Assessment, Development and Evaluation) tools. DATA SOURCES MEDLINE, EMBASE, PSYCHINFO, CINAHL, PEDRO, Cochrane Central Register of Controlled Trials, the International Clinical Trials Registry Platform Search Portal, ClinicalTrials.gov, PROSPERO, ISRCTN were search through to 11th April 2023. ELIGIBILITY CRITERIA Trials evaluating SDM interventions in patients living with CRD using quantitative or mixed methods were included. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted data, assessed risk of bias and certainty of evidence. A narrative synthesis, with reference to The Making Informed Decisions Individually and Together (MIND-IT) model, was undertaken. RESULTS Eight studies (n=1596 (of 17 466 citations identified)) fulfilled the inclusion criteria.Five studies included components targeting the patient, healthcare professionals and consultation process (demonstrating adherence to the MIND-IT model). All studies reported their interventions improved patient decision-making and health-related outcomes. No outcome was reported consistently across studies. Four studies had high risk of bias, three had low quality of evidence. Intervention fidelity was reported in two studies. CONCLUSIONS These findings suggest developing an SDM intervention including a patient decision aid, healthcare professional training, and a consultation prompt could support patient PR decisions, and health-related outcomes. Using a complex intervention development and evaluation research framework will likely lead to more robust research, and a greater understanding of service needs when integrating the intervention within practice. PROSPERO REGISTRATION NUMBER CRD42020169897.
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Affiliation(s)
- Amy C Barradell
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- College of Medicine, Biological Sciences & Psychology, National Institute for Health Research (NIHR) Applied Research Collaboration (East Midlands), Leicester, UK
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS trust, Leicester, UK
| | - Charlotte Gerlis
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS trust, Leicester, UK
| | - Linzy Houchen-Wolloff
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS trust, Leicester, UK
| | - Hilary L Bekker
- Leeds Unit of Complex Intervention Development (LUICD), University of Leeds, Leeds, UK
- Research Centre for Patient Involvement, Central Denmark Region and Aarhus University, Aarhus, Denmark
| | - Noelle Robertson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Sally J Singh
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
- Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS trust, Leicester, UK
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16
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Panjwani AA, Erblich J, Revenson TA, Badr HJ, Federman AD, Wisnivesky JP. The indirect influence of 'invisible' support on pulmonary function among adults with chronic obstructive pulmonary disease. PSYCHOL HEALTH MED 2023; 28:831-842. [PMID: 35373659 PMCID: PMC9527261 DOI: 10.1080/13548506.2022.2061720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
Individuals living with chronic obstructive pulmonary disease (COPD) often require support from family or friends. We examined whether invisible support - support that is provided but goes unnoticed - is related to pulmonary function, and whether this association is mediated by depressive symptoms and illness perceptions. Sixty-six dyads of individuals with COPD and their informal caregivers reported on receipt and provision of support, respectively. Those with COPD completed measures of depressive symptoms, illness perceptions and pulmonary function. Although invisible support was not directly related to pulmonary function, mediation analyses revealed a combined indirect effect through lower depressive symptoms and less negative illness perceptions. Interventions teaching skillful delivery of support to caregivers may reduce depressive symptoms and threatening illness cognitions, which may contribute to improvements in symptom burden among patients with COPD.
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Affiliation(s)
- Aliza A. Panjwani
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON
| | - Joel Erblich
- Department of Psychology, Hunter College & the Graduate Center, City University of New York, New York, NY
| | - Tracey A. Revenson
- Department of Psychology, Hunter College & the Graduate Center, City University of New York, New York, NY
| | - Hoda J. Badr
- Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Alex D. Federman
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Juan P. Wisnivesky
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
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17
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Association between inpatient palliative care encounter and 30-day all-cause readmissions after index hospitalization for chronic obstructive pulmonary disease. Heart Lung 2023; 58:69-73. [PMID: 36410155 DOI: 10.1016/j.hrtlng.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/26/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies exist on the association between inpatient Palliative Care Encounter (iPCE) and 30-day rehospitalization among cancer and several non-cancer conditions but limited in persons with Chronic Obstructive Pulmonary Disease (COPD). OBJECTIVE To assess the association between an iPCE with the risk of 30-day rehospitalization after an index hospitalization for COPD. METHODS We conducted a cross-sectional analysis of the Nationwide Readmissions Database (2010-2014). Index hospitalizations were defined as persons ≥ 18 years of age, discharge destinations of either Home/Routine, Home with Home Care, or a Facility, and an index hospitalization with Diagnosis Related Group of COPD. The International Classification of Diseases, 9th revision codes were used to extract comorbidities and a Palliative Care Encounter (V66.7). RESULTS There were 3,163,889 index hospitalizations and iPCE occurred in 21,330 (0.67%). There were 558,059 (17.63%) with a 30-day rehospitalization. An iPCE was associated with a significantly lower adjusted odds of 30-day readmission (Odds Ratio [OR], 0.50; 95% Confidence Interval [CI], 0.46 to 0.54). By discharge destination, the odds of 30-day rehospitalization were for a discharged to a facility (OR, 0.37; 95% CI, 0.32 to 0.42), to home with home health (OR, 0.42; 95% CI, 0.37 to 0.47), and to home (OR, 0.98; 95% CI, 0.85 to 1.12) for those with relative to without iPCE. CONCLUSION Inpatient PCE was associated with a 50% lower relative odds of 30-day rehospitalization after an index hospitalization for COPD. This association varied by discharge destination being statistically significant among those with a discharge destination of a facility (63%) and home with home care (58%).
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18
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Pergol-Metko P, Staniszewska A, Metko S, Sienkiewicz Z, Czyzewski L. Compassion Fatigue and Perceived Social Support among Polish Nurses. Healthcare (Basel) 2023; 11:healthcare11050706. [PMID: 36900712 PMCID: PMC10001227 DOI: 10.3390/healthcare11050706] [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: 12/30/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Social support has a vital role in preventing traumatic stress in nurses. Nurses are regularly exposed to contact with violence, suffering, and death. The situation worsened during the pandemic because they were also faced with the possibility of infection SARS-CoV-2 and death from COVID-19. Many nurses are faced with increased pressure, stress, and other adverse effects on their mental health. The study aimed to measure the relationship between compassion fatigue and perceived social support in polish nurses. METHODS The study was conducted on 862 professionally active nurses in Poland using the CAWI method (Computer-Assisted Web Interview). The professional Quality of Life scale (ProQOL) and the Multidimensional Scale of Perceived Social Support (MSPSS) were used for collecting the data. StatSoft, Inc. (2014) was used for data analysis. For comparisons between the groups: Mann-Whitney U test, ANOVA Kruskal-Wallis test, and multiple comparisons (post-hoc). The relationships between variables were tested using Spearman's rho, Tau Kendall, and the chi-square test. RESULTS The research showed the presence of compassion satisfaction, compassion fatigue, and burnout in the group of Polish hospital nurses. A higher level of perceived social support was associated with lower compassion fatigue (r = -0.35; p < 0.001). A higher level of social support was associated with higher job satisfaction (r = 0.40; p < 0.001). The study also found that a higher level of social support was associated with a lower risk of burnout (r = -0.41; p < 0.001). CONCLUSIONS Preventing compassion fatigue and burnout should be a priority for healthcare managers. Notably, an essential predictor of compassion fatigue is that Polish nurses often work overtime. It is necessary to pay more attention to the crucial role of social support in preventing compassion fatigue and burnout.
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Affiliation(s)
- Paulina Pergol-Metko
- Department of Development of Nursing and Social & Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
- Correspondence:
| | - Anna Staniszewska
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | | | - Zofia Sienkiewicz
- Department of Development of Nursing and Social & Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Lukasz Czyzewski
- Department of Geriatric Nursing, Medical University of Warsaw, 02-091 Warsaw, Poland
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19
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Effing TW. Developments in respiratory self-management interventions over the last two decades. Chron Respir Dis 2023; 20:14799731231221819. [PMID: 38129363 DOI: 10.1177/14799731231221819] [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] [Indexed: 12/23/2023] Open
Abstract
This paper describes developments in the fields of asthma and COPD self-management interventions (SMIs) over the last two decades and discusses future directions. Evidence around SMIs has exponentially grown. Efficacy on group level is convincing and both asthma and COPD SMIs are currently recommended by respiratory guidelines. Core components of asthma SMIs are defined as education, action plans, and regular review, with some discussion about self-monitoring. Exacerbation action plans are defined as an integral part of COPD management. Patient's adherence to SMI's is however inadequate and significantly reducing the intervention's impact. Adherence could be improved by tailoring of SMIs to patients' needs, health beliefs, and capabilities; the use of shared decision making; and optimising the communication between patients and health care providers. Due to the COVID-19 pandemic, digital health innovations have rapidly been introduced and expanded. Digital technology use may increase efficiency, flexibility, and efficacy of SMIs. Furthermore, artificial intelligence can be used to e.g., predict exacerbations in action plans. Research around digital health innovations to ensure evidence-based practice is of utmost importance. Current implementation of respiratory SMIs is not satisfactory. Implementation research should be used to generate further insights, with cost-effectiveness, policy (makers), and funding being significant determinants.
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Affiliation(s)
- Tanja W Effing
- College of Medicine and Public Health, Flinders University of South Australia, Bedford Park, South Australia, Australia
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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20
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Tsang A, Lynes D, McKenzie H, Spencer S, Kelly C. Self-management programmes for adult patients with bronchiectasis: a systematic review and realist synthesis. Disabil Rehabil 2022; 44:6939-6948. [PMID: 34658309 DOI: 10.1080/09638288.2021.1978563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Self-management for patients with bronchiectasis has been identified as an important component that could potentially empower patients to manage their condition and improve their quality of life. Evidence was reviewed to investigate what self-management programmes work, why and in what circumstances. METHODS A systematic review and realist synthesis were conducted. A comprehensive database search was performed on seven databases for evidence published up to July 2021. Leading candidate self-management programmes identified from the systematic review became the focus of the realist synthesis. A realist logic of analysis was applied to produce explanatory context-mechanism-outcome configurations. These explanations were consolidated into programme theories drawing on health behaviour change theory. RESULTS By synthesising the data from eight eligible articles, programme theories articulated how three different self-management programmes work that included: (i) education and action planning, (ii) education and airway clearance techniques (ACT) and, (iii) education, exercise and ACT. Patient characteristics and collaborative partnership between healthcare professionals and patients were identified as important contexts that influenced the improvement in self-efficacy, health-related quality of life, and exercise capacity. CONCLUSIONS This review contributes to a better understanding of how the complex interaction between contexts and mechanisms can improve outcomes of clinical interest.IMPLICATIONS FOR REHABILITATIONThis evidence synthesis has identified potentially important combinations of interventions to be considered in self-management programmes for adults with bronchiectasis.Collaborative partnership between patient and healthcare professionals should be considered to improve short-term self-efficacy.Targeting self-management programmes to increase short-term health-related quality of life and exercise capacity should consider the context of patient characteristics.
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Affiliation(s)
- Anthony Tsang
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK.,Department of Nursing, Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Manchester, UK
| | - Dave Lynes
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | - Hayley McKenzie
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK
| | - Sally Spencer
- Faculty of Health & Social Care, Health Research Institute, Edge Hill University, Ormskirk, UK
| | - Carol Kelly
- Faculty of Health, Social Care & Medicine, Edge Hill University, Ormskirk, UK.,Faculty of Health & Social Care, Health Research Institute, Edge Hill University, Ormskirk, UK
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21
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Peer Support and Chronic Obstructive Pulmonary Disease Self-Management: A Promising Approach? Ann Am Thorac Soc 2022; 19:1640-1641. [PMID: 36178399 PMCID: PMC9528742 DOI: 10.1513/annalsats.202207-591ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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22
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SINFONIA study protocol: a phase II/III randomised controlled trial examining benefits of guided online group singing in people with chronic obstructive pulmonary disease and interstitial lung disease and their carers. Respir Res 2022; 23:208. [PMID: 35974347 PMCID: PMC9380685 DOI: 10.1186/s12931-022-02133-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/06/2022] [Indexed: 11/30/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) and interstital lung disease (ILD) are incurable conditions characterised by airflow limitation, persisting respiratory symptoms, and progressive respiratory failure. People living with COPD or ILD often suffer from chronic and severe breathlessness, with limited treatment options and low engagement rates with current therapies. Group singing represents a potential community-based therapy to improve quality of life for patients with COPD or ILD and breathlessness. Methods This protocol papers describes SINFONIA, a parallel, double-arm, randomised, blinded-analysis, mixed-methods phase II/III trial of guided, online group singing that will be conducted over 24 months. Adults with confirmed COPD or ILD, on stable treatment for at least four weeks at time of recruitment, with a modified Medical Research Council (mMRC) dyspnoea score of two or greater, who are capable and willing to give consent, and not currently participating in pulmonary rehabilitation will be eligible to participate. Carers may optionally enrol in the trial. Data will be collected on quality of life, anxiety and depression, breathlessness, mastery of breathing, exercise tolerance, loneliness, healthcare utilisation, and carer quality of life (optional). Participants will be randomised 1:1 to intervention or control arms with intervention arm attending one 90 min, guided, online, group singing session per week for 12 weeks and control arm continuing routine care. Phase II of the trial aims to determine the feasibility and acceptability of guided, online group singing and will collect preliminary data on effectiveness. Phase III aims to determine whether guided, online group singing has an effect on quality of life with the primary outcome being a between arm difference in quality of life (36-item Short Form Survey) measured at 12 weeks. Discussion SINFONIA is the first study is the first of its kind in Australia and to our knowledge, the first to deliver the singing intervention program entirely online. Determining the feasibility, acceptability, and effectiveness of guided, online group singing is an important step towards improving low-cost, low-risk, community-based therapeutic options for patients living with COPD or ILD and breathlessness. Trial registration: Phase II—ACTRN12621001274864, registered 20th September 2021; Phase III—ACTRN12621001280897, registered 22nd September 2021.
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23
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Nasreen S, Gebretekle GB, Lynch M, Kurdina A, Thomas M, Fadel S, Houle SKD, Waite NM, Crowcroft NS, Allin S. Understanding predictors of pneumococcal vaccine uptake in older adults aged 65 years and older in high-income countries across the globe: A scoping review. Vaccine 2022; 40:4380-4393. [PMID: 35781171 DOI: 10.1016/j.vaccine.2022.06.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 05/31/2022] [Accepted: 06/20/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Pneumococcal disease causes substantial morbidity and mortality in older adults. Pneumococcal polysaccharide vaccine (PPV23) is routinely recommended to reduce the disease burden in this population. However, the vaccination coverage in older adults remains suboptimal in high-income countries. OBJECTIVES We sought to understand the current landscape of published literature on the predictors of pneumococcal vaccine uptake in older adults aged 65 years and older in high-income countries, and to identify the gaps in literature to inform future research. METHODS We conducted a scoping review employing the Arksey and O'Malley framework and Joanna Briggs Methods. We searched Medline, EMBASE, CINAHL, PsycInfo and Cochrane databases. We included quantitative and qualitative studies on predictors of pneumococcal vaccination in older adults that reported older adult- and pneumococcal vaccine-specific results, conducted in high-income settings, and published in English between January 2015 and April 2020. We excluded studies assessing interventions to improve vaccine uptake. We followed the Strategic Advisory Group of Experts on Immunization Working Group Vaccine Hesitancy Determinants Matrix to map the predictors within contextual, individual and social group, and vaccine and vaccination-specific influence determinants. Studies on providers and institutions were also included and results summarized separately. RESULTS We included 52 publications in our review. Most of the predictors in 39 quantitative studies belonged to the individual and social group influences (n = 12), followed by contextual influences (n = 11) and vaccine and vaccination-specific issues (n = 3). Few qualitative studies explored the barriers to pneumococcal vaccination. Only five studies examined predictors from the healthcare providers' perspective. Three studies examined the institutional characteristics as the predictors of pneumococcal vaccination in older adults. CONCLUSIONS We identified enablers and barriers of pneumococcal vaccination among older adults in high-income settings. We also identified gaps in the literature and provide recommendations for future research to address the gaps.
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Affiliation(s)
- Sharifa Nasreen
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
| | - Gebremedhin B Gebretekle
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
| | - Meghan Lynch
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Anna Kurdina
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Madeleine Thomas
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Shaza Fadel
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | | | - Nancy M Waite
- School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Natasha S Crowcroft
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Sara Allin
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Barankevich R, Loebach J. Self-Care and Mental Health Among College Students During the COVID-19 Pandemic: Social and Physical Environment Features of Interactions Which Impact Meaningfulness and Mitigate Loneliness. Front Psychol 2022; 13:879408. [PMID: 35783724 PMCID: PMC9244538 DOI: 10.3389/fpsyg.2022.879408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 05/23/2022] [Indexed: 12/03/2022] Open
Abstract
The COVID-19 pandemic has interrupted patterns and limited opportunities for social interaction, which increased already high loneliness rates among college students. Meaningful social interactions can mitigate negative mental health outcomes such as loneliness and bolster social support, which is in turn linked to better self-care practices. Social connection can aid in self-care through social support as well as be considered a self-care practice itself to counter the negative effects of loneliness. This study examined the social interaction patterns of 132 college students from a mid-sized United States university during the pandemic to understand which characteristics support meaningful interactions. Students completed an online survey from October through December 2020 to report details of their 2020 and 2019 social interactions, as well as their most recent interactions, including time spent, the mode (in-person versus virtual), their relationship to others in the interaction, the type of activity and privacy of the setting. Results found that students spent significantly less time interacting with non-roommates in-person in 2020, and more time in voice and video calls. No differences were found for texting and in-person roommate interactions. Meaningfulness was significantly higher for interactions with family or friends. Students reported the highest meaning for interactions that were planned and in-person, with lowest meaning for planned virtual interactions. No differences were observed for meaningfulness based on the type of interaction activity or privacy of the setting. Understanding the characteristics of the most meaningful interactions can help college students prioritize social interactions that may best promote self-care, mitigate loneliness, and bolster social support. High meaningfulness scores for planned in-person interactions suggests that these types of interactions may be most valuable for maintaining existing self-care patterns, engaging in self-care activities, and receiving support. Self-care activities for college students, including social interactions, were significantly impacted by the COVID-19 pandemic, which may have further exacerbated loneliness. College students should be encouraged to consciously engage in person with family and friends to practice self-care and maintain or improve mental health. Strategically selecting interactions that will optimize meaningfulness may therefore be critical to helping students to maintain positive mental health during and beyond the pandemic.
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Affiliation(s)
- Ruth Barankevich
- School of Social Ecology, University of California, Irvine, Irvine, CA, United States
- *Correspondence: Ruth Barankevich,
| | - Janet Loebach
- Department of Human Centered Design, Cornell University, Ithaca, NY, United States
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25
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Bamonti PM, Robinson SA, Wan ES, Moy ML. Improving Physiological, Physical, and Psychological Health Outcomes: A Narrative Review in US Veterans with COPD. Int J Chron Obstruct Pulmon Dis 2022; 17:1269-1283. [PMID: 35677347 PMCID: PMC9167842 DOI: 10.2147/copd.s339323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022] Open
Abstract
The Veterans Health Administration (VHA) is the largest integrated healthcare system in the United States (US) providing healthcare to an increasing number of middle-aged and older adults who remain at greater risk for chronic obstructive pulmonary disease (COPD) compared to their civilian counterparts. The VHA has obligated research funds, drafted clinical guidelines, and built programmatic infrastructure to support the diagnosis, treatment, and care management of Veterans with COPD. Despite these efforts, COPD remains a leading cause of morbidity and mortality in Veterans. This paper provides a narrative review of research conducted with US Veteran samples targeting improvement in COPD outcomes. We review key physiological, physical, and psychological health outcomes and intervention research that included US Veteran samples. We conclude with a discussion of directions for future research to continue advancing the treatment of COPD in Veterans and inform advancements in COPD research within and outside the VHA.
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Affiliation(s)
- Patricia M Bamonti
- Research & Development, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Stephanie A Robinson
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA.,The Pulmonary Center, Boston University School of Medicine, Boston, MA, USA
| | - Emily S Wan
- Research & Development, VA Boston Healthcare System, Boston, MA, USA.,Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA.,Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Marilyn L Moy
- Research & Development, VA Boston Healthcare System, Boston, MA, USA.,Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
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26
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LeBlanc RG, Chiodo L, Jacelon CS. Social relationship influence on self-care and health among older people living with long term conditions: A mixed-methods study. Int J Older People Nurs 2022; 17:e12450. [PMID: 35191193 DOI: 10.1111/opn.12450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Social relationships influence health, yet less is known on how social relationships influence self-care among older people living with multiple long-term conditions. OBJECTIVES The purpose of this study was to determine how social networks influence therapeutic self-care behaviours and health among community dwelling older people living with multiple long-term conditions. DESIGN Explanatory sequential mixed-methods. SETTING/SAMPLE Community dwelling older people living in the Northeast United States. METHODS A cross-sectional sample of eighty-nine people aged sixty-five and older participated in telephone surveys. A nested sample of twelve participants completed a follow-up open-ended interview. Descriptive statistics, bivariate correlations and regression statistics were used to examine the associations between social network features and functions with the dependent variables of therapeutic self-care behaviours and health. Qualities that emphasised the contexts of the relationships were integrated in the data analysis. RESULTS The strength of the social network and level of social support influenced the outcomes of therapeutic self-care and mental health. Thematic analysis expanded this explanation of self-care in relation to social network size, psycho-social support, activation of support, interaction frequency and type. CONCLUSION In supporting older people living with multiple long-term conditions, this nursing research offers new ways to understand close social relationships influence on self-care in developing systems of care at the community level. IMPLICATIONS FOR PRACTICE Designing care systems that include small trusted formal and informal caregivers that integrate social network members could improve health outcomes and improve access to supportive resources.
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Affiliation(s)
| | - Lisa Chiodo
- University of Massachusetts, Amherst, Massachusetts, USA
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CITTADINI N, BASILICI ZANNETTI E, IOVINO P, DE MARIA M, D'ANGELO D, PENNINI A, VELLONE E, ALVARO R. Factors influencing self-care in postmenopausal women with osteoporosis: The Guardian Angel® multicentric longitudinal study. Maturitas 2022; 161:7-11. [DOI: 10.1016/j.maturitas.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/03/2022] [Accepted: 01/19/2022] [Indexed: 11/29/2022]
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28
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Choi JY, Yun SY. Validity and Reliability of Korean Version of Self-Care Chronic Obstructive Pulmonary Disease Inventory (SC-COPD) and Self-Care Self-Efficacy Scale (SCES-COPD). J Korean Acad Nurs 2022; 52:522-534. [DOI: 10.4040/jkan.22062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/31/2022] [Accepted: 09/19/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Ja Yun Choi
- College of Nursing, Chonnam National University, Gwangju, Korea
| | - So Young Yun
- Department of Nursing, Nambu University, Gwangju, Korea
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29
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Predictors of health-related quality of life in patients with non-communicable diseases: A national cross-section study. Appl Nurs Res 2022; 64:151566. [DOI: 10.1016/j.apnr.2022.151566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 01/09/2022] [Accepted: 01/18/2022] [Indexed: 11/19/2022]
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30
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Arora S, Nika A, Sequeira W, Block JA, Jolly M. Pneumococcal Vaccination Among Lupus Patients: Who Are the Recipients? J Clin Rheumatol 2021; 27:e456-e461. [PMID: 32804752 DOI: 10.1097/rhu.0000000000001536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Pneumococcal vaccination (PV) is indicated for the elderly (age ≥65 years) and those with chronic disease or who are immunosuppressed. We aimed to study the rate and predictors of recommendation/receipt of 23 valent pneumococcal polysaccharide vaccine (PPSV23) in immunosuppressed systemic lupus erythematosus (SLE) patients. METHODS Data were obtained through self-report questionnaires and medical chart review of 150 SLE patients. Information on rheumatologist recommendation or receipt of PPSV23 in the preceding 5 years was collected if self-reported in a questionnaire or documented in the medical chart. Chart review was also done to collect data on patient demographics, physician characteristics (if patients had a primary care physician and rheumatologist's SLE patient volume), and the disease characteristics of SLE. Comparisons using χ2 or t tests and logistic regression analyses were conducted for predictors of recommendation/receipt of PV. RESULTS The mean (SD) age was 47.4 (15.9) years; 90% were women. Sixty-five of 94 eligible patients for PV (based on immunosuppressive medications use or age) had been either recommended or administered PPSV23. On univariate logistic regression analysis, age, duration of disease, current use of hydroxychloroquine or mycophenolate, and rheumatologist's SLE patient volume were significant correlates of recommendation/receipt of PPSV23. However, on multivariate analysis, the only significant predictor was rheumatologist's SLE patient volume after adjusting for the above correlates such that with every 50 patients increase in SLE patient clinic volume, the odds of recommendation/receipt of PPSV23 increased by 2.37 times. CONCLUSIONS The volume of lupus patients that rheumatologists see is strongly associated with the likelihood that their SLE patients will have PPSV23 recommended and delivered, suggesting a volume outcome relationship.
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Affiliation(s)
- Shilpa Arora
- From the Department of Medicine, Rush University Medical Center, Chicago, IL
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31
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Chat Chai AS, Draman N, Mohd Yusoff SS, Azman NF, Zulkifli MM, Yaacob NM, Mohamad N, Hassan R, Abdullah WZ, Zilfalil BA. Non-compliance to iron chelation therapy in patients with transfusion-dependent thalassaemia. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2021. [DOI: 10.1016/j.phoj.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Blanck E, Fors A, Ali L, Brännström M, Ekman I. Informal carers in Sweden - striving for partnership. Int J Qual Stud Health Well-being 2021; 16:1994804. [PMID: 34720063 PMCID: PMC8567876 DOI: 10.1080/17482631.2021.1994804] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose Informal carers have an important role in society through their care and support of their long-term ill relatives. Providing informal care is challenging and can lead to caregiver burden; moreover, many support needs of the carers are not met, leading to confusion, disappointment and frustration. We conducted an interview study to clarify the meaning of support given and received by informal carers to relatives with chronic obstructive pulmonary disease or chronic heart failure. Methods We purposively selected and recruited informants via participants in another study, thereby conducting interviews over the phone from June 2016 to May 2017. In total, we conducted 14 interviews with 12 informants. All interviews were transcribed verbatim and the content was analysed using a phenomenological hermeneutical approach. Result and conclusion Our comprehensive understanding of the meaning of support for these carers is twofold: it is a self-evident struggle for the good life of their relatives and that they want to be carers in partnership. The healthcare system must recognize the efforts of carers and include them in the strategic planning and operational stages of care and treatment for people with long-term illness.
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Affiliation(s)
- Elin Blanck
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Research and Development Primary Health Care, Gothenburg, Sweden
| | - Lilas Ali
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Psychiatric Department, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Margareta Brännström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Nursing, Umeå University, Campus Skellefteå, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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Bugajski A, Szalacha L, Rechenberg K, Johnson A, Beckie T, Morgan H. Psychometric Evaluation of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory in the United States. Heart Lung 2021; 51:1-8. [PMID: 34731690 DOI: 10.1016/j.hrtlng.2021.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/30/2021] [Accepted: 07/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND High quality self-care among individuals with chronic obstructive pulmonary disease (COPD) promotes better outcomes, however, there are few validated self-care measures that are psychometrically sound to be used in research. OBJECTIVES The purpose of this study is to examine the psychometric properties of the Self-Care in Chronic Obstructive Pulmonary Disease Inventory (SC-COPDI) in an English-speaking population in the United States. METHODS Factorial validity, construct validity and reliability of the SCCOPDI were examined using components analysis via principal components analysis, hypothesis testing via multivariate linear regression, Cronbach's alpha, and split-half reliability. RESULTS The SCCOPDI demonstrated strong evidence of validity and reliability on par with the SCCOPDI's original construction. Component analysis produced item loadings consistent with the theoretical underpinnings of the instrument. Reliability metrics yielded good internal consistency across all subscales of the SCCOPDI. CONCLUSIONS The SCCOPDI is a valid and reliable instrument to measure self-care in people with COPD.
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Affiliation(s)
- Andrew Bugajski
- Lakeland Regional Health, 1324 Lakeland Hills Blvd, Lakeland, FL, 33805.
| | - Laura Szalacha
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612, United States.
| | - Kaitlyn Rechenberg
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612, United States.
| | - Ayesha Johnson
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612, United States.
| | - Theresa Beckie
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612, United States.
| | - Hailey Morgan
- University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL 33612, United States.
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Husain MO, Chaudhry IB, Blakemore A, Shakoor S, Husain MA, Lane S, Kiran T, Jafri F, Memon R, Panagioti M, Husain N. Prevalence of depression and anxiety in patients with chronic obstructive pulmonary disease and their association with psychosocial outcomes: A cross-sectional study from Pakistan. SAGE Open Med 2021; 9:20503121211032813. [PMID: 34659761 PMCID: PMC8511919 DOI: 10.1177/20503121211032813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/25/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: Chronic obstructive pulmonary disease contributes to substantial health and
economic burden worldwide. Co-morbid depression and anxiety are highly
prevalent in patients with chronic obstructive pulmonary disease. Depressive
symptoms in chronic obstructive pulmonary disease are associated with poorer
survival, longer hospitalisation and impaired quality of life. Literature on
chronic obstructive pulmonary disease is largely derived from high-income
countries; yet 90% of deaths related to chronic obstructive pulmonary
disease occur in low- and middle-income countries. We aimed to establish the
prevalence of anxiety and depression in patients with chronic obstructive
pulmonary disease, as well as the association with psychosocial
outcomes. Methods: This was a cross-sectional study of chronic obstructive pulmonary disease
patients attending outpatient primary care clinics in Karachi, Pakistan. The
Patient Health Questionnaire-9 was used to assess depression and the
Generalised Anxiety Disorder-7 scale was used for the assessment of anxiety.
Health-related quality of life was assessed with EuroQol–Five Dimensions,
social support with Oslo-3 and social stress with Life Events Checklist. We
recruited 293 subjects. Results: The prevalence of depression and anxiety in the sample was 51%
(n = 149) and 20% (n = 59),
respectively. Depressed chronic obstructive pulmonary disease patients
reported significantly lower health-related quality of life scores as
compared to non-depressed patients. Participants with depression had
significantly higher levels of anxiety, less social support, higher social
stress and more subjective impairment in quality of life. Conclusion: Given the association with reduced social support and increased perceived
stress, the role of psychosocial interventions must be explored in improving
outcomes of chronic obstructive pulmonary disease patients in Pakistan.
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Affiliation(s)
- Muhammad Omair Husain
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada.,Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Imran B Chaudhry
- Department of Psychiatry, Dr. Ziauddin Hospital, Karachi, Pakistan
| | - Amy Blakemore
- Division of Nursing, Midwifery & Social Work, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Suleman Shakoor
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | | | - Steven Lane
- Medical Statistics Biostatistics, University of Liverpool, Liverpool, UK
| | - Tayyeba Kiran
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - Farhat Jafri
- Department of Community Medicine, Karachi Medical & Dental College, Karachi, Pakistan
| | | | - Maria Panagioti
- Division of Population Health, The University of Manchester, Manchester, UK
| | - Nusrat Husain
- Division of Psychology & Mental Health, The University of Manchester, Manchester, UK
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Matarese M, Pendoni R, Piredda M, De Marinis MG. Caregivers' experiences of contributing to patients' self-care in Chronic Obstructive Pulmonary Disease: A thematic synthesis of qualitative studies. J Adv Nurs 2021; 77:4017-4034. [PMID: 34245173 PMCID: PMC8518034 DOI: 10.1111/jan.14942] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/21/2021] [Accepted: 06/15/2021] [Indexed: 02/03/2023]
Abstract
Aim To identify, analyze and synthesize qualitative studies on caregivers’ experiences of contributions to the self‐care of patients with Chronic Obstructive Pulmonary Disease (COPD). Background COPD patients perform daily self‐care behaviours to manage the disease. With aging and disease progression, patients need to rely on the contributions of informal caregivers, usually family members, for disease management. Caregivers’ normal or habitual contributions to patients’ self‐care have not yet been completely investigated. Design Thematic synthesis of qualitative studies. Data sources CINAHL, EMBASE, PubMed, PsycINFO, Web of Science, Scopus, Emcare and OpenGrey databases were searched from inception to September 2020. The search was restricted to English‐language papers. Review methods Studies were critically appraised using the Critical Appraisal Skills Programme checklist. The initial line‐by‐line codes were aggregated into descriptive themes from which analytical themes were derived. Results Fifteen papers from nine countries, published 2009–2020, were included. Six analytical themes encompassing 22 descriptive themes were identified and grouped in two overarching themes describing caregivers’ experiences of contributions to patients’ self‐care during the stable and exacerbation phases of COPD. In the stable phases, caregivers contribute through maintaining disease stability, promoting healthy behaviours, fostering normal life and helping perform daily activities. During exacerbations, caregivers contribute through assessing, monitoring and managing symptoms in collaboration with patients or autonomously. They contribute by performing actions, motivating patients, organizing care, sensing variations in symptoms, acquiring knowledge and educating patients, making decisions, communicating and collaborating with healthcare providers and patients and advocating for patients. Conclusion This thematic synthesis enlarges knowledge of caregivers’ contributions to patients’ self‐care in COPD, detailing the ways by which caregivers provide care to patients. Impact Contributing daily to the self‐care of a family member with COPD is a complex experience. Nurses need to acknowledge the importance of caregivers’ contributions to patient disease management and develop effective educational interventions to support them.
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Affiliation(s)
- Maria Matarese
- Research Unit of Nursing Sciences, Campus Bio-Medico University of Rome, Rome, Italy
| | - Roberta Pendoni
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Michela Piredda
- Research Unit of Nursing Sciences, Campus Bio-Medico University of Rome, Rome, Italy
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Volpato E, Toniolo S, Pagnini F, Banfi P. The Relationship Between Anxiety, Depression and Treatment Adherence in Chronic Obstructive Pulmonary Disease: A Systematic Review. Int J Chron Obstruct Pulmon Dis 2021; 16:2001-2021. [PMID: 34262270 PMCID: PMC8275112 DOI: 10.2147/copd.s313841] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 06/01/2021] [Indexed: 01/04/2023] Open
Abstract
Background Almost half of the people with chronic obstructive pulmonary disease (COPD) do not adhere to the prescribed treatments and report anxiety and depression as comorbidities, resulting in higher rates of exacerbations, hospitalizations, and worse clinical outcomes. Objective This systematic review provided a synthesis of studies about the relationships between anxiety, depression, and adherence in people affected by COPD. Methods English language publications were searched in the PUBMED, SCOPUS, PsycInfo, Web of Science, PsycArticles, and Cochrane Library databases from December 2020 to March 2021, following PRISMA guidelines. The reference lists of eligible studies and other relevant systematic reviews were also searched. Data extraction and critical appraisal were undertaken by two reviewers working independently. The reference lists of eligible studies and other relevant systematic reviews were also searched. Data extraction and critical appraisal were undertaken by two reviewers working independently. Results A total of 34 studies (23 quantitative and 2 qualitative studies, 9 reviews) were included. The relationship between depression and treatment adherence was significant and negative. Adherence to both rehabilitation, psychological, and antidepressant pharmacological treatments in depressed patients was linked to a decreased risk of hospitalization. Moreover, depressed patients compliant with an antidepressant were more likely to adherent to COPD maintenance inhalers. On the other hand, the associations between anxiety and adherence were poorly investigated and high heterogeneity characterized the studies, leading to a weak and variable relationship as well as too few interventions. Conclusion The systematic review highlights the variability in estimates of the relationship between depression, anxiety, and treatment adherence in COPD. It could be explained by methodological differences across the included studies. This suggests that standardization is critical to improving the precision of the estimates. Recommendations for future research include attention to causal inferences, an exploration of mechanisms to explain the relationships between both anxiety and depression and adherence in COPD, and a comprehensive, systematic approach.
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Affiliation(s)
- Eleonora Volpato
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Heart-Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Stefania Toniolo
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.,Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Paolo Banfi
- Heart-Respiratory Rehabilitation Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
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Nguyen TA, Pham YN, Doan NP, Nguyen TH, Do TT, Van Vu G, Marks GB, McKinn S, Negin J, Bernays S, Fox GJ. Factors affecting healthcare pathways for chronic lung disease management in Vietnam: a qualitative study on patients' perspectives. BMC Public Health 2021; 21:1145. [PMID: 34130687 PMCID: PMC8207672 DOI: 10.1186/s12889-021-11219-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) and asthma rank among the leading causes of respiratory morbidity, particularly in low- and middle-income countries. This qualitative study aimed to explore the healthcare pathways of patients with chronic respiratory disease, and factors influencing their ability to access healthcare in Vietnam, where COPD and asthma are prevalent. METHODS We conducted 41 in-depth interviews among patients, including 31 people with COPD, eight with asthma and two with asthma-COPD overlap syndrome. Participants were recruited at provincial- or national-level health facilities in two urban and two rural provinces in Vietnam. The interviews were audio-recorded, transcribed, and analysed using thematic analysis. RESULTS Patients' healthcare pathways were complex and involved visits to multiple health facilities before finally obtaining a definitive diagnosis at a provincial- or national-level hospital. Access to healthcare was affected considerably by participants' limited knowledge of their respiratory conditions, the availability of social support, especially from family members, the costs of healthcare as well as health system factors (including the coverage of public health insurance, the distance to health facilities, and attitude of healthcare providers). CONCLUSION The study demonstrated the need for improved access to timely diagnosis and treatment of chronic lung disease within the lower level of the health system. This can be achieved by enhancing the communication skills and diagnostic capacity of local healthcare workers. Health education programmes for patients and caregivers will contribute to improved control of lung disease.
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Affiliation(s)
- Thu-Anh Nguyen
- Woolcock Institute of Medical Research, 298 Kim Ma, Ba Dinh, Hanoi, Vietnam. .,Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - Yen Ngoc Pham
- Woolcock Institute of Medical Research, 298 Kim Ma, Ba Dinh, Hanoi, Vietnam
| | - Nhung Phuong Doan
- Woolcock Institute of Medical Research, 298 Kim Ma, Ba Dinh, Hanoi, Vietnam
| | - Thao Huong Nguyen
- Woolcock Institute of Medical Research, 298 Kim Ma, Ba Dinh, Hanoi, Vietnam
| | - Toan Thanh Do
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | | | - Guy B Marks
- Australia South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Shannon McKinn
- School of Public Health, University of Sydney, Sydney, Australia
| | - Joel Negin
- School of Public Health, University of Sydney, Sydney, Australia
| | - Sarah Bernays
- School of Public Health, University of Sydney, Sydney, Australia.,London School of Hygiene and Tropical Medicine, London, UK
| | - Greg J Fox
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Binnie K, McGuire C, Carel H. Objects of safety and imprisonment: Breathless patients' use of medical objects in a palliative setting. JOURNAL OF MATERIAL CULTURE 2021; 26:122-141. [PMID: 35273452 PMCID: PMC7612482 DOI: 10.1177/1359183520931900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In this article, the authors consider breathless adults with advanced non-malignant lung disease and their relationship with health objects. This issue is especially relevant now during the Covid-19 pandemic, where the experiences of breathlessness and dependence on related medical objects have sudden and global relevance. These objects include ambulatory oxygen, oxygen concentrators and inhalers, and non-pharmacological objects such as self-monitoring devices and self-management technologies. The authors consider this relationship between things and people using an interdisciplinary approach employing psychoanalytic theory (in particular Winnicott's theory of object relations and object use), Science and Technology Studies (STS) and phenomenology. This collaborative approach allows them to relate patient use of health objects to ways of thinking about the body, dependency, autonomy, safety and sense-making within the context of palliative care. The authors illustrate the theoretical discussion with three reflective vignettes from therapeutic practice and conclude by suggesting further interdisciplinary research to develop the conceptual and practice-based links between psychoanalytic theory, STS and phenomenology to better understand individual embodied experiences of breathlessness. They call for palliative care-infused, psychoanalytically informed interventions that acknowledge breathless patients' dependence on things and people, concomitant with the need for autonomy in being-towards-dying.
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Sarwar MR, McDonald VM, Abramson MJ, Paul E, George J. Treatable traits in an English cohort: prevalence and predictors of future decline in lung function and quality of life in COPD. ERJ Open Res 2021; 7:00934-2020. [PMID: 34084787 PMCID: PMC8165376 DOI: 10.1183/23120541.00934-2020] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/29/2021] [Indexed: 12/04/2022] Open
Abstract
Background “Treatable traits (TTs)” is a precision medicine approach for facilitating multidimensional assessment of every patient with chronic airway disease, in order to determine the core traits associated with disease outcomes where targeted treatments may be applied. Objectives To determine the prevalence of TTs in chronic obstructive pulmonary disease (COPD) and which traits predict future decline in lung function and quality of life (QoL). Methods A 4-year longitudinal evaluation was conducted using data from 3726 participants in the English Longitudinal Study of Ageing (ELSA). TTs were identified based on published recommendations. Traits that predicted decline in lung function and QoL were analysed using generalised estimating equations. Results Overall, 21 TTs, including pulmonary (n=5), extra-pulmonary (n=13) and behavioural/lifestyle risk-factors (n=3) were identified. In multivariate analyses, the traits of chronic bronchitis (β −0.186, 95% CI −0.290 to −0.082), breathlessness (β −0.093, 95% CI −0.164 to −0.022), underweight (β −0.216, 95% CI −0.373 to −0.058), sarcopenia (β −0.162, 95% CI −0.262 to −0.061) and current smoking (β −0.228, 95% CI −0.304 to −0.153) predicted decline in forced expiratory volume in 1 s (FEV1). Of the seven traits that predicted decline in QoL, depression (β −7.19, 95% CI −8.81 to −5.57) and poor family and social support (β −5.12, 95% CI −6.65 to −3.59) were the strongest. Conclusion The core TTs of COPD associated with a decline in lung function and QoL were identified. Targeting these impactful traits with individualised treatment using a precision medicine approach may improve outcomes in people with COPD. Targeting the traits of chronic bronchitis, breathlessness, underweight, sarcopenia, depression, smoking, and poor family and social support may significantly improve health outcomes in people with COPDhttps://bit.ly/3cLHIPV
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Affiliation(s)
- Muhammad Rehan Sarwar
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Vanessa Marie McDonald
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and Centre of Excellence in Treatable Traits, The University of Newcastle, Callaghan, Australia.,The Priority Research Centre for Healthy Lungs, School of Nursing and Midwifery, Callaghan, Australia.,Dept of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, Newcastle, Australia
| | - Michael John Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Eldho Paul
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Johnson George
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
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40
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Dragnich AG, Yee N, Gylys-Colwell I, Locke ER, Nguyen HQ, Moy ML, Magzamen S, Fan VS. Sociodemographic Characteristics and Physical Activity in Patients with COPD: A 3-Month Cohort Study. COPD 2021; 18:265-271. [PMID: 33970723 DOI: 10.1080/15412555.2021.1920902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Decreased physical activity (PA) is associated with morbidity and mortality in COPD patients. In this secondary analysis of data from a 12-week longitudinal study, we describe factors associated with PA in COPD. Participants completed the Physical Activity Checklist (PAC) daily for a 7- to 8-day period. PA was measured monthly using the Physical Activity Scale for the Elderly (PASE). At three different time points, daily step count was measured for one week with an Omron HJ-720ITC pedometer. The 35 participants were primarily male (94%) and White (91%), with an average age of 66.5 years and FEV1 44.9% predicted. Common activities reported on the PAC were walking (93%), preparing a meal (89%), and traveling by vehicle (96%). PA measured by both PASE score (p = 0.01) and average daily step count (p = 0.04) decreased during follow-up. In repeated measures multivariable modeling, participants living with others had a higher daily step count (ß = 942 steps, p = 0.01) and better PASE scores (ß = 46.4, p < 0.001). Older age was associated with decreased step count (ß = -77 steps, p < 0.001) whereas White race was associated with lower PASE scores (ß = -55.4, p < 0.001) compared to non-White race. Other demographic factors, quality of life, and medications were not associated with PA. A better understanding of the role of social networks and social support may help develop interventions to improve PA in COPD.
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Affiliation(s)
- Alex G Dragnich
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Nathan Yee
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ina Gylys-Colwell
- Department of Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Emily R Locke
- Department of Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - Huong Q Nguyen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Marilyn L Moy
- Pulmonary and Critical Care Medicine Section, VA Boston Health Care System, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Vincent S Fan
- Department of Medicine, University of Washington, Seattle, WA, USA.,Department of Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
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Béland S, Dumont-Samson O, Hudon C. Case Management and Telehealth: A Scoping Review. Telemed J E Health 2021; 28:11-23. [PMID: 33847524 DOI: 10.1089/tmj.2021.0012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Case management (CM) is an intervention adapted to the needs of patients with chronic conditions or complex needs. Factors associated with effectiveness of CM, such as high intervention intensity, can represent challenges to its implementation. Telehealth has the potential to help overcome these challenges, but little work has been done to synthesize available evidence on telehealth CM. The purpose of this scoping review was thus to fill this gap and document which telehealth modalities have been used, summarize perspectives of key users, and discuss evidence on effectiveness of telehealth-delivered CM. Methods: A search in MEDLINE, Scopus, and CINAHL for articles published between January 2005 and January 2021 was done. Studies in which telehealth was used for patient-case manager interaction and conducted in a population with complex health needs and/or chronic conditions were included. Articles selected for full-text review were independently screened by two reviewers. Data extraction was conducted once and validated by a second reviewer. Results: Of 3,108 articles, 22 were retained for data extraction. A narrative synthesis was conducted. Most studies evaluated CM interventions delivered over telephone, yet, literature suggests that face-to-face contact is essential to CM success. Results also indicate that telehealth CM is acceptable and effective, associated with better utilization of health services and favorable clinical outcomes. Conclusions: Lack of research evaluating telehealth CM delivered using modalities other than telephone. Further research should evaluate CM interventions that integrate platforms enabling visual information exchange.
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Affiliation(s)
- Sophie Béland
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Canada
| | - Olivier Dumont-Samson
- Centre Intégré Universitaire de Santé et Services Sociaux du Saguenay-Lac-Saint-Jean, Chicoutimi, Canada.,Département de médecine de famille et de médecine d'urgence, Université de Sherbrooke, Sherbrooke, Canada
| | - Catherine Hudon
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Canada.,Département de médecine de famille et de médecine d'urgence, Université de Sherbrooke, Sherbrooke, Canada.,Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, Canada
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Catho H, Guigard S, Toffart AC, Frey G, Chollier T, Brichon PY, Roux JF, Sakhri L, Bertrand D, Aguirre C, Gorain S, Wuyam B, Arbib F, Borel JC. What are the barriers to the completion of a home-based rehabilitation programme for patients awaiting surgery for lung cancer: a prospective observational study. BMJ Open 2021; 11:e041907. [PMID: 33568371 PMCID: PMC7878140 DOI: 10.1136/bmjopen-2020-041907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Home-based rehabilitation programmes (H-RPs) could facilitate the implementation of pulmonary rehabilitation prior to resection for non-small cell lung cancer (NSCLC), but their feasibility has not been evaluated. The aim of this study was to identify determinants of non-completion of an H-RP and the factors associated with medical events occurring 30 days after hospital discharge. DESIGN A prospective observational study. INTERVENTION All patients with confirmed or suspected NSCLC were enrolled in a four-component H-RP prior to surgery: (i) smoking cessation, (ii) nutritional support, (iii) physiotherapy (at least one session/week) and (iv) home cycle-ergometry (at least three times/week). OUTCOMES The H-RP was defined as 'completed' if the four components were performed before surgery. RESULTS Out of 50 patients included, 42 underwent surgery (80% men; median age: 69 (IQR 25%-75%; 60-74) years; 64% Chronic Obstructive Pulmonary Disease (COPD); 29% type 2 diabetes). Twenty patients (48%) completed 100% of the programme. The median (IQR) duration of the H-RP was 32 (19; 46) days. Multivariate analysis showed polypharmacy (n=24) OR=12.2 (95% CI 2.0 to 74.2), living alone (n=8) (single vs couple) OR=21.5 (95% CI 1.4 to >100) and a long delay before starting the H-RP (n=18) OR=6.24 (95% CI 1.1 to 36.6) were independently associated with a risk of non-completion. In univariate analyses, factors associated with medical events at 30 days were H-RP non-completion, diabetes, polypharmacy, social precariousness and female sex. CONCLUSION Facing multiple comorbidities, living alone and a long delay before starting the rehabilitation increase the risk of not completing preoperative H-RP. TRIAL REGISTRATION NUMBER NCT03530059.
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Affiliation(s)
- Heloise Catho
- Department of Pneumology, University Hospital of Grenoble, Grenoble, France
| | - Sebastien Guigard
- Department of Thoracic surgery, Clinique Belledonne, Grenoble, France
| | - Anne-Claire Toffart
- Department of Pneumo-oncology, University Hospital of Grenoble, Grenoble, France
| | - Gil Frey
- Department of Thoracic surgery, University Hospital of Grenoble, Grenoble, France
| | - Thibaut Chollier
- Department of Thoracic surgery, University Hospital of Grenoble, Grenoble, France
| | - Pierre-Yves Brichon
- Department of Thoracic surgery, University Hospital of Grenoble, Grenoble, France
| | | | - Linda Sakhri
- Department of Oncology, Institut Daniel Hollard, groupe hospitalier mutualiste, Grenoble, France
| | | | | | - Sandy Gorain
- Research and Development, Agir à Dom, Association, Meylan, France
| | - Bernard Wuyam
- Clinical Research, HP2, INSERM U1042, Université Grenoble Alpes, Grenoble, France
- Sleep Laboratory and Exercise Physiology, Thorax and Vessels Division, Grenoble Alps University Hospital, Grenoble, France
| | - François Arbib
- Department of Pneumology, University Hospital of Grenoble, Grenoble, France
| | - Jean Christian Borel
- Research and Development, Agir à Dom, Association, Meylan, France
- Clinical Research, HP2, INSERM U1042, Université Grenoble Alpes, Grenoble, France
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Critically appraised paper: In people with chronic obstructive pulmonary disease, initiation of nocturnal non-invasive ventilation at home is non-inferior to initiation during a hospital admission [commentary]. J Physiother 2020; 66:267. [PMID: 32847763 PMCID: PMC7443213 DOI: 10.1016/j.jphys.2020.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 07/24/2020] [Indexed: 11/21/2022] Open
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Vaes AW, Machado FV, Meys R, Delbressine JM, Goertz YM, Van Herck M, Houben-Wilke S, Franssen FM, Vijlbrief H, Spies Y, Van ’t Hul AJ, Burtin C, Janssen DJ, Spruit MA. Care Dependency in Non-Hospitalized Patients with COVID-19. J Clin Med 2020; 9:E2946. [PMID: 32932582 PMCID: PMC7564703 DOI: 10.3390/jcm9092946] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND A large sample of "mild" COVID-19 patients still experience multiple symptoms months after being infected. These persistent symptoms are associated with many clinically relevant outcomes, including poor health status and impaired functional status. To date, no information is available about care dependency. Therefore, we aimed to explore the level of care dependency and the need for assistance with personal care in non-hospitalized COVID-19 patients. METHODS Members of two Facebook groups for COVID-19 patients with persistent complaints in The Netherlands and Belgium, and from a panel of people who registered at a website of the Lung Foundation Netherlands, were assessed for demographics, pre-existing comorbidities, health status, and symptoms. In addition, patients were asked about their dependence on others for personal care before and after the infection. The level of care dependency was assessed with the Care Dependency Scale (CDS) in members of the Belgian Facebook group (n = 210). RESULTS The data of 1837 non-hospitalized patients (86% women; median (IQR) age: 47 (38-54)) were analyzed. Only a small proportion of patients needed help with personal care before COVID-19, but the care need increased significantly after the infection (on average 79 ± 17 days after the onset of symptoms; 7.7% versus 52.4%, respectively; p < 0.05). The patients had a median (IQR) CDS score of 72 (67-75) points, and 31% of the patients were considered as care-dependent (CDS score ≤ 68 points). CONCLUSIONS COVID-19 has an important impact on care dependency in non-hospitalized patients. About three months after the onset of symptoms, a considerable proportion of non-hospitalized patients were to some degree dependent on others for personal care. This indicates that the impact of COVID-19 on patients' daily lives is tremendous, and more attention is needed to identify optimal treatment strategies to restore patients' independency.
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Affiliation(s)
- Anouk W. Vaes
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; (F.V.C.M.); (R.M.); (J.M.D.); (Y.M.J.G.); (M.V.H.); (S.H.-W.); (F.M.E.F.); (D.J.A.J.); (M.A.S.)
| | - Felipe V.C. Machado
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; (F.V.C.M.); (R.M.); (J.M.D.); (Y.M.J.G.); (M.V.H.); (S.H.-W.); (F.M.E.F.); (D.J.A.J.); (M.A.S.)
- Nutrim School of Nutrition and Translational Research in Metabolism, 6229 HX Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Roy Meys
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; (F.V.C.M.); (R.M.); (J.M.D.); (Y.M.J.G.); (M.V.H.); (S.H.-W.); (F.M.E.F.); (D.J.A.J.); (M.A.S.)
- Nutrim School of Nutrition and Translational Research in Metabolism, 6229 HX Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Jeannet M. Delbressine
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; (F.V.C.M.); (R.M.); (J.M.D.); (Y.M.J.G.); (M.V.H.); (S.H.-W.); (F.M.E.F.); (D.J.A.J.); (M.A.S.)
| | - Yvonne M.J. Goertz
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; (F.V.C.M.); (R.M.); (J.M.D.); (Y.M.J.G.); (M.V.H.); (S.H.-W.); (F.M.E.F.); (D.J.A.J.); (M.A.S.)
- Nutrim School of Nutrition and Translational Research in Metabolism, 6229 HX Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Maarten Van Herck
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; (F.V.C.M.); (R.M.); (J.M.D.); (Y.M.J.G.); (M.V.H.); (S.H.-W.); (F.M.E.F.); (D.J.A.J.); (M.A.S.)
- Nutrim School of Nutrition and Translational Research in Metabolism, 6229 HX Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands
- REVAL—Rehabilitation Research Center, BIOMED—Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3500 Diepenbeek, Belgium;
| | - Sarah Houben-Wilke
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; (F.V.C.M.); (R.M.); (J.M.D.); (Y.M.J.G.); (M.V.H.); (S.H.-W.); (F.M.E.F.); (D.J.A.J.); (M.A.S.)
| | - Frits M.E. Franssen
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; (F.V.C.M.); (R.M.); (J.M.D.); (Y.M.J.G.); (M.V.H.); (S.H.-W.); (F.M.E.F.); (D.J.A.J.); (M.A.S.)
- Nutrim School of Nutrition and Translational Research in Metabolism, 6229 HX Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Herman Vijlbrief
- Lung Foundation Netherlands, 3818 LE Amersfoort, The Netherlands; (H.V.); (Y.S.)
| | - Yvonne Spies
- Lung Foundation Netherlands, 3818 LE Amersfoort, The Netherlands; (H.V.); (Y.S.)
| | - Alex J. Van ’t Hul
- Department of Pulmonary Disease, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Chris Burtin
- REVAL—Rehabilitation Research Center, BIOMED—Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3500 Diepenbeek, Belgium;
| | - Daisy J.A. Janssen
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; (F.V.C.M.); (R.M.); (J.M.D.); (Y.M.J.G.); (M.V.H.); (S.H.-W.); (F.M.E.F.); (D.J.A.J.); (M.A.S.)
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Martijn A. Spruit
- Department of Research and Development, Ciro, 6085 NM Horn, The Netherlands; (F.V.C.M.); (R.M.); (J.M.D.); (Y.M.J.G.); (M.V.H.); (S.H.-W.); (F.M.E.F.); (D.J.A.J.); (M.A.S.)
- Nutrim School of Nutrition and Translational Research in Metabolism, 6229 HX Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The Netherlands
- REVAL—Rehabilitation Research Center, BIOMED—Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3500 Diepenbeek, Belgium;
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Paige SR, Salloum RG, Krieger JL, Williams M, Xue W, Brumback B. Promoting Clinical Conversations about Lung Cancer Screening: Exploring the Role of Perceived Online Social Support. JOURNAL OF HEALTH COMMUNICATION 2020; 25:650-659. [PMID: 33119451 PMCID: PMC8278871 DOI: 10.1080/10810730.2020.1836087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The perceived availability of online social support may contribute to patient-provider conversations about lung cancer screening. This study examines how the perceived availability of instrumental and emotional online social support is associated with patient-provider communication about lung cancer screening among adults who meet U.S. Preventive Services Taskforce (USPSTF) eligibility criteria and live with a COPD diagnosis. In April 2018, 575 adults completed an online survey after being recruited from a large southeastern academic medical center's broad research registry and website listing. Nearly half of the participants were 55-to-80 years old (41%), a current or former smoker who had quit smoking within the past 15 years (42%), and reported a smoking prevalence of 30 pack years or more (PPY; 41%). Results demonstrate that having a COPD diagnosis, identifying as male, and being a current or former tobacco smoker resulted in greater odds of having a clinical conversation about lung cancer screening. Conversely, meeting the 30 PPY smoking and 55-to-80 age thresholds lowered the odds of having these conversations. A high degree of instrumental and emotional online social support was associated with a greater incidence of annual patient-provider conversations about screening. This combination of perceived online social support was especially useful for patients with COPD.
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Affiliation(s)
- Samantha R Paige
- STEM Translational Communication Center, University of Florida , Gainesville, FL, USA
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, University of Florida , Gainesville, FL, USA
- UF Health Cancer Center, University of Florida , Gainesville, FL, USA
| | - Janice L Krieger
- STEM Translational Communication Center, University of Florida , Gainesville, FL, USA
- UF Health Cancer Center, University of Florida , Gainesville, FL, USA
| | - Maribeth Williams
- Department of Community Health and Family Medicine, University of Florida , Gainesville, FL, USA
| | - Wei Xue
- Department of Biostatistics, University of Florida , Gainesville, FL, USA
| | - Babette Brumback
- Department of Biostatistics, University of Florida , Gainesville, FL, USA
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Rayner J, Khan T, Chan C, Wu C. Illustrating the patient journey through the care continuum: Leveraging structured primary care electronic medical record (EMR) data in Ontario, Canada using chronic obstructive pulmonary disease as a case study. Int J Med Inform 2020; 140:104159. [DOI: 10.1016/j.ijmedinf.2020.104159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/06/2020] [Accepted: 04/23/2020] [Indexed: 12/25/2022]
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47
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A cohort study of medication adherence among patients with chronic obstructive pulmonary disease in Egypt. NPJ Prim Care Respir Med 2020; 30:31. [PMID: 32665684 PMCID: PMC7360753 DOI: 10.1038/s41533-020-0188-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 06/18/2020] [Indexed: 11/13/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD), the most common chronic respiratory disease, is expected to become the third leading cause of death worldwide in 2020. A prospective cohort study conducted in 2017 and 2018 aimed to identify factors associated with inhaler treatment adherence in patients with COPD in Cairo (Egypt). Physicians collected data regarding patient deaths, treatment-related adverse events, and patients’ social support (no support, patient, support by spouse, children, and siblings) from their patients with COPD. The reason for treatment discontinuation was categorized as per patient decision or per physician decision. Adherence was categorized as treatment continued or treatment stopped. Patients who decided to stop treatment were considered non-adherent to COPD therapy. A total of 1311 patients as well as 98 physicians and 205 pharmacists were included. Pharmacists and social support (spouse, children/siblings) were identified as key positive factors in patients’ decisions to adhere to their prescribed COPD treatment regimens. A total of 631 patients (48.1%) stopped the treatment, including 170 (27.0%) due to patient decision and 55 (8.7%) deceased. After Cox model analysis, a low number of patients (6–19) attended by the pharmacist was a significant predictive factor (hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.03–1.91, p = 0.03) for deciding to stop treatment. A wife or husband (HR = 0.85, 95% CI = 0.72–1.02, p = 0.07) as well as children or brother/sister (HR = 0.77, 95% CI = 0.57–1.04, p = 0.08) provided a positive effect for continued treatment. Pharmacists are well positioned to play a role as an essential public health resource that can help improve adherence as well as social support that should be considered as an important component to improve adherence to long-term therapy in COPD as well as other chronic non-communicable diseases in low- and middle-income countries.
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Alananzeh I, Lord H, Fernandez R. Social Support for Arab People with Chronic Conditions: A Scoping Review. Clin Nurs Res 2020; 30:380-391. [PMID: 32501107 DOI: 10.1177/1054773820932262] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Social support can play a crucial role in psycho-social well-being of people with chronic conditions. There is limited information about the experiences, barriers and sources of social support of Arab people affected by chronic conditions. The purpose of this review is to explore the experiences, barriers and sources of social support of Arab people affected by chronic conditions. A scoping review of the literature, based on Preferred Reporting Items for Scoping Reviews and Meta-Analyses (PRISMA) guidelines. Articles (n = 13) were identified for appraisal based on a group of inclusion and exclusion criteria. Eight articles were included in the final analysis. Three broad themes were identified: (a) Social support benefits-physical, emotional and financial benefits; (b) Source of social support-family and friends support, and (c) Support services utilization-cultural barrier, Arab migrants language and unfamiliarity with the health system barriers. Appropriate future support programs should be tailored based on Arab cultural beliefs and the inherent responsibility of the family together inside the Arab community.
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Affiliation(s)
| | - Heidi Lord
- Centre for Research in Nursing and Health St George Hospital, Kogarah, NSW, Australia.,Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, New South Wales, Australia
| | - Ritin Fernandez
- University of Wollongong, NSW, Australia.,Centre for Research in Nursing and Health St George Hospital, Kogarah, NSW, Australia.,Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Centre of Excellence, Wollongong, New South Wales, Australia
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Galiatsatos P, Woo H, Paulin LM, Kind A, Putcha N, Gassett AJ, Cooper CB, Dransfield MT, Parekh TM, Oates GR, Barr RG, Comellas AP, Han MK, Peters SP, Krishnan JA, Labaki WW, McCormack MC, Kaufman JD, Hansel NN. The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2020; 15:981-993. [PMID: 32440110 PMCID: PMC7211318 DOI: 10.2147/copd.s238933] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 04/20/2020] [Indexed: 01/10/2023] Open
Abstract
Rationale Individual socioeconomic status has been shown to influence the outcomes of patients with chronic obstructive pulmonary disease (COPD). However, contextual factors may also play a role. The objective of this study is to evaluate the association between neighborhood socioeconomic disadvantage measured by the area deprivation index (ADI) and COPD-related outcomes. Methods Residential addresses of SubPopulations and InteRmediate Outcome Measures in COPD Study (SPIROMICS) subjects with COPD (FEV1/FVC <0.70) at baseline were geocoded and linked to their respective ADI national ranking score at the census block group level. The associations between the ADI and COPD-related outcomes were evaluated by examining the contrast between participants living in the most-disadvantaged (top quintile) to the least-disadvantaged (bottom quintile) neighborhood. Regression models included adjustment for individual-level demographics, socioeconomic variables (personal income, education), exposures (smoking status, packs per year, occupational exposures), clinical characteristics (FEV1% predicted, body mass index) and neighborhood rural status. Results A total of 1800 participants were included in the analysis. Participants residing in the most-disadvantaged neighborhoods had 56% higher rate of COPD exacerbation (P<0.001), 98% higher rate of severe COPD exacerbation (P=0.001), a 1.6 point higher CAT score (P<0.001), 3.1 points higher SGRQ (P<0.001), and 24.6 meters less six-minute walk distance (P=0.008) compared with participants who resided in the least disadvantaged neighborhoods. Conclusion Participants with COPD who reside in more-disadvantaged neighborhoods had worse COPD outcomes compared to those residing in less-disadvantaged neighborhoods. Neighborhood effects were independent of individual-level socioeconomic factors, suggesting that contextual factors could be used to inform intervention strategies targeting high-risk persons with COPD.
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Affiliation(s)
- Panagis Galiatsatos
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Han Woo
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laura M Paulin
- Pulmonary and Critical Care, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| | - Amy Kind
- University of Wisconsin School of Medicine and Public Health, Department of Medicine Health Services and Care Research Program and Division of Geriatrics, Madison, WI, USA.,Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Nirupama Putcha
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Christopher B Cooper
- Department of Medicine, University of California Los Angeles School of Medicine, Los Angeles, CA, USA
| | - Mark T Dransfield
- Department of Medicine, University of Alabama Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
| | - Trisha M Parekh
- Department of Medicine, University of Alabama Birmingham and Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
| | - Gabriela R Oates
- Department of Medicine, University of Alabama Birmingham, Birmingham, AL, USA
| | - R Graham Barr
- Presbyterian Hospital, Columbia University Medical Center, New York, NY, USA
| | | | - Meilan K Han
- Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Stephen P Peters
- Department of Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Jerry A Krishnan
- Department of Medicine, University of Illinois, Chicago, IL, USA
| | - Wassim W Labaki
- Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Meredith C McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joel D Kaufman
- Office of the Dean, University of Washington School of Public Health, Seattle, WA, USA
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Goto T, Yoshida K, Faridi MK, Camargo CA, Hasegawa K. Contribution of social factors to readmissions within 30 days after hospitalization for COPD exacerbation. BMC Pulm Med 2020; 20:107. [PMID: 32349715 PMCID: PMC7191726 DOI: 10.1186/s12890-020-1136-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 04/06/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND To investigate whether, in patients hospitalized for COPD, the addition of social factors improves the predictive ability for the risk of overall 30-day readmissions, early readmissions (within 7 days after discharge), and late readmissions (8-30 days after discharge). METHODS Patients (aged ≥40 years) hospitalized for COPD were identified in the Medicare Current Beneficiary Survey from 2006 through 2012. With the use of 1000 bootstrap resampling from the original cohort (training-set), two prediction models were derived: 1) the reference model including age, comorbidities, and mechanical ventilation use, and 2) the optimized model including social factors (e.g., educational level, marital status) in addition to the covariates in the reference model. Prediction performance was examined separately for 30-day, early, and late readmissions. RESULTS Following 905 index hospitalizations for COPD, 18.5% were readmitted within 30 days. In the test-set, for overall 30-day readmissions, the discrimination ability between reference and optimized models did not change materially (C-statistic, 0.57 vs. 0.58). By contrast, for early readmissions, the optimized model had significantly improved discrimination (C-statistic, 0.57 vs. 0.63; integrated discrimination improvement [IDI], 0.018 [95%CI, 0.003-0.032]) and reclassification (continuous net reclassification index [NRI], 0.298 [95%CI 0.060-0.537]). Likewise, for late readmissions, the optimized model also had significantly improved discrimination (C-statistic, 0.65 vs. 0.68; IDI, 0.026 [95%CI 0.009-0.042]) and reclassification (continuous NRI, 0.243 [95%CI 0.028-0.459]). CONCLUSIONS In a nationally-representative sample of Medicare beneficiaries hospitalized for COPD, we found that the addition of social factors improved the predictive ability for readmissions when early and late readmissions were examined separately.
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Affiliation(s)
- Tadahiro Goto
- Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua Street, Suite 920, Boston, MA, 02114-1101, USA.
| | - Kazuki Yoshida
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mohammad Kamal Faridi
- Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua Street, Suite 920, Boston, MA, 02114-1101, USA
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua Street, Suite 920, Boston, MA, 02114-1101, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, 125 Nashua Street, Suite 920, Boston, MA, 02114-1101, USA.,Harvard Medical School, Boston, MA, USA
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