• Tuberculosis and Respiratory Diseases
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• 제77권4호
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• pp.155-160
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• 2014

Chronic obstructive pulmonary disease (COPD) is characterized by a diverse array of pulmonary and nonpulmonary manifestations, but our understanding of COPD pathogenesis and the factors that influence its heterogeneity in disease presentation is poor. Despite this heterogeneity, treatment algorithms are primarily driven by a single measurement, forced expiratory volume in 1 second ($FEV_1$) as a percentage of its predicted value ($FEV_1%$). In 2011, a major shift in Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment recommendations was proposed that stratifies patients with COPD on the basis of symptoms and exacerbation history. This article reviews the work reported in 2013 that enlightens our understanding of COPD with respect to COPD classification systems, phenotype, biomarker, exacerbation, and management for patients with COPD.

• 대한간호학회지
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• 제53권2호
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• pp.191-207
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• 2023

Purpose: This study aimed to develop a motivational interviewing pulmonary rehabilitation program based on self-determination theory to maintain pulmonary rehabilitation-related health behaviors in patients with chronic obstructive pulmonary disease. The program was developed by reviewing the literature on pulmonary rehabilitation guidelines, drawing on the self-determinism theory to establish its contents, recruiting experts to test its validity, and conducting a preliminary survey. Methods: A quasi-experimental design was used to confirm the effect of the program. The participants were outpatients diagnosed with chronic obstructive pulmonary disease at three general hospitals in Busan. There were 33 subjects: 15 in the experimental group and 18 in the control group. The experimental group performed a motivational interviewing pulmonary rehabilitation program which comprised 11 sessions delivered over 10 weeks. The outcomes were measured using basic psychological needs, dyspnea, 6-minute walking distance, and functional status. Intervention effects were analyzed using repeated-measures ANOVA. Results: The analysis revealed significant differences between the experimental and control groups in competence among the subdomains of basic psychological needs, dyspnea during exercise, and functional status. Conclusion: The developed program affects physical conditions and can be applied as an effective clinical nursing intervention to continuously improve the pulmonary rehabilitation behavior of patients with chronic obstructive pulmonary disease.

• 성인간호학회지
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• 제20권4호
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• pp.652-663
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• 2008

Purpose: This study was conducted to develop and test an explanatory model on functional capacity in patients with chronic obstructive pulmonary disease using path analysis. Methods: Data were collected from 149 chronic obstructive pulmonary disease patients using 6-minute walk test, measurement of oxygen saturation, pulmonary function test, and self-reported questionnaires from June to October, 2005. The collected data were analyzed using SPSS/WIN 12.0 program and AMOS/WIN 4.0 program. Results: The overall fitness indices of modified model were good($x^2$ = 14.324, p = .281 GFI = .981, RMSEA = .006, AGFI = .944, NFI = .927, NNFI = .999, CFI = .999, PNFI = .613, $x^2$/df = 1.194). Functional capacity was influenced directly by age(${\beta}$ = -.304, p = .000), dyspnea(${\beta}$ = -.278, p = .000), self-efficacy(${\beta}$ = .240, p = .000), social support(${\beta}$ = .175, p = .004), pulmonary function(${\beta}$ = .169, p = .008), and oxygen saturation(${\beta}$ = .099, p = .048). These variables explained 39.3% in functional capacity. Conclusion: The findings of this study suggest that comprehensive nursing interventions should focus on decreasing dyspnea and increasing self-efficacy, social support, and oxygen saturation. In this perspective, pulmonary rehabilitation would be an effective strategy for improving functional capacity in patients with chronic obstructive pulmonary disease.

• 농촌의학ㆍ지역보건
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• 제46권1호
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• pp.1-11
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• 2021

이 연구의 목적은 천식과 만성폐쇄성폐질환 환자들의 미세먼지에 대한 인식, 지식, 예방행위 수준과, 예방행위에 영향을 미치는 요인을 확인하기 위한 것이다. 이 연구는 서술적 조사연구로 연구대상은 대구광역시 소재 일개 대학병원 호흡기전문질환센터를 방문한 만 19세 이상, 만 80세 이하의 만성호흡기질환자를 편의표본추출하였고, 2019년 12월부터 2020년 1월까지 구조화된 자기기입식 설문조사로 자료를 수집하여, 총 212부의 자료를 분석 대상으로 하였다. 연구대상자는 212명이었으며, 이중 천식 112명(52.8%), 만성폐쇄성폐질환 100명(47.2%)이었다. 미세먼지에 대한 인식, 지식, 예방행위의 평균 점수(10점 만점)는 천식 환자는 각각 7.92점, 6.99점, 7.10점이었고, 만성폐쇄성폐질환자는 각각 7.72점, 6.24점, 6.80점 이었다.미세먼지 지식 점수는 천식환자가 만성폐쇄성폐질환자보다 유의하게 높았다(p=0.007). 미세먼지 예방행위 수준에 영향을 미치는 요인은 천식은 인식 점수, 지식 점수, 연령이며, 만성폐쇄성폐질환은 인식 점수가 유의한 요인이었다. 이상의 결과 천식과 만성폐쇄성폐질환 환자의 예방행위에 영향을 주는 요인은 천식은 인식 점수, 지식 점수, 연령이며, 만성폐쇄성폐질환은 인식점수였다. 미세먼지 예방행위 수준을 높이는 것은 미세먼지로 인한 만성호흡기질환의 악화를 막을 수 있으므로, 질환에 따른 대상자의 특성을 고려한 중재 프로그램의 개발과 지속적이고 반복적인 교육이 요구된다.

• 대한간호학회지
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• 제31권2호
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• pp.257-267
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• 2001

It is known that a pulmonary rehabilitation program improves dyspnea and exercise tolerence in patients with chronic obstructive pulmonary disease. However, it is also known that although it does not improve pulmonary function. This study was performed to evaluate the effect of a 4 week pulmonary rehabilitation on pulmonary function, gas exchange, and exercise tolerance in patients with chronic obstructive pulmonary disease. The pulmonary rehabilitation programs included breathing exercises, such as pursed-lip breathing and diaphragmatic breathing, upper-limb exercises, and inspiratory muscle training. These activities were performed for 4 weeks in twenty one patients with chronic obstructive pulmonary disease. Pre and post-rehabilitation pulmonary function and exercise capacities were compared after the 4 week period. Results are as follows: 1) Before the rehabilitation, the predicted value of FVC and FEV1 of the patients were 70.3$\pm$16.7% and 41.1$\pm$11.9% respectively. These pulmonary functions did not change after pulmonary rehabilitation. 2) Aloility of walking a 6 minute distance (325.29$\pm$122.24 vs 363.03$\pm$120.01 p=.01) and dyspnea (p=.00) were significantly improved after rehabilitation. Thus showing that pulmonary rehabilitation for 4 weeks can improve exercise performance and dyspnea in patients with chronic obstructive pulmonary disease.

• 대한간호학회지
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• 제37권6호
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• pp.855-862
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• 2007

Purpose: The purpose of this study was to identify the factors influencing fatigue in patients with chronic obstructive pulmonary disease. Methods: A descriptive correlational study design was used. A convenience sample of 125 subjects was recruited from the outpatient respiratory clinic at a large university hospital. Data was collected from June to October, 2005 using structured questionnaires, an oxygen saturation test, a 6-minute walking test, and a pulmonary function test. Results: Subjects had a slightly low degree of fatigue. The fatigue showed a significant correlation with emotion(r=.589, p= .000), dyspnea(r=.304, p= .001), self-efficacy(r=-.278, p= .002), and symptom experience(r=.238, p= .008). Emotion(34.7%) and dyspnea(5.8%) were significant predictors to explain fatigue. Conclusion: This study provides comprehensive understanding of the influencing factors on fatigue in patients with chronic obstructive pulmonary disease. Nursing interventions to decrease negative emotion and dyspnea for management of fatigue is suggested.

• 셀메드
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• 제7권3호
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• pp.12.1-12.6
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• 2017

The purpose of this study was to analyze the effect wool in patients with chronic obstructive pulmonary disease. The study was conducted experimentally on 53 patients with chronic obstructive pulmonary disease attending the chest diseases polyclinic of a hospital located in Erzurum. A randomized selection method was used to categorize patients into two groups; a treatment (n = 27), and a control group (n = 26). Patients in the treatment group (pre-test measurements were taken) wore wool vests for a period of three months, while patients in the control group wore cotton vests (placebo) for the same duration; post-test measurements were taken for both groups at the end of the three-month period. The Medical Outcomes Study Short Form 36, the St. George's Respiratory Questionnaire, and pulmonary function tests were used to collect data. Results concluded that there was a significant decrease (p < 0.05) in the overall score of the St. George's Respiratory Questionnaire, and the symptom, effect, and activity mean scores, while there was a significant increase (p < 0.05) in the SF-36 physical functioning, general health, bodily pain, role physical, vitality, role emotional, social functioning, mental health, physical and mental component summary mean scores of patients in the treatment group. Results of the study concluded that the symptoms, activity, disease effectiveness, and quality of life improved in patients that wore wool vests.

• Tuberculosis and Respiratory Diseases
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• 제76권4호
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• pp.169-174
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• 2014

Background: The Korean Obstructive Lung Disease (KOLD) Cohort Study is a prospective longitudinal study of patients with chronic obstructive pulmonary disease (COPD), asthma, or other unclassified obstructive lung diseases. It was designed to develop new classification models and biomarkers that predict clinically relevant outcomes for patients with obstructive lung diseases. Methods: Patients over 18 years old who have chronic respiratory symptoms and airflow limitations or bronchial hyper-responsiveness were enrolled at 17 centers in South Korea. After a baseline visit, the subjects were followed up every 3 months for various assessments. Results: From June 2005 to October 2013, a total of 477 subjects (433 [91%] males; 381 [80%] diagnosed with COPD) were enrolled. Analyses of the KOLD Cohort Study identified distinct phenotypes in patients with COPD, and predictors of therapeutic responses and exacerbations as well as the factors related to pulmonary hypertension in COPD. In addition, several genotypes were associated with radiological phenotypes and therapeutic responses among Korean COPD patients. Conclusion: The KOLD Cohort Study is one of the leading long-term prospective longitudinal studies investigating heterogeneity of the COPD and is expected to provide new insights for pathogenesis and the long-term progression of COPD.

• Korean Journal of Radiology
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• 제21권9호
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• pp.1104-1113
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• 2020

Objective: To assess the regional ventilation in patients with asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) using xenon-ventilation dual-energy CT (DECT), and to compare it to that in patients with COPD. Materials and Methods: Twenty-one patients with ACOS and 46 patients with COPD underwent xenon-ventilation DECT. The ventilation abnormalities were visually determined to be 1) peripheral wedge/diffuse defect, 2) diffuse heterogeneous defect, 3) lobar/segmental/subsegmental defect, and 4) no defect on xenon-ventilation maps. Emphysema index (EI), airway wall thickness (Pi10), and mean ventilation values in the whole lung, peripheral lung, and central lung areas were quantified and compared between the two groups using the Student's t test. Results: Most patients with ACOS showed the peripheral wedge/diffuse defect (n = 14, 66.7%), whereas patients with COPD commonly showed the diffuse heterogeneous defect and lobar/segmental/subsegmental defect (n = 21, 45.7% and n = 20, 43.5%, respectively). The prevalence of ventilation defect patterns showed significant intergroup differences (p < 0.001). The quantified ventilation values in the peripheral lung areas were significantly lower in patients with ACOS than in patients with COPD (p = 0.045). The quantified Pi10 was significantly higher in patients with ACOS than in patients with COPD (p = 0.041); however, EI was not significantly different between the two groups. Conclusion: The ventilation abnormalities on the visual and quantitative assessments of xenon-ventilation DECT differed between patients with ACOS and patients with COPD. Xenon-ventilation DECT may demonstrate the different physiologic changes of pulmonary ventilation in patients with ACOS and COPD.

• Tuberculosis and Respiratory Diseases
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• 제85권2호
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• pp.122-136
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• 2022

Although chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) have distinct clinical features, both diseases may coexist in a patient because they share similar risk factors such as smoking, male sex, and old age. Patients with both emphysema in upper lung fields and diffuse ILD are diagnosed with combined pulmonary fibrosis and emphysema (CPFE), which causes substantial clinical deterioration. Patients with CPFE have higher mortality compared with patients who have COPD alone, but results have been inconclusive compared with patients who have idiopathic pulmonary fibrosis (IPF). Poor prognostic factors for CPFE include exacerbation, lung cancer, and pulmonary hypertension. The presence of interstitial lung abnormalities, which may be an early or mild form of ILD, is notable among patients with COPD, and is associated with poor prognosis. Various theories have been proposed regarding the pathophysiology of CPFE. Biomarker analyses have implied that this pathophysiology may be more closely associated with IPF development, rather than COPD or emphysema. Patients with CPFE should be advised to quit smoking and undergo routine lung function tests, and pulmonary rehabilitation may be helpful. Various pharmacologic agents and surgical approaches may be beneficial in patients with CPFE, but further studies are needed.