Background: The aim of this study was to determine the effectiveness of self-efficacy promoting pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). Methods: thirty six patients, with clinically stable COPD were randomly assigned: 18 to a rehabilitation group and another 18 as a control group, The subjects participated in a the self-efficacy promoting pulmonary rehabilitation program for 8 weeks. This program consisted of education, breathing retraining, exercise training, relaxation and counseling. The control group received education only. The outcome variables were self-efficacy, dyspnea, exercise endurance, pulmonary function, and quality of life. Dyspnea was measured using the modified Borg scale. Exercise endurance was measured by the six minute walking distance. The quality of life was measured by the quality of life index for pulmonary disease patients. Results: In the rehabilitation group after performing the self-efficacy promoting pulmonary rehabilitation program, the self-efficacy score, exercise endurance, and quality of life score were higher than the control group (p=0.007, p=0.038, and p=0.039, respectively). and the exertional dyspnea score was significantly lower than controls(p=0.045). However, the dyspnea score and FEV1 were similar after performing the self-efficacy promoting pulmonary rehabilitation program. Conclusion: The self-efficacy promoting pulmonary rehabilitation program is effective to in improve self-efficacy, exertional dyspnea, exercise endurance and quality of life in patients with COPD.
The Journal of Korean Academic Society of Nursing Education
/
v.11
no.2
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pp.270-277
/
2005
Purpose: This study was to investigate relationships among self-care, self-efficacy and social support in patients with chronic obstructive pulmonary disease (COPD). Method: The subjects were 114 patients with COPD from both inpatient and outpatient department sin a branch hospital of C university located in Gyeonggi-do from April 2005 to May 2005. Self-care was measured by No Hyeon-Suk's (2003) scale, self-efficacy was measured by Wigal et al's (1991) scale, social support was measured by Park Sun-Ju's (2001) scale. Data were analyzed by using t-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regression. Results: The total mean was 3.1 for self-care, 3.5 for self-efficacy, and 4.3 for social support. The levels of self-efficacy and social support were significantly and positively correlated with the level of self-care. The level of self-care was influenced by social support explaining 16% and the level of self-efficacy explaining 6%, giving a total of 22%. Conclusion: The result of this study showed that the patients with COPD carried out self-care better when they had higher levels of self-efficacy and social support. Thus, we will improve the level of self-care of patients with COPD by nursing intervention to increase self-efficacy and social support.
Purpose: This study aimed to acquire a better understanding of experiences about health information (HI) for self-management in patients with chronic obstructive pulmonary disease (COPD). Method: The thirty patients with COPD participated in in-depth interviews, until data saturation was reached. The data was analyzed using the content analysis method. Results: Four major themes emerged from the analysis of the self-management HI in patients with COPD such as "self-management practice based on HI", "difficulty in adhering to self-management based on HI", "various attempts to obtain self-management HI" and "satisfaction with provided HI". Conclusion: The majority of patients had no specific educational experience for self-management HI from other staff except for their doctors. Thus, it is necessary to prepare a hospital environment in which various medical staff can provide self-management HI of COPD while also ensuring that accurate and continuous HI could be easily obtained through various media types, family, and acquaintances.
Objectives: The high readmission rate of patients with chronic obstructive pulmonary disease (COPD) has led to the worldwide establishment of proactive measures for identifying and mitigating readmissions. This study aimed to identify factors associated with readmission, as well as groups particularly vulnerable to readmission that require transitional care services. Methods: To apply transitional care services that are compatible with Korea's circumstances, targeted groups that are particularly vulnerable to readmission should be identified. Therefore, using the National Health Insurance Service's Senior Cohort database, we analyzed data from 4874 patients who were first hospitalized with COPD from 2009 to 2019 to define and analyze readmissions within 30 days after discharge. Logistic regression analysis was performed to determine factors correlated with readmission within 30 days. Results: The likelihood of readmission was associated with older age (for individuals in their 80s vs. those in their 50s: odds ratio [OR], 1.59; 95% confidence interval [CI], 1.19 to 2.12), medical insurance type (for workplace subscribers vs. local subscribers: OR, 0.84; 95% CI, 0.72 to 0.99), type of hospital (those with 300 beds or more vs. fewer beds: OR, 0.77; 95% CI, 0.66 to 0.90), and healthcare organization location (provincial areas vs. the capital area: OR, 1.66; 95% CI, 1.14 to 2.41). Conclusions: Older patients, patients holding a local subscriber insurance qualification, individuals admitted to hospitals with fewer than 300 beds, and those admitted to provincial hospitals are suggested to be higher-priority for transitional care services.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.11
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pp.433-444
/
2017
This study was conducted to identify relationships between lung function disorders and Metabolic Syndrome(MetS) that have common comorbidities such as Cardio Vascular Diseases(CVD). According to the hypothesis that there may be a significant relationship between them, analyses were conducted to identify the proper management point for those diseases. Overall, 53,829 data were taken from KNHANES 2008-2013. Included data were PFT(Pulmonary Function Test) done and age over 40. All the 14 confounders applied, only 8,137 cases (M:3,951, F:4,186) were left. Low pulmonary function was divided into two categories, obstructive and restrictive patterns, based on the Global Initiative for Chronic Obstructive Lung Disease(GOLD) criteria, while MetS was defined based on the revised NCEP-ATPIII criteria. The relationships between those diseases were analyzed using logistic regression analysis. In addition, for the prevalence rate, cross-tab analysis were conducted. There were no significant relationships observed between obstructive lung disease and MetS, but a restrictive pattern had a meaningful relationship with MetS. Specifically, MetS showed a higher prevalence rate for both obstructive and restrictive pattern patients than the control group. Restrictive pattern patients showed a higher prevalence rate to MetS than obstructive patients. Overall, restrictive lung patterns showed a meaningful association with MetS, but not with obstructive patterns. Additionally, the prevalence rate of MetS among restrictive patients was higher than among obstructive patients.
Background : Advanced chronic obstructive pulmonary disease is characterized by progressive pulmonary hypertension leading to right heart dysfunction, which plays a Important role in clinical evaluation but remains difficult and challenging to quantify. The noninvasive doppler echocardiographic value referred to as the Tei index has been suggested as a simple, reproducible and reliable parameter of the right ventricular function. The purpose of this was to assess the right ventricular function in patients with chronic obstructive pulmonary disease using the Tei index and to evaluate its relationship with the pulmonary functional status. Methods : The study population comprised of 26 patients with chronic obstructive pulmonary disease and 10 normal control subjects. The Tei index was obtained by dividing the sum of the isovolumetric contraction and the relaxation times by the ejection time using a pulsed-wave doppler. It was compared with the other available Doppler echocardiographic parameters of systolic or diastolic function and with the pulmonary function of the patients. Results : The Tei indices of the patients with COPD were significantly higher than those of normal subjects($0.45{\pm}0.17$ vs. $0.27{\pm}0.03$, p<0.01). The isovolumetric contraction time/ejection time($0.32{\pm}0.08$ vs. $0.25{\pm}0.05$, p<0.05), the isovolumetric relaxation time/ejection time($0.29{\pm}0.16$ vs. $0.15{\pm}0.08$, p<0.05)and the preejection period/ejection time ($0.46{\pm}0.10$ vs. $0.38{\pm}0.06$, p<0.05) were prolonged and the ejection time ($255.2{\pm}32.6$ vs. $314.2{\pm}16.5$ msec, p<0.05) was significantly shortened in patients with COPD compared to normal subjects. The tei indices were inversely correlated with the $FEV_1$ (r=-0.46, p<0.05) and were prolonged significantly in patients with a severe obstructive ventilatory dysfunction(less than 35% of predicted $FEV_1$) compared to those with a mild and moderate ventilatory dysfunction. The tei indices showed an inverse correlation to with the ejection time (r=-0.469), the isovolumetric contraction time/ejection time(r=0.453), the isovolumetric relaxation time/ejection time(r=0.896) and the preejection period/ejection time(r=0.480). Conclusion : The tei index appeared to be a useful noninvasive means of evaluating the right ventricular function. It revealed a significant correlation with the pulmonary function in patients with COPD.
An insufficient intake of magnesium may be associated with the development of chronic obstructive pulmonary disease (COPD). We aimed to determine the relationship between health related quality of life (QoL), anthropometric indices and nutritional status with dietary magnesium intake in COPD patients. Sixty-one COPD patients participated in this cross-sectional study. QoL and nutritional status were assessed. Furthermore, body composition, calf circumference, and muscle strength were measured; equations were used to calculate fat-free mass index, body mass index, and muscle mass value. Dietary magnesium intake was assessed by three 24-hours recalls and magnesium intake was categorized as ≤ 188.08 mg/day (A group) and > 188.08 mg/day (B group). The χ2, independent-sample t-test and Mann-Whitney test were used for statistical analysis. The p values less than 0.05 were considered significant. Of QoL assessments the total and impact mean scores of St. George's respiratory questionnaire in the B group were significantly lower than the means of the A group (p value = 0.007 and 0.005, respectively). The instrumental activity of daily living score was significantly improved in patients with higher consumption of dietary magnesium (p = 0.02). Participants had a significantly lower mean score of patient-generated subjective global assessment in the B group compared to the A group (p = 0.003). Higher intake of dietary magnesium can lead to improve QoL and nutrition status.
Radionuclide cardioangiography has been widely applied and has played major roles in non-invasive assessment of cardiac function. Three techniques, first-pass, gated first and gated equilibrium methods, have commonly been used to evaluate right ventricular ejection fraction which usually abnormal in the patients with cardiopulmonary disease. It has been known that the gated first pass method is the most accurate method among the three techniques in assessment of right ventricular ejection fraction. The radionuclide right ventricular ejection fraction values were determined in 13 normal subjects and in 15 patients with chronic obstructive pulmonary disease by the gated first pass method and compared with those of the first pass method because there ha,j been no published data of right ventricular ejection fraction by the gated first pass method in Korea. The values of right ventricular ejection fraction by the gated first pass method were compared with the detas from the pulmonary function test performed in the patients with chronic obstructive pulmomary disease. The results were as follows: 1) The values of right ventricular ejection fraction by the gated first pass method were $50.1{\pm}6.1%$ in normal subjects and $38.5{\pm}8.5$ in the patients with chronic obstructive pulmonary disease. There was statistically significant difference between the right ventricular ejection fraction of each of the two groups (p < 0.05). 2) The right ventricular ejection fraction by the gated first pass method was not linearly correlated with $FEV_1$, VC, DLCO, and FVC as well as $P_aO_2$ and $P_aCO_2$ of the patients with chronic obstructive pulmonary disease. We concluded that right ventricular ejection fraction by the gated first pass method using radionuclide cardioangiography may be useful in clinical assessment of the right ventricular function.
Purpose: This study was conducted to examine the effects of the nurse-led one-on-one discharge education on the levels of symptom experience and self-care compliance among patients with chronic obstructive pulmonary disease (COPD) who had not previously participated in an education or respiratory rehabilitation program. Methods: This study used a quasi-experimental pre-and post-test design with nonequivalent control group. Sixty seven hospitalized patients (34 for experimental and 33 for control groups) were recruited from in-patient units of a general hospital from August to November, 2010. The one-on-one education session of symptom management and daily self-care was administered to experimental group for 50 minutes along with a follow-up phone call. Self-administered questionnaire was administered at the pretest and at 1 month after discharge. Results: The subjects were 67.43(${\pm}10.24$)years old in average. The mean differences of symptom experience (t=3.39, p=.001) and self-care compliance (t=-38.13, p<.001) in the experimental group was significantly higher than those of the control group. Conclusion: Nurse-led one-on-one discharge education was effective in reducing the level of symptom experience and enhancing self-care compliance at home within one month after discharge. Therefore, this form of one-on-one education provided by nurses might be applicable effectively for COPD patients who do not have access to respiratory rehabilitation programs.
Park, Kwang Joo;Ahn, Chul Min;Kim, Hyung Jung;Chang, Joon;Kim, Sung Kyu;Lee, Won Young
Tuberculosis and Respiratory Diseases
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v.44
no.1
/
pp.93-103
/
1997
Background : Malnutrition is a common finding in patients with chronic obstructive pulmonary disease, especially in the emphysema group. Although the mechanism of malnutrition is not confirmed, it is believed to be a relative deficiency caused by hypermetabolism due to increased energy requirements of the respiratory muscles, rather than a dietary deficiency. Malnutrition in chronic obstructive pulmonary disease is not a merely coincidental finding. It is known that the nutritional status correlates with physiologic parameters including pulmonary function, muscular power, and exercise performance, and is one of the important and independent prognostic factors of the disease. Methods : Patients with chronic obstructive pulmonary disease Yongdong Severance Hospital from May, 1995 to March, 1996 and age-matched healthy control group were studied. Survey of nutritional intake, anthropometric measurements and biochemical tests were done to assess nutritional status. Relationship between nutritional status and FEV1 (forced expiratory volume at one second), which was a significant functional parameter, was assessed. Results : 1) The patient group was consisted of 25 males with mean age of 66.1years and FEV1 of $42{\pm}14%$ of predicted values. The control group was consisted of 26 healthy males with normal pulmonary function, whose mean age was 65.0 years. 2) The ratio of calorie intake/calorie requirement per day was $107{\pm}28%$ in the patient group, and $94{\pm}14%$ in the control group, showing a tendency of more nutritional intake in patient group(B=0.06). 3) There were significant differences between the patient group and control group in percent ideal body weight(92.8% vs 101.6%, p=0.024), body mass index($20.0kg/m^2$ VS $21.9kg/m^2$, p=0.015), and handgrip strength(29.0kg vs 34.3kg, p=0.003). However, there were no significant differences in triceps skinfold thickness, mid-arm muscle circumference, albumin, and total lymphocyte count between two groups. Percentage of underweight population was 40%(10/25) in the patient group, and 15%(4/26) in the control group. 4) The percent ideal body weight, triceps skinfold thickness, and mid-arm muscle circumference had significant correlation with FEV1. Conclusion : The patients with chronic obstructive pulmonary disease showed significant depletion in nutritional parameters such as body weight and peripheral muscle strength, while absolute amount of dietary intake was not insufficient. Nutritional parameters were well correlated with FEV1.
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