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Kronik Obstrüktif Akciğer Hastalığı Olan Malnütrisyonlu Bireylerde Hemşirelik Yaklaşımı

Year 2022, Volume: 15 Issue: 3, 387 - 394, 15.07.2022
https://doi.org/10.46483/deuhfed.931900

Abstract

Kronik Obstrüktif Akciğer Hastalığı (KOAH), dünya çapında morbidite ve mortalitenin önde gelen nedenleri arasında yer almaktadır. KOAH’lı bireylerde malnütrisyon prevalansının %20 ile %50 arasında değiştiği bildirilmektedir. Malnütrisyon, akciğer fonksiyonları, immünite, egzersiz kapasitesi ve yaşam kalitesi üzerinde olumsuz etkilere sahip olmakla birlikte sağlık bakım maliyetlerinin artması, hastanede kalış süresinin uzaması gibi sonuçlara da neden olmaktadır. Yetersiz beslenme ve kas kütlesi kaybı, bireylerin solunum kas fonksiyonunu ve egzersiz kapasitesini etkilemektedir. Solunum yetmezliği malnütrisyon için bir sebep iken, nutrisyonel durumun kendisi de solunum sistemi fonksiyonlarını olumsuz etkileyebilmektedir. Malnütrisyonun neden olduğu iştah azalması ve egzersiz intoleransı solunum kaslarının gücünü azaltmakta bu nedenle KOAH hastalarındaki problemleri daha da ağırlaştırmaktadır. Malnütrisyon, KOAH'lı bireylerde önemli bir sorun olmakla birlikte genellikle hastalığın yönetimi sırasında gözden kaçmaktadır. KOAH’lı bireylerin beslenme durumlarının değerlendirilmesi, risk grubunun belirlenmesi, risk grubuna uygun girişimlerin uygulanması önem teşkil etmektedir. Kılavuzlara dayalı olarak belirlenen doğru girişimlerin uygulanması ile hastaların besin alımlarının ve dolayısıyla klinik sonuçlarının iyileşmesi sağlanmaktadır. Multidisipliner ekip içerisinde hemşireler KOAH’lı malnütrisyon riski taşıyan bireyleri belirleyebilmeli, malnütrisyon gelişmiş olan hastaları saptayabilmeli, dengeli ve yeterli bir beslenmenin sağlanmasına yönelik bakım planı uygulayabilmelidirler. Bu derleme makalede, malnütrisyonu ve malnütrisyon riski olan KOAH hastalarının belirlenmesi, malnütrisyon durumunun değerlendirilmesi ve hemşirelik girişimlerinin güncel literatür ve kılavuzlar eşliğinde açıklanması amaçlanmıştır.

References

  • 1. Agusti A, Beasley R, Celli BR, Chen R, Criner G, Helpin D et al. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease 2021 Report. Global Initiative for Chronic Obstructive Lung Disease (GOLD). https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf
  • 2. Gülen Ş, Yılmaz PÖ. KOAH’da nutrisyonel durumun değerlendirmesinde mini nutrisyonel anketin kullanılabilirliği ve solunum fonksiyon parametreleriyle ilişkisi. Kocaeli Medical J 2017;6(2):38-42.
  • 3. Luo Y, Zhou LZ, Li Y, Guo S, Li X, Zheng J et al. Fat-Free Mass Index for evaluating the nutritional status and disease severity in COPD. Respir Care 2016;61(5):681-688.
  • 4. Hsieh MJ, Yang TM, Tsai YH. Nutritional supplementation in patients with chronic obstructive pulmonary disease. JFMA 2016;115: 595-601.
  • 5. Hallin R, Janson C, Arnardottir RH, Olsson R, Emtner M, Branth S et al. Relation between physical capacity, nutritional status and systemic inflammation in COPD. Clin Respir J 2011;5: 136-142.
  • 6. Sehgal İS, Dhooria S, Agarwal R. Chronic obstructive pulmonary disease and malnutrition in developing countries. Curr Opin Pulm Med 2017;23:139-148.
  • 7. Saka M, Balkan A, Demirci N, Sarıkayalar Ü. Solunum fonksiyonları ve beslenme. Tüberküloz ve Toraks Dergisi 2003;51(4):461-6.
  • 8. Hodson M. The nurse role in addressing malnutrition in COPD patients. Pract Nurs 2016;27(10):502-504.
  • 9. Pirabbasi E, Najafiyan M, Cheraghi M, Shahar S, Manaf ZA, Rajab N et al. Predictors’ factors of nutritional status of male chronic obstructive pulmonary disease patients. International Scholarly Research Network Nursing 2012;Article ID 782626:1-7.
  • 10. Lee H, Kim S, Lim Y, Gwon H, Kim Y, Ahn JJ et al. Nutritional status and disease severity in patients with chronic obstructive pulmonary disease (COPD). Arch of Gerontol Geriatr 2013;56:518-523.
  • 11. Tüzel ÖE, Uçar ZZ, Tellioğlu E. Biçmen C, Meral AL, Tibet G. KOAH’lı olgularda biyokimyasal beslenme parametreleri ile hastalığın şiddeti arasındaki ilişki. İzmir Göğüs Hastanesi Dergisi 2012;16(3):157-163.
  • 12. Hadson M. Integrating nutrition into pathways for patients with COPD. Br J Community Nurs 2016;21(11):548-552.
  • 13. Akner G, Larsson K. Undernutrition state in patients with chronic obstructive pulmonary disease. A critical appraisal on diagnostics and treatment. Respir Med 2016;117:81-91.
  • 14. Itoh M, Tsuji T, Nemoto K, Nakamura H, Aoshiba K. Undernutrition in patients with COPD and its treatment. Nutrients 2013;5:1316-1335.
  • 15. Seo SH. Medical nutrition therapy based on nutrition intervention for a patient with chronic obstructive pulmonary disease. Clin Nutr Res 2014;3:150-156.
  • 16. Grigorakos L. The role of nutrition in patients with chronic obstructive pulmonary disease. ASNH 2018;2(4):20-23.
  • 17. Balıoğlu M, Kömürcüoğlu M, Biçmen C, Çelikten E, Aktoğu S. KOAH’lı hastalarda beslenme durumu ve solunum fonksiyonları. Toraks Dergisi 2002;3(3):236-241.
  • 18. Kocabaş A, Atış S, Çöplü L, Erdinç E, Ergan B, Gürgün A ve ark. Kronik obstrüktif akciğer hastalığı (KOAH) koruma, tanı ve tedavi raporu 2014. Official journal of the Turkish Thoracic Society 2014;15(2): 1-72.
  • 19. Brug J, Schols A, Mesters I. Dietary change, nutrition education and chronic obstructive pulmonary disease. Patient Educ Couns 2004;52:249-257.
  • 20. Chen R, Xing L, You C, OU X. Prediction of prognosis in chronic obstructive pulmonary disease patients with respiratory failure: A comparison of three nutritional assessment methods. Eur J Intern Med 2018;57:70-75.
  • 21. Chaudhary SC, Rao PK, Sawlani KK, Himanshu D, Gupta KK, Patel ML et al. Assessment of nutritional status in chronic obstructive pulmonary disease patients. Int J Contemp Med Res 2017;4(1):268-271.
  • 22. Ingadottir AR, Beck AM, Baldwin C, Weekes CE, Geirsdottir OG, Ramel A et al. Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD). Clin Nutr 2018;37:1323-1331.
  • 23. Shepherd A. The nutritional management of COPD: An overview. Br J Nurs 2010;19(9):559-562.
  • 24. Holdoway A, Anderson L, Ashworth A, Cudby S, Doyle C, Nash L, et al. Guide to managing adult malnutrition in the community. 2nd Edition:2017:4-9.
  • 25. Anderson L, Banner J, Bowden M, Cotton J, Holdoway A, King S, et al. Managing malnutrition in COPD. 3 rd Edition: 2020.
  • 26. Long R, Stracy C, Oliver MC. Nutritional care in chronic obstructive pulmonary disease. Nutrition 2018;23(Sup7):19-26.
  • 27. Odencrants S, Ehnfors M, Grobe SJ. Living with chronic obstructive pulmonary disease (COPD): Part II. RNs’ experience of nursing care for patients with COPD and impaired nutritional status. Scand J Caring Sci 2007;21:56-63.
  • 28. Sivrikaya SK, Eryılmaz A. Nütrisyonel destek ekibinde hemşirelik. Samsun Sağ. Bil Der 2018;3(2):33-37.
  • 29. Mete B, Pehlivan E, Gülbaş G. Prevalence of malnutrition in COPD and its relationship with the parameters related to disease severity. Int J Chron Obstruct Dis 2018;13:3307-3312.
  • 30. Managing adult malnutrition: Ten top tıps for implementıng the malnutrıtıon pathway: nurses. Retrieved April 26, 2022 from https://www.malnutritionpathway.co.uk/tipsheets/tipsheet_nurses.pdf
  • 31. Shepherd AB, Bowell K. ‘Mind the gap’: The importance of managing malnutrition in chronic obstructive pulmonary disease. Br. J. Community Nurs 2019;28(22):1442-1449.
  • 32. Arslan S. D vitamini ile kronik obstrüktif akciğer hastalığı ilişkisi. SAK 2020;5(1):78-90.
  • 33. Çiftçi H. Solunum sistemi hastalıkları ve beslenme tedavisi. Ankara. Klasmat Matbaacılık. 2008.
  • 34. Rawal G, Yadav S. Nutrition in chronic obstructive pulmonary disease: A review. J Transl Int Med 2015;3(4):151-154. 35. Özkaptan BB, Kapucu S. KOAH’lı bireylerde öz-etkililiğin geliştirilmesinde evde bakımın önemi. Cumhuriyet Hem Der 2015;4(2):74-80.
  • 36. Boyacı N. Noninvaziv mekanik ventilasyonda nütrisyon desteği ne zaman, nasıl ve kime yapılmalı? İçinde Öcal S, Noninvaziv mekanik ventilasyon uygulamaları. İstanbul TÜSAD Eğitim Kitapları Serisi; 2017: 63-68.
  • 37. Ingadottir AR, Beck AM, Baldwin C, Weekes CE, Geirsdottir OG, Ramel A et al. Oral nutrition supplements and between- meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: A randomised feasibility trial. BMJ Open Resp Res 2019;6:e000349.
  • 38. Pison CM, Cano NJ, Cherion C, Caron F, Fortune CI, Antonini MT et al. Multimodal nutritional rehabilitation improves clinical outcomes of malnourished patients with chronic respiratory failure: a randomised controlled trial. Thorax 2011;66:953-960.
  • 39. Collins PF, Stratton RJ, Elia M. Nutritional support in chronic obstructive pulmonary disease: A systematic review and meta- analysis. Am J Clin Nutr 2012;95:1385-1395.
  • 40. Rafic R, Prins HJ, Boersma BG, Daniels JMA, Heijer M, Jongh RT. Effects of daily vitamin D supplementation on respiratory muscle strength and physical performance in vitamin D-deficient COPD patients: A pilot trial. Int J Chron Obstruct Pulmon Dis 2017;12:2583-2592.
  • 41. Furuland E, Bemanian M, Berggren N, Madebo T, Rivedal SH, Lid TG et al. Effects of nutritional ınterventions in ındividuals with chronic obstructive lung disease: A systematic review of randomized controlled trials. Int J Chron Obstruct Pulmon Dis 2021;16:3145-3156.
  • 42. Ting HYT, Chan SHY, Luk EKH, To QMY, Wong CY, Choo KL. Prevalence of malnutrition in copd ınpatients and its relationship with nutritional ıntakes and clinical outcomes. J Aging Sci 2020;8(1):1-5.
  • 43. Collins PF, Yang IA, Chang YC, Vaughan A. Nutritional support in chronic obstructive pulmonary disease (COPD): An evidence update. J Thorac Dis 2019;11(Suppl 17):2230-2237.

Nursing Approach In Individuals With Malnutrition With Chronic Obstructive Pulmonary Disease

Year 2022, Volume: 15 Issue: 3, 387 - 394, 15.07.2022
https://doi.org/10.46483/deuhfed.931900

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is among the leading causes of morbidity and mortality worldwide. It has been reported that the prevalence of malnutrition in individuals with COPD varies between 20% and 50%. Although malnutrition has negative effects on lung functions, immunity, exercise capacity and quality of life, it also causes consequences such as increased health care costs and prolonged hospital stay. Malnutrition and loss of muscle mass affect the respiratory muscle function and exercise capacity of individuals. While respiratory failure is a cause for malnutrition, nutritional status itself can adversely affect respiratory system functions. Decreased appetite and exercise intolerance caused by malnutrition reduce the strength of the respiratory muscles, which further exacerbates the problems in COPD patients. Malnutrition is an important problem in individuals with COPD, but it is often overlooked during the management of the disease. It is important to evaluate the nutritional status of individuals with COPD, determine the risk group and apply appropriate interventions to the risk group. With the implementation of the correct interventions determined based on the guidelines, it is ensured that the food intake of the patients and thus the clinical results are improved. Within a multidisciplinary team, nurses should be able to identify individuals at risk of malnutrition with COPD, identify patients with malnutrition and implement a care plan for a balanced and adequate nutrition. In this review article, it is aimed to identify malnutrition and COPD patients with malnutrition risk, to evaluate malnutrition status and to explain nursing interventions in the light of current literature and guidelines.

References

  • 1. Agusti A, Beasley R, Celli BR, Chen R, Criner G, Helpin D et al. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease 2021 Report. Global Initiative for Chronic Obstructive Lung Disease (GOLD). https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf
  • 2. Gülen Ş, Yılmaz PÖ. KOAH’da nutrisyonel durumun değerlendirmesinde mini nutrisyonel anketin kullanılabilirliği ve solunum fonksiyon parametreleriyle ilişkisi. Kocaeli Medical J 2017;6(2):38-42.
  • 3. Luo Y, Zhou LZ, Li Y, Guo S, Li X, Zheng J et al. Fat-Free Mass Index for evaluating the nutritional status and disease severity in COPD. Respir Care 2016;61(5):681-688.
  • 4. Hsieh MJ, Yang TM, Tsai YH. Nutritional supplementation in patients with chronic obstructive pulmonary disease. JFMA 2016;115: 595-601.
  • 5. Hallin R, Janson C, Arnardottir RH, Olsson R, Emtner M, Branth S et al. Relation between physical capacity, nutritional status and systemic inflammation in COPD. Clin Respir J 2011;5: 136-142.
  • 6. Sehgal İS, Dhooria S, Agarwal R. Chronic obstructive pulmonary disease and malnutrition in developing countries. Curr Opin Pulm Med 2017;23:139-148.
  • 7. Saka M, Balkan A, Demirci N, Sarıkayalar Ü. Solunum fonksiyonları ve beslenme. Tüberküloz ve Toraks Dergisi 2003;51(4):461-6.
  • 8. Hodson M. The nurse role in addressing malnutrition in COPD patients. Pract Nurs 2016;27(10):502-504.
  • 9. Pirabbasi E, Najafiyan M, Cheraghi M, Shahar S, Manaf ZA, Rajab N et al. Predictors’ factors of nutritional status of male chronic obstructive pulmonary disease patients. International Scholarly Research Network Nursing 2012;Article ID 782626:1-7.
  • 10. Lee H, Kim S, Lim Y, Gwon H, Kim Y, Ahn JJ et al. Nutritional status and disease severity in patients with chronic obstructive pulmonary disease (COPD). Arch of Gerontol Geriatr 2013;56:518-523.
  • 11. Tüzel ÖE, Uçar ZZ, Tellioğlu E. Biçmen C, Meral AL, Tibet G. KOAH’lı olgularda biyokimyasal beslenme parametreleri ile hastalığın şiddeti arasındaki ilişki. İzmir Göğüs Hastanesi Dergisi 2012;16(3):157-163.
  • 12. Hadson M. Integrating nutrition into pathways for patients with COPD. Br J Community Nurs 2016;21(11):548-552.
  • 13. Akner G, Larsson K. Undernutrition state in patients with chronic obstructive pulmonary disease. A critical appraisal on diagnostics and treatment. Respir Med 2016;117:81-91.
  • 14. Itoh M, Tsuji T, Nemoto K, Nakamura H, Aoshiba K. Undernutrition in patients with COPD and its treatment. Nutrients 2013;5:1316-1335.
  • 15. Seo SH. Medical nutrition therapy based on nutrition intervention for a patient with chronic obstructive pulmonary disease. Clin Nutr Res 2014;3:150-156.
  • 16. Grigorakos L. The role of nutrition in patients with chronic obstructive pulmonary disease. ASNH 2018;2(4):20-23.
  • 17. Balıoğlu M, Kömürcüoğlu M, Biçmen C, Çelikten E, Aktoğu S. KOAH’lı hastalarda beslenme durumu ve solunum fonksiyonları. Toraks Dergisi 2002;3(3):236-241.
  • 18. Kocabaş A, Atış S, Çöplü L, Erdinç E, Ergan B, Gürgün A ve ark. Kronik obstrüktif akciğer hastalığı (KOAH) koruma, tanı ve tedavi raporu 2014. Official journal of the Turkish Thoracic Society 2014;15(2): 1-72.
  • 19. Brug J, Schols A, Mesters I. Dietary change, nutrition education and chronic obstructive pulmonary disease. Patient Educ Couns 2004;52:249-257.
  • 20. Chen R, Xing L, You C, OU X. Prediction of prognosis in chronic obstructive pulmonary disease patients with respiratory failure: A comparison of three nutritional assessment methods. Eur J Intern Med 2018;57:70-75.
  • 21. Chaudhary SC, Rao PK, Sawlani KK, Himanshu D, Gupta KK, Patel ML et al. Assessment of nutritional status in chronic obstructive pulmonary disease patients. Int J Contemp Med Res 2017;4(1):268-271.
  • 22. Ingadottir AR, Beck AM, Baldwin C, Weekes CE, Geirsdottir OG, Ramel A et al. Two components of the new ESPEN diagnostic criteria for malnutrition are independent predictors of lung function in hospitalized patients with chronic obstructive pulmonary disease (COPD). Clin Nutr 2018;37:1323-1331.
  • 23. Shepherd A. The nutritional management of COPD: An overview. Br J Nurs 2010;19(9):559-562.
  • 24. Holdoway A, Anderson L, Ashworth A, Cudby S, Doyle C, Nash L, et al. Guide to managing adult malnutrition in the community. 2nd Edition:2017:4-9.
  • 25. Anderson L, Banner J, Bowden M, Cotton J, Holdoway A, King S, et al. Managing malnutrition in COPD. 3 rd Edition: 2020.
  • 26. Long R, Stracy C, Oliver MC. Nutritional care in chronic obstructive pulmonary disease. Nutrition 2018;23(Sup7):19-26.
  • 27. Odencrants S, Ehnfors M, Grobe SJ. Living with chronic obstructive pulmonary disease (COPD): Part II. RNs’ experience of nursing care for patients with COPD and impaired nutritional status. Scand J Caring Sci 2007;21:56-63.
  • 28. Sivrikaya SK, Eryılmaz A. Nütrisyonel destek ekibinde hemşirelik. Samsun Sağ. Bil Der 2018;3(2):33-37.
  • 29. Mete B, Pehlivan E, Gülbaş G. Prevalence of malnutrition in COPD and its relationship with the parameters related to disease severity. Int J Chron Obstruct Dis 2018;13:3307-3312.
  • 30. Managing adult malnutrition: Ten top tıps for implementıng the malnutrıtıon pathway: nurses. Retrieved April 26, 2022 from https://www.malnutritionpathway.co.uk/tipsheets/tipsheet_nurses.pdf
  • 31. Shepherd AB, Bowell K. ‘Mind the gap’: The importance of managing malnutrition in chronic obstructive pulmonary disease. Br. J. Community Nurs 2019;28(22):1442-1449.
  • 32. Arslan S. D vitamini ile kronik obstrüktif akciğer hastalığı ilişkisi. SAK 2020;5(1):78-90.
  • 33. Çiftçi H. Solunum sistemi hastalıkları ve beslenme tedavisi. Ankara. Klasmat Matbaacılık. 2008.
  • 34. Rawal G, Yadav S. Nutrition in chronic obstructive pulmonary disease: A review. J Transl Int Med 2015;3(4):151-154. 35. Özkaptan BB, Kapucu S. KOAH’lı bireylerde öz-etkililiğin geliştirilmesinde evde bakımın önemi. Cumhuriyet Hem Der 2015;4(2):74-80.
  • 36. Boyacı N. Noninvaziv mekanik ventilasyonda nütrisyon desteği ne zaman, nasıl ve kime yapılmalı? İçinde Öcal S, Noninvaziv mekanik ventilasyon uygulamaları. İstanbul TÜSAD Eğitim Kitapları Serisi; 2017: 63-68.
  • 37. Ingadottir AR, Beck AM, Baldwin C, Weekes CE, Geirsdottir OG, Ramel A et al. Oral nutrition supplements and between- meal snacks for nutrition therapy in patients with COPD identified as at nutritional risk: A randomised feasibility trial. BMJ Open Resp Res 2019;6:e000349.
  • 38. Pison CM, Cano NJ, Cherion C, Caron F, Fortune CI, Antonini MT et al. Multimodal nutritional rehabilitation improves clinical outcomes of malnourished patients with chronic respiratory failure: a randomised controlled trial. Thorax 2011;66:953-960.
  • 39. Collins PF, Stratton RJ, Elia M. Nutritional support in chronic obstructive pulmonary disease: A systematic review and meta- analysis. Am J Clin Nutr 2012;95:1385-1395.
  • 40. Rafic R, Prins HJ, Boersma BG, Daniels JMA, Heijer M, Jongh RT. Effects of daily vitamin D supplementation on respiratory muscle strength and physical performance in vitamin D-deficient COPD patients: A pilot trial. Int J Chron Obstruct Pulmon Dis 2017;12:2583-2592.
  • 41. Furuland E, Bemanian M, Berggren N, Madebo T, Rivedal SH, Lid TG et al. Effects of nutritional ınterventions in ındividuals with chronic obstructive lung disease: A systematic review of randomized controlled trials. Int J Chron Obstruct Pulmon Dis 2021;16:3145-3156.
  • 42. Ting HYT, Chan SHY, Luk EKH, To QMY, Wong CY, Choo KL. Prevalence of malnutrition in copd ınpatients and its relationship with nutritional ıntakes and clinical outcomes. J Aging Sci 2020;8(1):1-5.
  • 43. Collins PF, Yang IA, Chang YC, Vaughan A. Nutritional support in chronic obstructive pulmonary disease (COPD): An evidence update. J Thorac Dis 2019;11(Suppl 17):2230-2237.
There are 42 citations in total.

Details

Primary Language Turkish
Subjects Nursing
Journal Section Review
Authors

Gizem Özbudak 0000-0002-2063-9544

Öznur Usta Yeşilbalkan 0000-0001-5607-0751

Asiye Akyol 0000-0003-1018-4715

Publication Date July 15, 2022
Published in Issue Year 2022 Volume: 15 Issue: 3

Cite

APA Özbudak, G., Usta Yeşilbalkan, Ö., & Akyol, A. (2022). Kronik Obstrüktif Akciğer Hastalığı Olan Malnütrisyonlu Bireylerde Hemşirelik Yaklaşımı. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 15(3), 387-394. https://doi.org/10.46483/deuhfed.931900

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