EVALUATION OF DYSPNEA AND QUALITY OF LIFE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Öz

Aim: The study was conducted to determine the relationship between the perception of dyspnea and quality of life in patients with Chronic Obstructive Pulmonary Disease (COPD) and affecting factors.
Methods: Seventy-five COPD patients treated in a University Hospital in Edirne province were included in this descriptive cross-sectional study in order to evaluate the dyspnea and quality of life in patients with chronic obstructive pulmonary disease. The data of the study were collected by The Modified Medical Research Council scale to determine the dyspnea of the patients and the Saint George Respiratory Questionnaire to measure the quality of life and Patient information form.
Results: The average age of the patients was 60.86 ± 9.4 years, 73.30% of them were male. It was observed that the perception of dyspnea was severe in half of the patients (53%) and the quality of life was well. In this study, factors such as age, smoking, exposure to passive tobacco smoke were found to be effective on perception of dyspnea and quality of life (p <0.05). In our study, a negative relationship was found between dyspnea and quality of life (p <0.05). It was determined that the quality of life deteriorated as the severity of dyspnea increased.
Conclusions: It was found out that personal characteristics of patients with COPD (age, smoking, etc.) and the characteristics related to the disease (duration of diagnosis, severity of dyspnea, etc.), affects dyspnea and quality of life. By taking these characteristics into account, education and nursing care practices are thought to have a positive effect on improving dyspnea and quality of life. 

Anahtar Kelimeler

• Dyspnea
• Chronic Obstructive Pulmonary Disease
• quality of life

KRONİK OBSTRÜKTİF AKCİĞER HASTALARINDA DİSPNE ALGISI VE YAŞAM KALİTESİNİN DEĞERLENDİRİLMESİ

Öz

Amaç: Bu araştırma, Kronik Obstrüktif Akciğer Hastaları (KOAH)’nda dispne algısı ve yaşam kalitesi arasındaki ilişkiyi ve etkileyen faktörleri belirlemek amacı ile planlandı.
Yöntem: Tanımlayıcı kesitsel tipte yapılan araştırma bir üniversite hastanesinde 75 KOAH tanısı olan birey ile yürütülmüştür. Çalışmanın verileri Hasta Bilgi Formu, dispne algısını belirlemek için Modified Medical Research Council Skalası ve yaşam kalitesi düzeyini ölçmek için Saint George Solunum Anketi ile toplanmıştır.
Bulgular: Hastaların yaş ortalaması 60.86 ± 9.4’ yıldır, %73.30’u erkektir. Dispne algısının hastaların yarısında (%53) şiddetli olduğu, yaşam kalitesi düzeyinin ise iyi olduğu görülmüştür. Bu araştırmada yaş, sigara kullanımı, pasif sigara dumanına maruz kalma gibi faktörlerin dispne algısı ve yaşam kalitesi üzerinde etkili olduğu bulunmuştur (p<0,05). Çalışmamızda dispne ile yaşam kalitesi arasında negatif yönde anlamlı bir ilişki bulunmuştur (p<0,05). Hastaların dispne şiddeti arttıkça yaşam kalitesinin kötüleştiği belirlenmiştir.
Sonuç: KOAH’lı bireylerin kişisel (yaş, sigara kullanımı vb) ve hastalığa ilişkin özelliklerinin (tanı süresi, dispne şiddeti vb) dispne algısı ve yaşam kalitesini etkilediği saptanmıştır. Bu özellikler dikkate alınarak verilecek eğitim ve bakımın dispne algısı ve yaşam kalitesini iyileştireceği düşünülmektedir. 

Anahtar Kelimeler

• Dispne
• Kronik Obstrüktif Akciğer Hastalığı
• Yaşam kalitesi

Kaynakça

1. 1. 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;2(15):15-35.
2. 2. Demirel İ, Altun AY, Bolat E. Kronik Obstrüktif Akciğer Hastalığı ve Anestezi Yönetimi. Türkiye Klinikleri Journal of Anesthesiology Reanimation 2017;15(3):100-9.
3. 3. Türkiye İstatistik Kurumu Ölüm Nedeni İstatistikleri 2017. http://www.tuik.gov.tr/PreHaberBultenleri.do?id=27620 Erişim Tarihi: 10.02.20184.
4. 4. Lopez AD, Shibuya K, Rao C, Mathers CD, Hansell AL, Held LS. et al. Chronic Obstructive Pulmonary Disease: Current Burden and Future Projections. European Respiratory Journal 2006; 27(2): 397-412.
5. 5. Kaptan G, Dedeli Ö. Temel İç Hastalığı Hemşireliği. İstanbul Tıp Kitabevi, İstanbul 2012:200-4.
6. 6. Mathers CD, Loncar D. Projections of Global Mortality and Burden of Disease from 2002 to 2030. PLOS Medicine 2006;3(111):e442.
7. 7. Demir G, Akkoca Ö, Doğan R, Saryal S, Karabıyıkoğlu G. KOAH’da Dispne ve Yaşam Kalitesinin Değerlendirilmesi. Tüberküloz ve Toraks Dergisi 2003;51(4):365-72.
8. 8. Wasserman K, Hansen J, Sue D, Whipp Bj. Principles of Exercise Testing and Interpretation. Canadian Journal of Cardiology 2007;23(4):274.

9. 9. Falter LB, Gignac MA, Cott C. Adaptation to Disability in Chronic Obstructive Pulmonary Disease: Neglected Relation Relationship to Older Adults, Perceptions of Independence. Disability and Rehabilitation 2003;25(14):795-806.
10. 10. Blake D, Roberts NJ, Partridge MR. How Much of a Primary Care Nurse's Time is Spent on those with Respiratory Disease, A pilot study. Primary Care Respiratory Journal 2007;16(5):319-20.
11. 11. Meguro M, Barley EA, Spencer C, Jones P. Development and Validation of an Improved COPD Specific Version of the SGRQ. Chest 2007;132(2):456-63.
12. 12. Zakrisson AB, Engfeldt P, Hagglung D, Odencrants S, Hasselgren M, Arne M. et al. Nurse-led Multidisciplinary Programme for Patients with COPD in Primary Health Care: a Comtrolled Trial. Primary Care Respiratory Journal 2011;20(4):427-33.
13. 13. Wood-Baker R, Reid D, Robinson A, Walters E. Clinical Trial of Community Nurse Mentoring to Improve Self-Management in Patients with Chronic Obstructive Pulmonary Disease. International Journal of Chronic Obstructive Pulmonary Disease 2012;7:407-13.
14. 14. Fletcher CM. The Clinical Diagnosis of Pulmonry Empysema: An Experimental Study. Proceeding of the Royal Society of Medicine, 1952;45(9):577-84.
15. 15. Jones PW. Health Status Measurement in Chronic Obstructive Pulmonary Disease. Thorax 2001;56(11):880-7.
16. 16. Jones PW, Carone M. Health status “ Quality of Life”. European Respiratory Monograph 2000;13(5):22-35.
17. 17. Polatlı M, Yorgancıoğlu A, Aydemir Ö, Demirci N, Kırkıl K, Naycı S, ve ark. St. George Solunum Anketinin Türkçe Geçerlilik Güvenilirliği. Tuberk Toraks 2013;61(2):81-7.
18. 18. Akdemir N, Birol L. İç Hastalıkları ve Hemşirelik Bakımı, Sistem Ofset, Ankara, 2005:193-200.
19. 19. Kuyucu T, Güçlü SZ, Saylan B, Demir C, Senol T, Güner S, ve ark. A Cross-Sectional Observational Study to Investigate Daily Symptom Variability, Effects of Symptom on Morning Activities and Therapeutic Expectations of Patients and Physicians in COPD-SUNRISE study. Tüberkuloz ve Toraks Dergisi 2011;59(4):328-39.
20. 20. Saryal S. KOAH’ta Etyopatogenez ve Tanı Yöntemleri. Toraks Derneği 1. Kış Okulu, 2002: 23-37.
21. 21. Gündüz C, Erdinç M. Dispnenin Pulmoner Nedenlerine Yaklaşım. Ege Tıp Dergisi 2014;53(0):7-13.
22. 22. Ahmed A, Graber M. Evaluation of the Adult With Dyspnea in The Emergency Department. UpToDate;2017:22-6.
23. 23. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, et al. An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea. American Journal of Respiratory and Critical Care Medicine. 2012;185(4):435-52.
24. 24. Currow DC, Plummer JL, Crockett A, Abernethy AP. A Community Population Survey of Prevalence and Severity of Dyspnea in Adults. Journal of Pain and Symptom Management. 2009;38(4):533-45.
25. 25. Huisman M, Kunst A, Bopp M, Borgan JK, Borrel C, Costa G, et al. Educational Inequalities in Cause-Specific Mortality in Middle-aged and Older Men and Women in Eight Western European Populations. Lancet 2005; 365(9458): 493-500.
26. 26. Riesco J, Alcázar B, Trigueros J, Campuzano A, Pérez J, Lorenzo J. Active Smoking and COPD Phenotype: Distribution and İmpact on Prognostic Factors. International Journal of COPD. 2017;12:1989–99.
27. 27. Wijnhoven HA, Kriegsman DM, Hesselink AE, Penninx BW, de Haan M. Determinants of Different Dimensions of Disease Severity in Asthma and COPD: Pulmonary Function and Health-related Quality of Life. Chest.2001;119(4):1034–42.
28. 28. Kutlu R, Demirbaş N, Çivi S, Can A. Göğüs Cerrahisi Servisinde Yatan Hastalarda Depresyonun ve Yaşam Kalitesinin Kısa Form 36 ile Değerlendirilmesi. Türk Göğüs Kalp Damar Cerrahisi Dergisi 2015;23(3):524-31.
29. 29. Cheruvu V, Odhiambo L, Mowls D, Zullo M, Gudina A. Health-related Quality of Life in Current Smokers with COPD: Factors Associated With Current Smoking and New Insights Into Sex Differences. International Journal of COPD. 2016;11:2211–9.
30. 30. Hagstad S, Bjerg A, Ekerljung L, Backman H, Lindberg A, Rönmark E, Lundbäck B. Passive Smoking Exposure Is Associated With Increased Risk of COPD in Never Smokers. CHEST 2014; 145(6):1298–1304.
31. 31. Jordan R, Cheng K, Miller M, Adab P. Passive Smoking and Chronic Obstructive Pulmonary Disease: Cross-sectional Analysis of Data From the Health Survey for England. BMJ Open 2011;1(2):e000153.
32. 32. Salepçi B, Eren A, Çağlayan B, Fidan A, Torun E, Kıral N. The Effect of Body Mass Index on Functional Parameters and Quality of Life in COPD Patients. Tüberküloz ve Toraks Dergisi. 2007;55(4):342-9.
33. 33. Aytac S, Kilic S, Ovayolu N. Effect of Inhaler Drug Education on Fatigue, Dyspnea Severity, and Respiratory Function Tests in Patients with COPD. Patient Education and Counseling. 2020;103(4):709-16.
34. 34. Taytard A, Cousson F. Symptoms and Life of Patients with Chronic Bronchitis. Preliminary Results. Revue de Pneumologie Clinique 1996; 52(6): 379-85.
35. 35. Van Manen JG, Bindels PJ, Dekker FW, Bottema BJ, van der Zee JS, Ijzermans CJ. et al. The Influence of COPD on Health-related Quality of Life Independent of the Influence of Comorbidity. Journal of Clinical Epidemiology 2003; 56(12):1177-84.
36. 36. Öztürk C, Ayar D. Tip 1 Diabetes Mellitus’lu Çocuklarda Yaşam Kalitesi ve Önemi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi 2017;6(2):15-8.
37. 37. Scichilone N, Paglino G, Battaglia S, Martino L, Interrante A, Bellia V. The Mini Nutritional Assessment is Associated with the Perception of Dyspnoea in Older Subjects with Advanced COPD. Age Ageing 2008;37(2):214-7.
38. 38. Gülseren L, Hekimsoy Z, Gülseren Ş, Bodur Z, Kültür S. Diabetes Mellituslu Hastalarda Depresyon, Anksiyete, Yaşam Kalitesi ve Yeti Yitimi. Türk Psikiyatri Dergisi 2001;12(2):89-98.
39. 39. Akbay S, Kurt B, Ertürk A, Kronik Obstrüktif Akciğer Hastalığında Yaşam Kalitesi ve Solunum Fonksiyon Testi ile İlişkisi. Tüberküloz ve Toraks Dergisi 2001; 49(3):338-44.