To see the other types of publications on this topic, follow the link: COPD patients.
Dissertations / Theses on the topic 'COPD patients'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'COPD patients.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Ottenheijm, Coen, Leo Heunks, and Richard Dekhuijzen. "Diaphragm adaptations in patients with COPD." BioMed Central, 2008. http://hdl.handle.net/10150/610242.
Full textAbstract:
Inspiratory muscle weakness in patients with COPD is of major clinical relevance. For instance, maximum inspiratory pressure generation is an independent determinant of survival in severe COPD. Traditionally, inspiratory muscle weakness has been ascribed to hyperinflation-induced diaphragm shortening. However, more recently, invasive evaluation of diaphragm contractile function, structure, and biochemistry demonstrated that cellular and molecular alterations occur, of which several can be considered pathologic of nature. Whereas the fiber type shift towards oxidative type I fibers in COPD diaphragm is regarded beneficial, rendering the overloaded diaphragm more resistant to fatigue, the reduction of diaphragm fiber force generation in vitro likely contributes to diaphragm weakness. The reduced diaphragm force generation at single fiber level is associated with loss of myosin content in these fibers. Moreover, the diaphragm in COPD is exposed to oxidative stress and sarcomeric injury. This review postulates that the oxidative stress and sarcomeric injury activate proteolytic machinery, leading to contractile protein wasting and, consequently, loss of force generating capacity of diaphragm fibers in patients with COPD. Interestingly, several of these presumed pathologic alterations are already present early in the course of the disease (GOLD I/II), although these patients appear not limited in their daily life activities. Treatment of diaphragm dysfunction in COPD is complex since its etiology is unclear, but recent findings indicate the ubiquitin-proteasome pathway as a prime target to attenuate diaphragm wasting in COPD.
2
Albert, Paul. "Physical activity monitoring in COPD patients." Thesis, University of Liverpool, 2012. http://livrepository.liverpool.ac.uk/7173/.
Full textAbstract:
The importance of physical activity in health and disease is recognised, and its relevance in COPD is of increasing interest since it is related to patient outcomes. This thesis primarily sets out to examine physical activity levels in COPD patients in three clinical situations: The early stages of recovery and the subsequent 4 months after hospitalisation for exacerbation (a prospective cohort study of 60 patients), after a course of pulmonary rehabilitation and 6 months later (a prospective cohort study of 37 patients) and at a stage of disease where long term oxygen therapy is being considered (a retrospective cohort study of 35 patients). We have measured physical activity levels using two types of accelerometer: the DynaPort and the Actiwatch. We have also made measures of lung physiology, exercise capacity, peripheral muscle strength and health status. COPD patients have very low levels of physical activity when stable, worse still while in hospital recovering from an exacerbation. Across the 3 patient groups, levels of physical activity do not consistently correlate with other measures, suggesting that what patients actually do does not correlate with what they can do or say they can do. Exacerbating patients who receive early discharge have higher levels of physical activity than those who remain in hospital, and baseline physical activity predicts re exacerbation and readmission at 4 months but not 12 months. Improvements in levels of physical activity are lost 6 months after completing pulmonary rehabilitation despite preservation of peripheral muscle strength and exercise capacity, suggesting that methods to sustain the benefits of PR should focus on changing patient behaviour rather than simply improving physiology. COPD patients who use LTOT show comparable levels of physical activity to a similar patient group with better FEV11 % predicted who do not use LTOT, suggesting that the potential physical constraints of being connected to oxygen tubing for much of the day do not cause patients to be more sedentary. Measuring levels of physical activity in COPD patients with accelerometers offers additional information about patients that may help to determine prognosis and appropriate management. However, further work is needed to determine clinically relevant measures and clinically significant changes.
3
Chu, Ling-fung, and 朱凌峯. "Plasma inflammatory biomarkers in stable COPD patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48333682.
Full textAbstract:
Chronic obstructive pulmonary disease (COPD) is one of the world’s most common chronic diseases, and consists of chronic bronchitis that involves chronic inflammation of the bronchi, or emphysema that involves destruction of lung alveoli. In COPD patients, the airways become narrowed, and the airflow is irreversibly obstructed. This leads to a limitation of the flow of air to and from the lungs, causing shortness of breath (dyspnea), as well as abnormal inflammatory response in the lung. Nowadays, COPD is often under-diagnosed, as spirometry was not performed until patient has significant symptoms of dyspnea, cough and sputum production. At that stage, the COPD patients may have reached an advanced stage with considerable loss of lung function. Thus, biomarkers are of great interest for research and clinical purposes in COPD, especially for early diagnosis of COPD.
In this study, the relationship between plasma levels of different biomarkers, including monocyte chemoattractant protein-1 (MCP)-1 (a primary chemoattractant biomarker), matrix metalloproteinase nine (MMP)-9, vascular endothelial growth factor (VEGF), and hepatocyte growth factor (HGF) (injury and repair biomarkers), and growth differentiation factor 15 (GDF)-15 (a novel biomarker), in 29 healthy ever-smokers and 116 COPD patients was investigated using commercially available enzyme-linked immunosorbent assay (ELISA) kits. We also investigated the correlations between these biomarkers and lung function. There were significant increases in plasma MCP-1, MMP-9, HGF and GDF-15 in COPD patients compared to healthy smokers. Among ever-smokers with or without COPD, plasma MCP-1, MMP-9 and HGF levels were inversely correlated with force expiratory volume in one second![FEV1 (% predicted)] after adjustment for age, smoking status and packyears smoked. Correlation was also found between plasma MCP-1 and HGF, plasma MMP-9 and HGF or GDF-15, plasma HGF and GDF-15 after adjustment for age, smoking status and pack-years smoked. Further multiple linear regression analyses demonstrated that plasma MMP-9 level increased with the COPD GOLD stages.
In conclusion, our findings suggest that MMP-9 might be as an important biomarker for COPD initiation and progression. As this study provides only evidence of association rather than of causation, prospective studies are required to assess biological significance of these associations between the plasma biomarkers.published_or_final_version
Medicine
Master
Master of Medical Sciences
4
Nilsson, Catharina, and Elisabeth Svebring. "Education for patients with the diagnos COPD." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-24469.
Full textAbstract:
Kronisk obstruktiv lungsjukdom (KOL) är en av våra största folksjukdomar och den fjärde vanligaste dödsorsaken i världen. KOL är en progressiv sjukdom med symtom som påverkar livskvalitén. Rökning kombinerat med hög ålder är dominerande riskfaktor. Behandlingsmål för KOL är att minska symtom, förebygga exacerbationer och förbättra livskvalitén. Patientutbildningens syfte är att stödja och stärka patientens kontroll över sjukdom och behandling. I Sverige förekommer ingen standardiserad patientutbildning för KOL-patienter. Syftet med denna litteraturstudie var att identifiera kritiska aspekter i en utbildning för patienter med diagnosen KOL. Litteratursökning gjordes i PubMed och Cinahl. Åtta kvantitativa och två kvalitativa studier som överensstämde med problemformuleringen kvalitetsgranskades och inkluderades. I denna litteraturstudie har vi sett att patientut-bildning kan innefatta många olika moment och de kan inte utvärderas enskilt. Dock tycks faktorer som individuellt anpassad utbildning utifrån patientens tidigare erfarenheter och regelbunden uppföljning vara grundläggande för en utbildning som påverkar patientens följsamhet och därigenom en positiv effekt på patientens behandlingsmål.Chronic Obstructive Pulmonary Disease (COPD) is a common disease, the 4th cause of global mortality. COPD is progressive and its symptoms influence the daily life. Smoking and ageing are risk factors. The treatment goals are to decrease the symptoms, prevent exacerbation and increase the quality of life. The aim of patient education are supporting and encouraging the patient to take control over the disease and the treatment. Sweden does not have any standard education concerning patients with COPD. The aim of this review was to identify critical aspects in an education for patients with COPD. The literature was searched in PubMed and Cinahl. Eight quantitative and two qualitative studies were selected as they were according to the aim of the study. The quality of the studies was evaluated. In this review we found patient education contenting different factors which could not be evaluated separately. Tailor made education based on the patient previous experience and regular follow-up seems to influence patient adher-ence and thereby give a positive effect on the treatment goals.
5
Ashmore, Jamile A. "Marital adjustment among COPD patients participating in exercise rehabilitation." Connect to this title online, 2003. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1069435900.
Full textAbstract:
Thesis (Ph. D.)--Ohio State University, 2003.Document formatted into pages; contains xi, 81 p; also contains graphics. Title from first page of PDF file. Includes bibliographical references (p. 74-81). Available online via OhioLINK's ETD Center.
6
Li, Meng. "Hospitalization cost analysis of COPD patients in Guangdong province." Thesis, University of Macau, 2018. http://umaclib3.umac.mo/record=b3952154.
Full text
7
Chau, Laurence. "Predictors of outcome of exercise training in COPD patients (POET)." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0003/MQ42594.pdf.
Full text
8
Wadell, Karin. "Physical training in patients with chronic obstructive pulmonary disease - COPD." Doctoral thesis, Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-363.
Full text
9
Gana-inatimi, Joy. "Self-management education in pulmonary rehabilitation for patients with COPD." Thesis, University of Central Lancashire, 2017. http://clok.uclan.ac.uk/25388/.
Full textAbstract:
Pulmonary rehabilitation (PR) is an effective strategy to manage chronic obstructive pulmonary disease (COPD). Self-management is an evolving and under-researched area within PR. The aim of this thesis was to explore the impact of self-management on health outcomes in patients with COPD.
10
Bell, Keisha. "The Role of Spirituality in Ethnic Minority Patients with COPD." Thesis, University of North Texas, 2015. https://digital.library.unt.edu/ark:/67531/metadc822782/.
Full textAbstract:
COPD is the third leading cause of death in the United States and is the sixth leading cause of death for low-to middle income countries (Downs & Appel, 2006; GOLD, 2011). COPD is a largely preventable disease due to the lifestyle factors that heavily contribute to disease onset and severity. Although traditionally COPD research has focused on health outcomes related to risk factors, compliance, comorbid psychological and physical conditions, and treatment interventions, a growing body of research suggests religious and spiritual factors may play an equally important role in health outcomes for several medical conditions, including pulmonary disease. However, studies of this kind have not specifically examined COPD nor have they examined the role of religious and spiritual beliefs in COPD management among ethnic minority patients. As such, the current study aimed to examine whether spiritual ethnic minority patients with COPD hold religious fatalistic attitudes and less active religious problem solving . A sample of 35 ethnic minority patients from the Louis. B. Stokes Cleveland VA Medical Center (LSCVAMC) Outpatient Pulmonary Clinic in Cleveland, OH. were recruited to participate in the study. Due to the acknowledgeable limitations of the present study, results are preliminary but convey associations between religious health fatalistic beliefs and religious problem solving approaches. Implications and areas of future study are discussed.
11
Robinson, Laura. "Anti-inflammatory interventions in primary lung cells from COPD patients." Thesis, University of Manchester, 2011. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.549082.
Full text
12
Gonzalez, Anne Valerie. "Gender differences in the treatment and outcome of patients with COPD." Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=32592.
Full textAbstract:
Chronic Obstructive Pulmonary Disease (COPD) is a respiratory disease characterized by progressive airflow limitation that is not fully reversible. Tobacco smoke is the most important risk factor. COPD is a leading cause of morbidity and mortality worldwide, and the burden of disease has been increasing, particularly for women. Despite these alarming trends, little is known about gender differences in the clinical manifestations and management of patients with COPD. In a large cohort of patients with chronic airflow obstruction hospitalized for COPD, gender differences in the treatment and outcome of disease were investigated. The cohort consisted of 19,260 women and 23,893 men with a mean age of 77 years. Women were more likely to have been previously hospitalized for asthma. In the year preceding the index hospitalization, women were dispensed fewer prescriptions for bronchodilators (particularly ipratropium bromide and theophylline) but were more likely to have received benzodiazepines and antidepressants. There were 11,245 (58.4%) female and 16,754 (70.1%) male deaths after cohort entry. The most frequent cause of death in both men and women was COPD. Mean survival and time to re-hospitalization for COPD or asthma were higher for female patients.La Maladie Pulmonaire Obstructive Chronique (MPOC) est une maladie respiratoire caractérisée par une augmentation de la résistance au flot respiratoire, de nature progressive et non-réversible. Le tabagisme est la principale cause de la MPOC. La MPOC est une cause importante de morbidité et de mortalité dans le monde entier, et la prévalence de la maladie continue d'augmenter de façon alarmante, tout particulièrement chez les femmes. Malgré cet essor de la MPOC, nous en savons peu sur les différences qui peuvent exister entre les sexes, au niveau des manifestations cliniques, du traitement et de l'évolution de la maladie. Dans une cohorte de patients traités pour une maladie pulmonaire obstructive et hospitalisés avec un diagnostique principal de MPOC, nous avons comparé le traitement reçu ainsi que le pronostic de la maladie chez les hommes et les femmes. La cohorte était constituée de 19260 femmes et 23893 hommes, et l'âge moyen était de 77 ans. Plus de femmes que d'hommes avaient été précédemment hospitalisées avec un diagnostic d'asthme. Dans l'année précédant l'hospitalisation index, les femmes avaient reçu moins de prescriptions pour des bronchodilatateurs (particulièrement le bromure d'ipratropium et la théophylline), mais plus de prescriptions pour des benzodiazépines et des antidépresseurs. Un total de 11245 (58.4%) femmes et 16754 (70.1%) hommes sont décédés après l'entrée dans la cohorte. La cause de décès la plus fréquente chez les hommes comme les femmes était la MPOC. La survie moyenne, ainsi que le temps moyen avant la ré-hospitalisation pour un diagnostic de MPOC ou d'asthme, étaient plus élevés chez les fe
13
Andersson, Mari. "Perceptions on the use of home telemonitoring in patients with COPD." Thesis, Umeå universitet, Avdelningen för fysioterapi, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-160086.
Full textAbstract:
Introduction: There is a growing interest in how technology can be used in order to provide efficient healthcare. Aim: The aim is to explore perceptions on the use of home telemonitoring in patients with COPD. Method: Semi-structured individual interviews were carried out with eight women and five men who were part of a larger project aiming to develop and evaluate a telemonitoring system. Participants were interviewed after having used the system for two to four months. Interview transcripts were analysed with qualitative content analysis. Results: The analysis resulted in the theme a transition towards increased control and security and the categories: facing enablers or barriers, increasing control over the disease, providing easy access to care and affecting technical confidence or concern. Participants expressed initial feelings of insecurity, both in practical aspects using the telemonitoring system as well as regarding their disease. The telemonitoring system could reinforce and confirm the participants´ feelings of their current state of health, and the practical management of the telemonitoring system became easier with time. Conclusion: Telemonitoring can be a valuable complement to healthcare with the potential to contribute to equity in care. However, in order to improve further development and implementation of telemonitoring, several actions are needed such as improved patient education and the use of co-creation. Additional research is needed particularly in the design of user-friendly systems as well as tools to predict which patients are most likely to find the equipment useful as it may result in reduced costs and increased empowerment.Introduktion: Intresset för hur teknologi kan användas för att erbjuda effektiv sjukvård ökar. Syfte: Syftet är att utforska KOL-patienters upplevelse av att använda ett webbaserat rapporteringssystem i hemmet. Metod: Semi-strukturerade individuella intervjuer med åtta kvinnor och fem män som deltog i ett större projekt med syfte att utveckla och utvärdera ett webbaserat rapporteringssystem. De intervjuades efter att ha använt systemet två till fyra månader. Intervjuerna analyserades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i temat en övergång till ökad kontroll och trygghet samt kategorierna: möta möjligheter eller hinder, ökad kontroll över sjukdomen, skapar lättillgänglig vård samt påverkar teknisk självkänsla eller oro. Deltagarna uttryckte till en början osäkerhetskänslor, både vad gäller praktiska aspekter i användandet av rapporteringssystemet samt kring själva sjukdomen. Det webbaserade rapporteringssystemet kunde förstärka och bekräfta deltagarnas egna känsla av mående och det praktiska hanterandet av rapporteringssytemet blev lättare med tiden. Konklusion: Webbaserade rapporteringssystem kan vara ett värdefullt komplement till sjukvården med potential att bidra till jämlik vård. I syfte att förbättra fortsatt utveckling och implementering bör förbättrad patientinformation samt vikten av att ta med användarna i utformningen beaktas. Mer forskning behövs för att optimera användarvänlighet samt att identifiera de patienter som har bäst nytta av systemet då det kan ge hälsoekonomiska vinster och inte minst öka patienters delaktighet.
14
Suzuki, Masao. "A Randomized, Placebo-Controlled Trial of Acupuncture in Patients With Chronic Obstructive Pulmonary Disease (COPD): the COPD-Acupuncture Trial (CAT)." Kyoto University, 2015. http://hdl.handle.net/2433/202643.
Full text
15
Arnardóttir, Ragnheiður Harpa. "Physical Training and Testing in Patients with Chronic Obstructive Pulmonary Disease (COPD)." Doctoral thesis, Uppsala University, Department of Medical Sciences, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7632.
Full textAbstract:
The overall aims of the studies were to investigate the effects of different training modalities on exercise capacity and health-related quality of life (HRQoL) in patients with moderate or severe COPD and, further, to explore two of the physical tests used in pulmonary rehabilitation.
In study I, the 12-minute walking distance (12MWD) did not increase on retesting in patients with exercise-induced hypoxemia (EIH) whereas 12MWD increased significantly on retesting in the non-EIH patients. In study II, we found that the incremental shuttle walking test was as good a predictor of peak exercise capacity (W peak) as peak oxygen uptake (VO2 peak) is. In study III, we investigated the effects of two different combination training programmes when training twice a week for eight weeks. One programme was mainly based on endurance training (group A) and the other on resistance training and callisthenics (group B). W peak and 12MWD increased in group A but not in group B. HRQoL, anxiety and depression were unchanged in both groups. Ratings of perceived exertion at rest were significantly lower in group A than in group B after training and during 12 months of follow-up. Twelve months post-training, 12MWD was back to baseline in group A, but significantly shorter than at baseline in group B. Thus, a short endurance training intervention delayed decline in 12MWD for at least one year. Patients with moderate and severe COPD responded to training in the same way. In study IV, both interval and continuous endurance training increased W peak, VO2 peak, peak exhaled carbon dioxide (VCO2 peak) and 12MWD. Likewise, HRQoL, dyspnoea during activities of daily life, anxiety and depression improved similarly in both groups. At a fixed, submaximal workload (isotime), the interval training reduced oxygen cost and ventilatory demand significantly more than the continuous training did.
16
Khurana, Shruti. "Lung physiology & airway inflammation in COPD patients with persistent sputum production." Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/lung-physiology-and-airway-inflammation-incopd-patients-with-persistent-sputum-production(b0f3374e-9a67-4ff9-a51e-d94eefa2f13c).html.
Full textAbstract:
Background: The clinical and pathological presentation of COPD is heterogeneous. ‘Chronic bronchitis’ is a phenotype of COPD, which is a clinical diagnosis of a productive cough of ≥ 3 months for ≥ 2 consecutive years. Chronic bronchitis is associated with worse lung function, frequent exacerbations, recurrent hospitalisations and premature death in patients with COPD. Chronic bronchitis sufferers can be further subphenotyped into those who produce sputum during exacerbation or during winter months only and those who are ‘persistent sputum producers,’ who experience mucous hypersecretion throughout the year. An improved understanding of persistent sputum producers is the object of this thesis. Aims: 1) To compare the clinical characteristics and airway inflammatory biomarker profile of COPD persistent sputum producers to that of COPD sputum non-producers 2) To investigate the short term repeatability of sputum parameters in COPD persistent sputum producers 3) To study the expression and relationship of mucins, hypoxia inducible factor (HIF-1α) and carbonic anhydrase IX (CAIX) in COPD persistent sputum producers. Methods: 1) Lung physiology, health status, sputum inflammatory biomarkers and sputum culture results were compared between COPD persistent sputum producers and sputum non-producers 2) Repeatability of spontaneous and induced sputum parameters at 8 weeks was assessed in COPD persistent sputum producers 3) Immunohistochemistry was performed on bronchial biopsies of COPD persistent sputum producers and control groups (COPD sputum non-producers, smokers with normal lung function and lifelong healthy non-smokers with normal lung function) to study the expression of MUC5AC, MUC5B, HIF-1α and CAIX 4) The association between HIF-1α and MUC5B expression was investigated in vitro. Results and Conclusions: The findings suggest that 1) COPD persistent sputum producers have clinically more severe disease, increased airway inflammation, increased impact on health status, increased rate of bacterial colonization and higher number of exacerbations compared to COPD sputum non-producers 2) Induced sputum is repeatable over short term in COPD persistent sputum producers 3) Expression of MUC5B, HIF-1α and CAIX is increased in COPD persistent sputum producers compared to COPD sputum non-producers, smokers with normal lung function and healthy non-smokers 4) HIF-1α can potentially cause increased MUC5B expression. This work reveals potential targets for the development of novel therapies to limit mucous hypersecretion in COPD.
17
Arnardóttir, Ragnheiður Harpa. "Physical training and testing in patients with chronic obstructive pulmonary disease (COPD) /." Uppsala : Acta Universitatis Upsaliensis, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7632.
Full text
18
Haddad, Donna L. "Nutritional status indicators in hospitalized patients with chronic obstructive pulmonary disease (COPD)." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=67536.
Full textAbstract:
Malnutrition, as evidenced by low weight for height, low triceps skinfold thickness and low midarm muscle circumference, is prevalent among COPD patients. A stepped decline in nutritional status has been postulated as a mechanism for malnutrition wherein patients progressively suffer weight loss with each COPD exacerbation. A randomized clinical trial of continuous enteral nutrition could not successfully address whether or not the stepped decline in weight can be prevented. Despite this, sixteen patients admitted for a COPD exacerbation, participated in an observational prospective study wherein anthropometric, biochemical, dynamometric, respiratory, general well-being and energy consumption measures were obtained. Twelve patients had body weights below 90% of ideal weight. The mean energy intake was 107% $ pm$ 30 of estimated resting energy expenditure. Measures were repeated to assess changes during hospitalization. Weight change was a poor indicator of nutritional status. Midarm muscle circumference and handgrip strength appear to be useful as nutritional status indicators among unstable hospitalized COPD patients. Changes in handgrip strength and midarm muscle circumference were closely linked (r =.78, p $<$ 0.0005) and tended to decrease over the course of hospitalization despite clinical improvement. In the absence of adequate nutrition, COPD patients have at least as much risk of developing iatrogenic malnutrition as are other hospitalized medical patients.
19
Rossi, Stephanie. "COPD patients responding to Tiotropium with dyspnea relief: a proof of efficacy?" Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=66898.
Full textAbstract:
Characteristics of COPD patients who respond to Tiotropium with dyspnea relief Rossi, S., Glady, C., Baril, J., Perrault, H. and Bourbeau, J., RECRU, Montréal Chest Institute, McGill University, Montréal, Québec, Canada. Introduction: Our prescription practice is based essentially on patient self-reporting dyspnea relief. Objective: To assess whether COPD patients (pts) who reported dyspnea relief "tiotropium responders" provide similar response on repeated treatment attempt, and examine the potential underlying physiological determinants of the response. Method: A randomized (TIO or placebo), two-treatment period (2-weeks each), double-blind, cross-over design was conducted using pts characterised as "responder" based on self-reported dyspnea relief and a 1-point decrease on the TDI after the initial 2-week washout period. Each treatment period was preceded by a 2-week washout. Pts were taking Atrovent® and continue their regular medication except for TIO. Total lung capacity (TLC) and inspiratory capacity (IC) were obtained at rest (static hyperinflation) while IC, breathing frequency (BF), tidal volume (VT) and ventilation (VE) and Borg dyspnea scores were obtained at the end of steady-state cycling at 40% and 75% of peak power under both treatment. Paired t-test and a non-parametric analysis were done on all physiological outcomes versus dyspnea scores, as assessed by the TDI and CRQ at each visit. Results: Of the 21 pts recruited, 7 pts (69 ± 7 yrs; FEV1 33 ± 15% pred) drop out due to worsening of respiratory symptoms during washout (n=4) and during placebo treatment period (n=3). In the remaining 14 pts (67 ± 9 yrs; FEV1 55 ± 14%pred), 11 and 10 pts reported decreases in dyspnea on the TDI and CRQ respectively, under TIO. Decreases in dyspnea corresponded to increases in exercise IC and BF in 7 pts and decreases in TLC rest in 7 pts as compared to placebo. Improvements in Borg scores duringLes caractéristics des patients MPOC qui répondent au tiotropium par un soulagement de dyspnée Rossi, S., Baril, J., Gladis, C., Perrault, H. et Bourbeau, J., Épidémiologie respiratoire et Unité de recherches cliniques, Institut thoracique de Montréal, Université McGill, Montréal, Québec, Canada. Introduction : Notre pratique en matière de prescription est basée essentiellement sur le soulagement de dyspnée exprimé par le patient. Objectif : Évaluer si les patients MPOC qui ont rapporté un soulagement de dyspnée, « répondeur tiotropium », fournissent une réponse semblable sur la tentative répétée du traitement, et examiner les causes déterminantes physiologiques de la réponse. Méthode : La période de deux traitements (deux semaines chacun) randomisés (TIO ou placebo) à double anonymat croisé, en utilisant des patients caractérisés en tant que « répondeur » basé sur leurs rapports individuels de soulagement dyspnée et de la diminution d'un point sur le TDI après la période initiale d'élimination de deux semaines. Les patients prenaient Atrovent® et continuaient leur médicament habituel excepté le TIO. La capacité pulmonaire totale (TLC) et la capacité inspiratoire (IC) ont été obtenues au repos (hyperinflation statique) tandis que l'IC, la fréquence de respiration (BF), le volume courant (VT), la ventilation (VE), et les pointages de dyspnée de Borg ont été obtenus pendant effort constant à 40 % et à 75 % de puissance maximale pour les deux traitements. Le test t pour échantillons appariés et une analyse non-paramétrique ont été faites sur tous les résultats physiologiques contre les pointages de dyspnée évaluée par le TDI et le CRQ à chaque visite. Résultats : Des 21 patients recrutés, 7 patients (± 69 7 ans; FEV1 33 que le ± 15 % pred) ont lâché en raison de la détérioration des symptômes respiratoires pendant la période d'élimin
20
Fung, Yiu-ting Tina, and 馮耀婷. "Evidence-based clinical practice guidelines of smoking cessation programs for COPD patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46581856.
Full text
21
Elander, Astrid. "Adherence to inhalation technique and drugsin general in asthma- and COPD-patients." Thesis, Umeå universitet, Farmakologi, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-157698.
Full text
22
Wright, Peter Richard. "The clinical effects of specific exercise interventions in CHF and COPD patients." Doctoral thesis, Universitätsverlag der Technischen Universität Chemnitz, 2013. https://monarch.qucosa.de/id/qucosa%3A19942.
Full textAbstract:
End-stage conditions such as chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) have shown some of the most dramatic increases in mortality in the developed world over the past 40 years. Both are therefore leading causes of morbidity and mortality worldwide and should be considered as a major economic and social burden that is both substantial and increasing.
In these conditions, exercise therapy should play an integral part in maintaining the patient’s maximal level of independence and functioning, as well as slowing or possibly even stopping the progression of the condition. In this context the main objectives of these doctoral theses are:
a. Proving the safety of different exercise modalities.
b. Identifying the most effective exercise interventions in regards to clinical parameters.
c. Proving the feasibility of outpatient rehabilitation programmes for these high risk populations.
This work, therefore, combines three studies looking into the effects of non-pharmaceutical interventions – predominantly different exercise regimes in the two major conditions in the mortality statistics of CHF and COPD - both with a very poor prognosis.
In conclusion it can be said that the results and experience of all three studies demonstrate the safe feasibility of different outpatient exercise interventions and suggest specific positive adaptations in patients with heart failure and COPD which also led to a lower hospitalisation rate. There are clear hints that the therapy spectrum could be supplemented significantly by specific training interventions. The financial implications for any health care system are also highly relevant.
23
Wright, Peter Richard. "The clinical effects of specific exercise interventions in CHF and COPD patients." Doctoral thesis, Universitätsbibliothek Chemnitz, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:ch1-qucosa-122066.
Full textAbstract:
End-stage conditions such as chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) have shown some of the most dramatic increases in mortality in the developed world over the past 40 years. Both are therefore leading causes of morbidity and mortality worldwide and should be considered as a major economic and social burden that is both substantial and increasing.
In these conditions, exercise therapy should play an integral part in maintaining the patient’s maximal level of independence and functioning, as well as slowing or possibly even stopping the progression of the condition. In this context the main objectives of these doctoral theses are:
a. Proving the safety of different exercise modalities.
b. Identifying the most effective exercise interventions in regards to clinical parameters.
c. Proving the feasibility of outpatient rehabilitation programmes for these high risk populations.
This work, therefore, combines three studies looking into the effects of non-pharmaceutical interventions – predominantly different exercise regimes in the two major conditions in the mortality statistics of CHF and COPD - both with a very poor prognosis.
In conclusion it can be said that the results and experience of all three studies demonstrate the safe feasibility of different outpatient exercise interventions and suggest specific positive adaptations in patients with heart failure and COPD which also led to a lower hospitalisation rate. There are clear hints that the therapy spectrum could be supplemented significantly by specific training interventions. The financial implications for any health care system are also highly relevant.
24
Lau, Wai-lee Cherry, and 劉慧莉. "Outcomes of COPD patients receiving long term oxygen therapy: a retrospective cohort study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2001. http://hub.hku.hk/bib/B3197014X.
Full text
25
He, Yongyi, and 何勇毅. "Evaluation of quality of life in Hong Kong COPD patients using SF-6D." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45172262.
Full text
26
Pike, Elizabeth. "Development of a questionnaire to measure self-conscious emotions in patients with COPD." Thesis, University of Leicester, 2018. http://hdl.handle.net/2381/43015.
Full textAbstract:
Chronic obstructive pulmonary disease (COPD) is a respiratory condition which can severely limit physical and social activities. Self-management and pulmonary rehabilitation programmes are commonly used to enhance clinical outcomes and quality of life in patients with COPD. However, completion rates for treatment programs are low and psychological factors remain poorly understood. The current literature review aimed to explore the impact of self-management programmes on psychological wellbeing in individuals with COPD. Four electronic databases were searched and fifteen studies met the inclusion criteria. Findings suggested that self-management programmes appeared to have some beneficial effect on psychological wellbeing, however due to the lack of good quality studies and methodological limitations, strong conclusions could not be drawn. Conclusions suggested a need for a more standardised and theoretically driven approach to be taken, and for future research to look at a wider definition of psychological wellbeing factors. The current empirical study aimed to develop a brief and clinically-based questionnaire that could be self-administered in outpatient settings to assess the level of self-conscious emotions experienced by patients with COPD. An empirical approach to scale development was utilised across four phases to develop the COPD Self-conscious Emotion Scale (CSES). Principal Component Analysis of the CSES suggested an 11-item measure comprising an underlying two subscale structure of 'guilt and embarrassment', and 'shame-based avoidance', best fitted the data. Findings were discussed in relation to previous literature, and clinical implications and recommendations for future research were suggested. The critical appraisal presents a reflective account of the research process, including the trainees' professional and personal development, with the aim of maximizing transparency.
27
Kinose, Daisuke. "NOD2 Gene Polymorphism was associated with prevalence and severity in Japanese COPD patients." Kyoto University, 2012. http://hdl.handle.net/2433/152499.
Full text
28
Lau, Wai-lee Cherry. "Outcomes of COPD patients receiving long term oxygen therapy a retrospective cohort study /." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk/hkuto/record.jsp?B23316767.
Full text
29
Gibson, Shekeita. "Thirty-Day Readmission Risk Factors of African American Adult COPD Patients With Tracheostomies." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7005.
Full textAbstract:
The purpose of this study was to assess the association between hospital readmission and demographic variables (age, BMI, gender, income, marital status, comorbidities, and smoking history), and size and type of tracheostomy among African American chronic obstructive pulmonary disease (COPD) patients with tracheostomies. The Andersen model was the theoretical framework for this quantitative study. Secondary data were obtained from a long-term acute care facility. The sample comprised 438 African American adult patients admitted between 2010 and 2017. Logistic regression was used to analyze each research question and assess the odds of 30-day hospital readmission. The results indicated that the odds of readmission did not differ based on age, gender, marital status, income, smoking history, BMI, sepsis, congestive heart failure, hypertension, stoma cellulitis or size of tracheostomy. There was a significant relationship between the type of tracheostomy and odds of readmission, diabetes diagnosis, and odds of readmission. These findings suggest when controlling for length of stay, there is no association between age, gender, marital status, income, smoking history, BMI, sepsis, congestive heart failure, hypertension, stoma cellulitis or size of tracheostomy and hospital readmissions among African American COPD patients with tracheostomies. The results of this study provide information that may be useful for discharge planning and program implementation research. Such planning and research might help to reduce rates of hospital readmissions and as a result lower healthcare costs for African American COPD patients with tracheostomies.
30
Sohanpal, Ratna. "Understanding the reasons for non-participation in self-management interventions amongst patients with chronic conditions : addressing and increasing opportunities for patients with advanced chronic obstructive pulmonary disease to access self-management." Thesis, Queen Mary, University of London, 2015. http://qmro.qmul.ac.uk/xmlui/handle/123456789/15031.
Full textAbstract:
Background: In chronic obstructive pulmonary disease (COPD), understanding the problem of poor patient participation in evidence-based self-management (SM) and pulmonary rehabilitation (PR) programmes (together referred to as SM support programmes) is critical. This thesis aimed to improve understanding of poor patient participation and retention in these programmes; how participation might be improved; and how might patients be better supported with their SM. Methods: Using the Medical Research Council guidance on complex interventions this thesis (1) quantified the 'actual' patient participation and completion rates; (2) explained, using theory, the factors that influenced participation in studies of SM support including the programmes among chronic disease and COPD patients; and (3) explored patient and expert stakeholders' perspectives on the reasons for non-participation in SM support programmes, how participation might be improved, how might patients be supported with their SM. Results: (1) Among 56 studies, high study participation rates and completion rates were seen however, the incomplete reporting of participant flow confused the problem of participation. (2) Among 31 studies, participation among patients with chronic disease including COPD was shown to be influenced by their 'attitude' and 'perceived social influence/subjective norms'; 'illness' and 'intervention perceptions'. (3) From 38 interviewees, besides patients' beliefs, non-participation was also influenced by resignation and denial of the illness; health systems; and programme organisational factors. Professionals building relationships and supporting patients with their SM alongside programme organisational improvements might encourage patient participation in SM and the programmes. Conclusions Patient participation is a complex behaviour, besides socio-behavioural factors, participation behaviour can by influenced by a mix of several health system and programme organisational factors. Changing the behaviour of health professionals and indeed the wider health system, towards normalising a patient partnership approach, with implementation of SM support in routine care might help more patients to consider participation in their care and improve patient participation in COPD SM support programmes.
31
O'Brien, Grainne. "Examination of the contribution of mindfulness and catastrophising to the presence of anxiety and frequency of COPD related hospital admissions in COPD patients." Thesis, University of Edinburgh, 2014. http://hdl.handle.net/1842/16453.
Full textAbstract:
Purpose: The aim of the systematic review was to explore the role that anxiety plays in hospital admissions for those with Chronic Obstructive Pulmonary Disease (COPD). The empirical study aimed to examine whether the frequency of COPD related admissions is related to psychological factors (anxiety, depression, catastrophising, and mindfulness), disease severity, perceived disability and demographic factors. It also sought to examine whether cognitive factors (mindfulness and catastrophising) may explain unique variance in predicting anxiety and COPD-related admissions when other relevant factors are controlled for. Methods: The literature was systematically searched for research related to the predictive power of anxiety in relation to COPD related hospital admissions. A postal cross-sectional survey of 54 people with COPD examined the psychological profile of those who are admitted to hospital for COPD, and if mindfulness and catastrophising can predict anxiety and COPD hospital admissions. Correlations and multiple regressions were utilised to explore these hypotheses. Results: Fourteen studies met inclusion criteria for the systematic review, demonstrating mixed results regarding whether anxiety plays a role in COPD related hospital admissions. Findings from the empirical study suggest that a significant relationship exists between disease severity and number of COPD hospital admissions and catastrophising and overall mindfulness predicted 16.3% of variance in COPD hospital admissions (non-significant). Anxiety scores were significantly correlated with breathlessness, depression, catastrophising and mindfulness with catastrophising and mindfulness predicting 22.3% of variance in anxiety (significant). Conclusions: Further research with robust measures of anxiety and hospital utilization are needed to aid our understanding of the role of anxiety in COPD related admissions. Further research is necessary to determine if mindfulness and catastrophising are useful constructs in predicting anxiety levels and hospital admissions in those with COPD. This will help to inform future psychological interventions with this population.
32
Donaire, Gonzalez David. "Measure and effects of physical activity in patients with Chronic Obstructive Pulmonary Disease (COPD)." Doctoral thesis, Universitat Ramon Llull, 2015. http://hdl.handle.net/10803/347216.
Full textAbstract:
Antecedents: La Malaltia Pulmonar Obstructiva Crònica (MPOC) és una de les principals causes de mortalitat i discapacitat a nivell mundial. L'activitat física és un dels pocs factors modificables que desacceleren l'evolució de la MPOC. No obstant, la dosi i les característiques de l'activitat física responsables de la desacceleració són encara desconegudes. En conseqüència, els objectius d'aquesta tesi són avançar i perfeccionar la metodologia i els instruments per avaluar l'activitat física realitzada pels malalts amb MPOC, aprofundir en el coneixement sobre les característiques i els patrons de la seva activitat física i determinar quines característiques de l'activitat física milloren el pronòstic dels malalts amb MPOC. Mètodes: Han participat 177 individus amb MPOC estable seleccionats de 8 hospitals a Espanya (94% homes, edat mitjana±DE 71±8 anys, volum expiratori forçat en 1 s 52±16% i índex de massa corporal 29±5 kg·m-2). L'activitat física va ser mesurada per un acceleròmetre (SenseWear® Pro2 Armband) i per un qüestionari (Yale Physical Activity Survey, YPAS). Les variables sociodemogràfiques (edat, sexe, estat civil, nivell educatiu, nivell socioeconòmic, situació laboral i hàbit tabàquic) i les variables clíniques (limitació al flux d'aire, hiperinsuflació pulmonar, díspnea, intercanvi de gasos, inflamació sistèmica i local, composició corporal, comorbiditats, qualitat de vida i capacitat d'exercici), es van obtenir utilitzant instruments validats i seguint les normes internacionals. La informació sobre l'evolució de la malaltia (els ingressos hospitalaris i la mortalitat) es va obtenir dels registres dels governs. Resultats: (Objectiu 1) El YPAS és una eina vàlida per a la detecció precoç de la inactivitat dels individus amb MPOC [àrea sota la corba ROC (95% IC) = 0.71 (0,63-0,79)]. (Objectiu 2) El 97% dels individus amb MPOC són capaços de realitzar episodis de 10 minuts d'activitat física moderada-vigorosa. Més del 50% dels individus amb MPOC compleixen amb les recomanacions de l'Organització Mundial de la Salut sobre l'activitat física per a la gent gran. La quantitat d'activitat física, la proporció d'aquesta activitat realitzada en episodis de 10 minuts i la freqüència d'aquests episodis va disminuir amb l'augment de la gravetat de la MPOC. (Objectiu 3) La quantitat i la intensitat de l'activitat física són determinants independents de l'evolució de la MPOC. El risc d'hospitalització per MPOC és un 20% menor per cada 1000 passos diaris addicionals realitzats en baixa intensitat. No obstant, una major quantitat de passos diaris a una alta intensitat mitjana no influeix en el risc d'hospitalització per MPOC (HR = 1.01; p = 0,919). Conclusions: El YPAS és una eina vàlida per a la detecció precoç dels individus amb MPOC físicament inactius. Els pacients amb MPOC greu i molt greu realitzen menys episodis i quantitat d'activitat física, i tenen menor la ràtio entre episodis i quantitat que en aquells en estat lleu i moderat. Una major quantitat d'activitat física de baixa intensitat redueix el risc d'hospitalització per MPOC.Antecedentes: La Enfermedad Pulmonar Obstructiva Crónica (EPOC) es una de las principales causas de mortalidad y discapacidad a nivel mundial. La actividad física es uno de los pocos factores modificables que desaceleran la evolución de la EPOC. Sin embargo, la dosis y las características de la actividad física responsables de la desaceleración son todavía desconocidas. En consecuencia, los objetivos de esta tesis son avanzar y perfeccionar la metodología e instrumentos para evaluar la actividad física realizada por los enfermos con EPOC, profundizar en el conocimiento sobre las características y patrones de su actividad física y determinar qué características de la actividad física mejoran el pronóstico de los enfermos con EPOC. Métodos: Han participado 177 individuos con EPOC estable seleccionados de 8 hospitales en España (94% hombre, edad media±DE 71±8 años, volumen espiratorio forzado predicho en 1 s 52±16% e índice de masa corporal 29±5 kg·m-2). La actividad física fue medida por un acelerómetro (SenseWear® Pro2 Armband) y por un cuestionario (Yale Physical Activity Survey, YPAS). Las variables sociodemográficas (edad, sexo, estado civil, nivel educativo, nivel socioeconómico, situación laboral y hábito tabáquico) y las variables clínicas (limitación al flujo aereo, hiperinsuflación pulmonar, disnea, intercambio de gases, inflamación sistémica y local, composición corporal, comorbilidades, calidad de la vida y capacidad de ejercicio), se obtuvieron utilizando instrumentos validados y siguiendo las normas internacionales. La información sobre la evolución de la enfermedad (ingresos hospitalarios y mortalidad) se obtuvo de los registros gubernamentales. Resultados: (Objetivo 1) El YPAS es una herramienta válida para la detección precoz de la inactividad de los individuos con EPOC [área bajo la curva ROC (95% IC) = 0.71 (0.63-0.79)]. (Objetivo 2) El 97% de los individuos con EPOC son capaces de realizar episodios de 10 minutos de actividad física moderada-vigorosa. Más del 50% de los individuos con EPOC cumplen con la recomendación de la Organización Mundial de la Salud sobre actividad física para las personas mayores. La cantidad de actividad física, la proporción de ésta realizada en episodios de 10 minutos y la frecuencia de estos episodios disminuyó con el aumento de la gravedad de la EPOC. (Objetivo 3) La cantidad y la intensidad de la actividad física son determinantes independientes de la evolución de la EPOC. El riesgo de hospitalización por EPOC es un 20% menor por cada 1000 pasos adicionales realizados en baja intensidad media. Sin embargo, una mayor cantidad de pasos diarios a una alta intensidad media no influye en el riesgo de hospitalización por EPOC (HR = 1.01; p = 0,919). Conclusiones: El YPAS es una herramienta válida para la detección precoz de los individuos con EPOC físicamente inactivos. Los pacientes con EPOC grave y muy grave realizan menos episodios y cantidad de actividad física, y tienen menor el ratio entre episodios y cantidad que en aquellos en estado leve y moderado. Una mayor cantidad de actividad física de baja intensidad reduce el riesgo de hospitalización por EPOC.
Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of worldwide mortality and disability. Physical activity is one of the few modifiable factors that decelerate COPD evolution. Nonetheless, the dose and characteristics of physical activity responsible of the deceleration are still unknown. In consequence, the aims of this thesis are to move forward and refine the methodology and instruments to evaluate the physical activity of COPD individuals, go in depth in the knowledge about the characteristics and the pattern of their physical activity, and determine which physical activity characteristics improve the prognosis of COPD patients. Methods: 177 individuals with stable COPD selected from 8 hospitals in Spain have participated (94% male, mean±SD age 71±8 years, forced expiratory volume in 1 s 52±16% predicted and body mass index 29±5 kg·m-2). Physical activity was measured with an accelerometer (SenseWear® Pro2 Armband) and with a questionnaire (Yale Physical Activity Survey, YPAS). The sociodemographic (age, sex, civil status, educational level, socioeconomic status, employment status, and tobacco habit) and clinical variables (airflow limitation, lung hyperinflation, dyspnoea, gas exchange, local and systemic inflammation, body composition, comorbidities, quality of life, and exercise capacity), were obtained using validated tools and following international standards. Information about the evolution of the disease (Hospital Admissions and Mortality) was obtained from government registries. Results: (Objective 1) The YPAS is a valid tool for the detection of COPD individuals’ inactivity [the area under the ROC curve is 0.71 (95% CI: 0.63–0.79)]. (Objective 2) The 97% of COPD individuals are able to perform 10-minutes bouts of moderate-to-vigorous physical activity. More than 50% of the COPD individuals met the World Health Organization recommendation of physical activity for the elderly. The quantity of physical activity, the percentage of activity done in bouts and the frequency of bouts decreased with increasing COPD severity. (Objective 3) The quantity and the intensity of physical activity are independent determinants of the COPD evolution. Every additional 1000 daily steps at low-average intensity reduce by 20% the risk of COPD hospitalisation. However, a greater quantity of daily steps at high-average intensity does not influence the risk of COPD hospitalisation (HR 1.01, p=0.919). Conclusion: The YPAS is a valid instrument for the early screening of COPD patients who run the risk of sedentarism. Patients with severe and very severe COPD perform fewer bouts and less quantity of physical activity, and have lower ratio between bouts and quantity than those in mild and moderate stages. Higher quantity of low-intensity physical activity reduces the risk of COPD hospitalization.
33
Nasr, Abir. "The prevalence of COPD among patients suspected for pulmonary embolism using V/P SPECT." Thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-50802.
Full text
34
Bissonnette, Janice. "The feasibility of developing, implementing, and evaluating an educational intervention for hospitalized COPD patients." Thesis, University of Ottawa (Canada), 2000. http://hdl.handle.net/10393/8669.
Full textAbstract:
Objective. Development and reinforcement of self-management skills for patients with Chronic Obstructive Pulmonary Disease (COPD) is an ongoing challenge. As the disease advances, hospitalizations increase, managing respiratory infections and medication administration become more difficult for patients. Pulmonary rehabilitation programs assist patients with mastery of self-management skills but access is limited. In 1996 less than two percent of Canadian COPD patients participated in rehabilitation programs. Hospitalization provides opportunity for interventions aimed at reinforcing self-management strategies. The following study sought to determine the feasibility of providing and evaluating an education intervention tailored to hospitalized COPD patients. Design. Feasibility pre-test post-test method. Setting. Three medical wards of a tertiary care teaching hospital. Participants. Convenience sample of 20 patients admitted with COPD/COPD exacerbation. Intervention. Participants received a maximum of three, 40 minute sessions during hospitalization. Content delivery was tailored to participants' learning needs and low self-efficacy areas. Based on Self-Efficacy Theory, teaching strategies included performance accomplishment, role modeling, and positive reinforcement. Outcome measures. Learning needs, descriptive and clinical data, program evaluation, COPD Self-Efficacy Scale (CSES) and Dartmouth Functional Health Status (FHS) Charts. Results. Key learning needs included: inappropriate medication inhalation technique (n = 19), lack of disease acknowledgement (n = 16), no previous self-management education (n = 10). Health care providers identified the need for better access to educational materials for patients and family members. FHS, in five of the nine domains, and CSES scores (z = 3.51, p = .004) improved. Participants evaluated the experience as positive and recommended the intervention for other patients (n = 20). Conclusions. An educational intervention for hospitalized COPD patients can feasibly be developed, implemented and evaluated.
35
Christenhusz, Lieke Cornelia Anna. "Smoking cessation in COPD patients (cost-)effectiveness of the smokestoptherapy and validation of abstinence /." Enschede : University of Twente [Host], 2006. http://doc.utwente.nl/55444.
Full text
36
Hryniuk, O. Ye. "Treatment optimization of non-alcoholic steatohepatitis in obese patients according to comorbidity with COPD." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19612.
Full text
37
Stulce, Jill. "Low-Flow Domiciliary Oxygen as a Mechanism of Ongoing Oxidative Stress in COPD Patients." VCU Scholars Compass, 2015. http://scholarscompass.vcu.edu/etd/4076.
Full textAbstract:
Healthcare costs are escalating in the U.S., with a projected 48 trillion dollars by 2021. More than ever medical researches are obligated to ensure that costly treatment modalities are safe and effective. Chronic obstructive pulmonary disease (COPD) is a costly and debilitating disease, ranked as the third leading cause of death in America. Currently, treatment for COPD consists of anti-inflammatory agents, bronchodilators, antibiotics and supplemental oxygen when hypoxemia or clinical manifestations ensue. Oxidative stress is central to the pathology of COPD. Supplemental oxygen has been substantiated as an instigator of oxidative stress; however, LFDO has not been evaluated as a mechanism of ongoing oxidative stress in individuals with COPD. Isofuran (IsoF), a biosynthetic relative of the validated oxidative stress biomarker 8-isoprostane, is preferentially synthesized during periods of increased tissue oxygen tension. This sort of specificity allows for refinement in the assessment of supplemental oxygen as a source of oxidative stress. To address this potential this study evaluated individuals diagnosed with COPD utilizing LFDO. The study also aimed to determine if IsoF possessed clinical application in predicting the standard pulmonary function test (PFT) parameters of FEV1, FVC, FEV1/FVC and FEF25-75. The exhaled breath condensate (EBC) of 52 individuals with COPD was evaluated for the presence of IsoF. An active control group not receiving LFDO (n=26) was compared to an active treatment group receiving LFDO for a minimum of 6 hrs/day (n=26). The groups showed no statistically significant demographic differences in age, gender, height, weight, ethnicity or smoking history or in the pulmonary function test parameters of FEV1, FVC, and FEV1/FVC, with the exception of the FEF25-75 (P=0.03). The active control group generated a mean EBC IsoF level of 35.81 ± 4.91 pg/ml (± SEM) compared to the active treatment group mean EBC IsoF level of 51.37 ± 8.27 pg/ml (P=0.057). Currently, no research has been conducted that defines baseline EBC IsoF levels in healthy or diseased lungs. No statistically significant differences in mean EBC IsoF levels were noted between the control and treatment groups; however, the results, in conjunction with the only two studies available utilizing EBC IsoF as an oxidative stress biomarker, may serve to provide benchmark information for future research regarding individuals with diseased lungs, specifically COPD.
38
Guo, Jing. "Assessment of Health Outcomes for Chronic Obstructive Pulmonary Disease (COPD) Patients Using Long-acting Beta2- Agonists." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1367938331.
Full text
39
Rittmaster, Dana. "Anthropometric, clinical and lifestyle determinants of exercise energy expenditure in patients with chronic obstructive pulmonary disease (COPD)." Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=82412.
Full textAbstract:
Total body fat and muscle mass depletion has been reported in some patients with COPD. This study used simple anthropometric measurements to compare the body composition of patients with moderate-severe COPD to that of healthy controls, and examines relationships between body composition, disease severity, habitual physical activity and resting and exercise energy expenditure. Results show no significant differences in overall Heath-Carter somatotype characteristics, percent body fat, fat free mass and girth measurements between COPD and control subjects although when stratified by gender, female COPD patients exhibited a greater body fat component. Measured VO2 (L/min) at rest or during steady-state exercise was not significantly different between COPD and control subjects despite a higher exercise ventilation in patients. Neither resting or exercise energy expenditure was related to body composition, however it was related to DLCO/VA (ml·min-1·mmHg -1·L-1). Findings from this study suggest that COPD patients capable of participating in dynamic exercise studies do not exhibit total body fat and muscle depletion. Findings in women suggest that the relative decrease in FFM may be related to a relatively higher proportion of body fat and not a decrease in absolute muscle mass.
40
Al-Khdour, Maher Rateb. "An integrated disease and medicines management programme for patients with chronic obstructive pulmonary disease (COPD)." Thesis, Queen's University Belfast, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.501233.
Full text
41
Doel, Thomas MacArthur Winter. "Developing clinical measures of lung function in COPD patients using medical imaging and computational modelling." Thesis, University of Oxford, 2012. http://ora.ox.ac.uk/objects/uuid:34bbf6fd-ea01-42a2-8e99-d1e4a3c765b7.
Full textAbstract:
Chronic obstructive pulmonary disease (COPD) describes a range of lung conditions including emphysema, chronic bronchitis and small airways disease. While COPD is a major cause of death and debilitating illness, current clinical assessment methods are inadequate: they are a poor predictor of patient outcome and insensitive to mild disease. A new imaging technology, hyperpolarised xenon MRI, offers the hope of improved diagnostic techniques, based on regional measurements using functional imaging. There is a need for quantitative analysis techniques to assist in the interpretation of these images. The aim of this work is to develop these techniques as part of a clinical trial into hyperpolarised xenon MRI. In this thesis we develop a fully automated pipeline for deriving regional measurements of lung function, making use of the multiple imaging modalities available from the trial. The core of our pipeline is a novel method for automatically segmenting the pulmonary lobes from CT data. This method combines a Hessian-based filter for detecting pulmonary fissures with anatomical cues from segmented lungs, airways and pulmonary vessels. The pipeline also includes methods for segmenting the lungs from CT and MRI data, and the airways from CT data. We apply this lobar map to the xenon MRI data using a multi-modal image registration technique based on automatically segmented lung boundaries, using proton MRI as an intermediate stage. We demonstrate our pipeline by deriving lobar measurements of ventilated volumes and diffusion from hyperpolarised xenon MRI data. In future work, we will use the trial data to further validate the pipeline and investigate the potential of xenon MRI in the clinical assessment of COPD. We also demonstrate how our work can be extended to build personalised computational models of the lung, which can be used to gain insights into the mechanisms of lung disease.
42
Perumal, Rubeshan. "The relationship between clinical trial participation and inhaler technique errors in asthma and COPD patients." Master's thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33928.
Full textAbstract:
Background Incorrect inhaler use is associated with poorer health outcomes, reduced quality of life, and higher healthcare utilisation in patients with asthma and COPD. Method We performed an observational study of pressurized metered-dose inhaler technique in patients with asthma or COPD. Patients were assessed using a six-point inhaler checklist to identify common critical inhaler technique errors. An inadequate inhaler technique was defined as the presence of one or more critical errors. A multivariate logistic regression model was used to determine the odds of an inadequate inhaler technique. Results During the 14-month study period, 357 patients were enrolled. At least one critical error was executed by 66.7% of participants, and 24.9% made four or more critical errors. The most common errors were: failure to exhale completely prior to pMDI activation and inhalation (49.6%), failure to perform a slow, deep inhalation following device activation (48.7%), and failure to perform a breathhold at the end of inspiration (47.3%). The risk of a critical error was higher in COPD patients (aOR 2.25, 95%CI 1.13 – 4.47). Prior training reduced error risk specifically when trained by a doctor (aOR 0.08, 95% CI 0.1 – 0.57) or a pharmacist (aOR 0.02, 95% CI 0.01 – 0.26) compared to those with no training. Previous clinical trial participation significantly reduced error risk and rate:< 3 trials (aOR 0.35, 95% CI 0.19 – 0.66) and ≥3 trials (aOR 0.17, 95% CI 0.07 – 0.42). The rate of critical errors was not significantly associated with age, sex, or prior pMDI experience. Conclusion This study found a high rate of critical inhaler technique errors in a mixed population of asthma and COPD patients; however, prior training and in particular, multiple previous clinical trial participation significantly reduced the risk of errors.
43
Preusser, Barbara Ann. "The effects of high versus low intensity inspiratory muscle interval training in patients with COPD /." The Ohio State University, 1992. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487776801322686.
Full text
44
Tatari, Wisam. "Using Pharmacist-Led Tele-Consultation to Review Patients with Chronic Obstructive Pulmonary Disease." Thesis, University of Bradford, 2018. http://hdl.handle.net/10454/17311.
Full text
45
Machado, Stacey Jerrick. "Reducing 30-Day Readmission Rates in Chronic Obstructive Pulmonary Disease Patients." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6609.
Full textAbstract:
Early avoidable 30-day post discharge readmission among patients diagnosed with chronic obstructive pulmonary disease (COPD) is associated with poor transition care processes. The purpose of this project was to analyze organizational system processes for admission and discharge transition care of patients diagnosed with COPD to identify key intervention strategies that could decrease the rate of 30-day post-discharge readmission by 1%. The project used the transitional care model as the framework to target specific care transition needs and create patient-centered, supportive, evidence-based relationships among the patient, the providers, the community, and the health care system to identify key intervention strategies for implementation. A retrospective chart review was conducted of transitional care management and care coordination practices of providers of patients diagnosed with COPD. Analysis of the data revealed that the local regional organization used a single, generic, computerized discharge planning and care transition process for patients diagnosed with COPD. As a result, missed opportunities to target a patient's specific care needs led to higher rates of readmission. The implications of the findings of this project for social change include identification of evidence-based recommendations and practices that could influence clinician practices and improve patient outcomes and the quality of health care delivery.
46
Hammonds, Tracy Lynn. "The Influence of the Caregiver on Healthcare Outcomes in Patients with Chronic Obstructive Pulmonary Disease (COPD)." Kent State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=kent1426543939.
Full text
47
Oguma, Tsuyoshi. "Longitudinal shape irregularity of airway lumen assessed by CT in patients with bronchial asthma and COPD." Kyoto University, 2016. http://hdl.handle.net/2433/215214.
Full textAbstract:
Final publication is available at http://thorax.bmj.com/content/70/8/719.longKyoto University (京都大学)
0048
新制・論文博士
博士(医学)
乙第13001号
論医博第2109号
新制||医||1016(附属図書館)
32929
京都大学大学院医学研究科医学専攻
(主査)教授 伊達 洋至, 教授 富樫 かおり, 教授 平家 俊男
学位規則第4条第2項該当
48
Rytilä, Paula. "Induced sputum for assessment of airway inflammation in patients with COPD, asthma and asthma-like symptoms." Helsinki : University of Helsinki, 2002. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/rytila/.
Full text
49
Janaudis-Ferreira, Tania. "Strategies for exercise assessment and training in patients with chronic obstructive pulmonary disease." Doctoral thesis, Umeå universitet, Sjukgymnastik, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-35565.
Full textAbstract:
Rationale: Chronic obstructive pulmonary disease (COPD) is not only a common lung disease but is a major cause of morbidity and mortality worldwide. Pulmonary rehabilitation (PR) helps optimize function and independence by increasing exercise capacity, reducing symptoms and improving health related quality of life (HRQL). Exercise training is certainly a key component of the PR programs; however, many of its aspects still need to be better defined such as optimal exercise assessment and training modality for these patients. The general purpose of this thesis was to generate new knowledge that could contribute to new strategies for exercise assessment and training in patients with COPD. Methods and results: This thesis is comprised of four independent studies. Thigh muscle strength, endurance and fatigue were compared between 42 patients with moderate to severe COPD and 53 healthy controls (Study I). Impaired thigh muscle strength and endurance in patients with COPD was found, except for muscle strength in knee extension in male patients. Female patients had higher fatigue index than female controls while no difference was found between male patients and controls. The six-minute walk test (6MWD) performed on a non-motorized treadmill (6MWD-T) was compared with the 6MWD performed in a corridor (6MWD-C) in 16 healthy elderly subjects (Study II). They performed twelve tests (six 6MWD-C and six 6MWD-T) on two different days in a randomized order. An average discrepancy was found between the two methods with the subjects walking a shorter distance on the non-motorized treadmill. However, the results showed good test-retest reliability between days and test repetitions. A systematic review (Study III) was done of studies that investigated the effects of an arm training program in patients with COPD. The findings of this review indicated that there is evidence that an arm training program improves arm exercise capacity, but its effects on dyspnea, arm fatigue and healthy-related quality of life is unclear. Finally, a two-armed randomized controlled trial examined the effects of an arm training program on arm function, arm exercise capacity, muscle strength, symptoms and HRQL in patients with COPD (Study IV). The groups were randomized to arm training or sham. Compared with the changes observed in the control group, the magnitude of change in the intervention group was greater for arm function, arm exercise capacity and muscle strength. There was no difference between groups in HRQL or symptoms. Conclusions: Upper extremity resistance training improves arm exercise capacity, arm function and muscle strength in patients with COPD. Training and assessment of upper and lower limb muscles should be included into PR programs. The 6MWD performed on a non-motorized treadmill may offer an alternative option to the standard 6MWD when a 30-meter corridor is not available.
50
Long, Risa Nicole. "The Moderating Influence of Patient and Caregiver Illness Perceptions on Psychological and Physical Outcomes of Coping Skills Training among Patients with Chronic Obstructive Pulmonary Disease." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1503056464182065.
Full text