Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease

Abstract

Background and aims: Fatigue is associated with longitudinal ratings of health in patients with chronic obstructive pulmonary disease (COPD). Although the degree of airflow obstruction is often used to grade disease severity in patients with COPD, multidimensional grading systems have recently been developed. The aim of this study was to investigate the relationship between perceived and actual fatigue level and multidimensional disease severity in patients with COPD.
 Materials and methods: Twenty-two patients with COPD (aged 52-74 years) took part in the study. Multidimensional disease severity was measured using the SAFE and BODE indices. Perceived fatigue was assessed using the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). Peripheral muscle endurance was evaluated using the number of sit-ups, squats, and modified push-ups that each patient could do. Results: Thirteen patients (59%) had severe fatigue, and their St George’s Respiratory Questionnaire scores were significantly higher (p < 0.05). The SAFE index score was significantly correlated with the number of sit-ups, number of squats, FSS score and FIS score (p < 0.05). The BODE index was signif- icantly associated with the numbers of sit-ups, squats and modified push-ups, and with the FSS and FIS scores (p < 0.05).
 Conclusions: Peripheral muscle endurance and fatigue perception in patients with COPD was related to multidimensional disease severity measured with both the SAFE and BODE indices. Improvements in perceived and actual fatigue levels may positively affect multidimensional disease severity and health status in COPD patients. Further research is needed to investigate the effects of fatigue perception and exercise training on patients with different stages of multidimensional COPD severity.

A Mixed Methods Evaluation of a Pilot Multidisciplinary Breathlessness Support Service

“…In order to optimize capacity for symptom mastery as a key outcome of breathlessness support interventions, self-efficacy is an essential pre-requisite (Hoffman, 2013; Luckett et al, 2021; Spathis et al, 2017). Variability in self-efficacy may be attributed to a range of personal, socio-economic, health-related and symptom-related factors; and therefore, assessment of the factors which influence self-efficacy should be a foundational component of interventions which aim to promote mastery or self-management of complex symptoms (Foster et al, 2015; Grimmett et al, 2017; Inal-Ince et al, 2005). The MBSS service structure, aligns with the (BTF) Model (Spathis et al, 2017), and the Cambridge Breathlessness Intervention Service (Farquhar et al, 2014, 2016) (Figure 1; Table 1), and integrates holistic needs assessment.…”