Informal caregivers of patients with COPD: Home Sweet Home?

Nakken, Nienke; Janssen, Daisy J.A.; Bogaart, Esther H. A. van den; Wouters, Emiel F.M.; Franssen, Frits M.E.; Vercoulen, J.H.M.M.; Spruit, Martijn A.

doi:10.1183/16000617.00010114

Cited by 96 publications

(118 citation statements)

References 62 publications

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“…Our finding of increased residual dyspnea in the COPD cohort fits with prior studies that have shown impaired health-related quality of life for patients discharged after COPD exacerbation. 27, 28 In this patient group, the financial and emotional burden is high, 29 and increased residual dyspnea is a very plausible explanation for this.…”

Section: Discussionmentioning

confidence: 77%

The Trajectory of Dyspnea in Hospitalized Patients

DiNino

Stefan

Priya

et al. 2016

Journal of Pain and Symptom Management

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Context The trajectory of dyspnea for patients hospitalized with acute cardiopulmonary disease, who are not terminally ill, is poorly characterized. Objectives To investigate the natural history of dyspnea during hospitalization, and examine the role that admission diagnosis, and patient factors play in altering symptom resolution. Methods Prospective cohort study of patients hospitalized for an acute cardiopulmonary condition at a large tertiary care center. Dyspnea levels and change in dyspnea score were the main outcomes of interest and were assessed at admission, 24 and 48 hours and at discharge using the verbal 0 - 10 numeric scale. Results Among 295 patients enrolled, the median age was 68 years, and the most common admitting diagnoses were heart failure (32%), chronic obstructive pulmonary disease (COPD) (39%), and pneumonia (13%). The median dyspnea score at admission was 9 (interquartile range [IQR] 7, 10); decreased to 4 (IQR 2, 7) within the first 24 hours; and subsequently plateaued at 48 hours. At discharge, the median score had decreased to 2.75 (IQR 1, 4). Compared to patients with heart failure, patients with COPD had higher median dyspnea score at baseline and admission, and experienced a slower resolution of dyspnea symptoms. After adjusting for patient characteristics, the change in dyspnea score from admission to discharge was not significantly different between patients hospitalized with congestive heart failure, COPD or pneumonia. Conclusion Most patients admitted with acute cardiopulmonary conditions have severe dyspnea on presentation, and their symptoms improve rapidly after admission. The trajectory of dyspnea is associated with the underlying disease process. These findings may help set expectations for the resolution of dyspnea symptoms in hospitalized patients with acute cardiopulmonary diseases.

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Section: Discussionmentioning

confidence: 77%

The Trajectory of Dyspnea in Hospitalized Patients

DiNino

Stefan

Priya

et al. 2016

Journal of Pain and Symptom Management

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“…Previous research has acknowledged that older people with COPD depend on a carer for assistance, potentially resulting in considerable carer burden 8 9 14–16 23 24. However, in these studies there has been little focus on assistance with medicines, which is vital for treatment outcomes, yet contributes to carer burden 25.…”

Section: Discussionmentioning

confidence: 99%

Assistance of family carers for patients with COPD using nebulisers at home: a qualitative study

Alhaddad

Taylor

Robertson³

et al. 2015

Eur J Hosp Pharm

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ObjectiveFor many patients with chronic conditions, such as chronic obstructive pulmonary disease (COPD), the assistance of family carers with medicines is vital for optimal treatment outcomes. The aim of this study was to identify the assistance carers provide to patients with COPD using nebuliser-delivered therapy at home, and the problems experienced that may impact on the safety and effectiveness of therapy and contribute to carer burden.MethodsA cross-sectional, qualitative descriptive study was conducted with participants recruited from primary and intermediate care. Home interviews were conducted with 14 carers who assisted a family member with COPD using a nebuliser. Qualitative procedures enabled analysis of nebuliser-related activities and problems experienced by carers.ResultsThe carer sample included 10 female and 4 male carers, with a mean age of 61 years: 11 spouses and 3 daughters. They had assisted patients with use of their nebuliser and associated medications for, on average, 4.5 years. Assistance ranged from taking full responsibility for nebuliser use to providing help with particular aspects only when required. Nebuliser-related activities included assembling and setting up equipment, mixing medicines, operating the device, dismantling and cleaning equipment. Difficulties were described with all aspects of care. Carers reported concerns about medication side effects and the lack of information provided.ConclusionsThe study revealed the vital role of carers in enabling effective therapy. The wide-ranging responsibilities assumed by carers and problems experienced relate to all aspects of COPD management with nebulisers, and have a potential impact on treatment outcomes and carer burden. A systematic approach to addressing carers’ needs and prioritising support would be anticipated to have positive consequences for patients, carers and health services.

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“…La aparición de exacerbaciones y hospitalizaciones son situaciones angustiosas y estresantes para los cuidadores (Grant, Cavanagh, y Yorke, 2012), y se sabe que los cuidadores de pacientes con EPOC habitualmente experimentan una sobrecarga importante, así como sintomatología depresiva y ansiosa subclínica (Mansfi eld et al, 2016;Nakken et al, 2015;Miravitlles et al, 2015). La aparición de este tipo de sintomatología supone una disminución en la funcionalidad y la calidad de vida de los cuidadores, pues está relacionada con una mayor discapacidad en el funcionamiento psicosocial de la persona y, además, esto infl uye en la persona en situación de dependencia, ya que se relaciona con una disminución en la calidad de los cuidados que se le proporcionan (Váz-quez et al, 2015).…”

Section: Introductionunclassified

Factores asociados a la ansiedad de los cuidadores de pacientes con enfermedad pulmonar obstructiva crónica (EPOC) durante su hospitalización

García-Guillamón

2017

RPPC

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Factors associated with anxiety in caregivers of patients with chronic obstructive pulmonary disease (COPD) during their hospitalizationAbstract: Little is known about the impact that hospitalization of patients suffering from chronic obstructive pulmonary disease (COPD) has on the mental health of their caregivers. The purpose of this cross-sectional descriptive study was to determine rates and factors associated with symptoms of anxiety in caregivers of patients hospitalized for acute exacerbation of COPD (AECOPD). Anxiety symptoms related to four domains (context of care, caregiving demands, caregiver resources, and patient characteristics) were measured in 87 caregivers of patients hospitalized for AECOPD. We used multiple logistic regressions to determine protective factors of anxiety during the hospitalization time. Of the 87 participants, 50 caregivers reported symptoms of anxiety during hospitalization. Caregiver burden, frailty, and degree of airfl ow limitation were the strongest independent factors associated to caregiver's anxiety at the time of hospitalization.Key words: Anxiety; caregivers; chronic obstructive pulmonary disease; COPD; family care; acute exacerbation.Resumen: Se conoce poco acerca del impacto que tiene la hospitalización de los pacientes con exacerbación aguda de la enfermedad pulmonar obstructiva crónica (EPOC) en la salud mental de sus cuidadores. El objetivo de este estudio de tipo descriptivo transversal fue determinar las tasas y factores asociados a síntomas de ansiedad en los cuidadores de pacientes hospitalizados por exacerbación aguda de EPOC (EAEPOC). Se midieron síntomas de ansiedad relacionados con cuatro dominios (contexto del cuidado, demandas del cuidado, recursos del cuidador y características del paciente) en 87 cuidadores de pacientes hospitalizados por EAEPOC. Se utilizaron análisis de regresión logística múltiple para determinar los factores protectores de la ansiedad durante la hospitalización. De los 87 participantes, 50 cuidadores presentaron síntomas de ansiedad durante la hospitalización. La sobrecarga del cuidador, la fragilidad y el grado de limitación del fl ujo aéreo fueron los factores independientes más fuertes asociados a la ansiedad del cuidador durante la hospitalización.

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Informal caregivers of patients with COPD: Home Sweet Home?

Cited by 96 publications

References 62 publications

The Trajectory of Dyspnea in Hospitalized Patients

The Trajectory of Dyspnea in Hospitalized Patients

Assistance of family carers for patients with COPD using nebulisers at home: a qualitative study

Factores asociados a la ansiedad de los cuidadores de pacientes con enfermedad pulmonar obstructiva crónica (EPOC) durante su hospitalización

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