Multidiscipline Treatment of Chronic Pulmonary Insufficiency

Agle, David P.; Baum, Gerald L.; Chester, Edward H.; Wendt, Miriam

doi:10.1097/00006842-197301000-00005

Cited by 111 publications

(40 citation statements)

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“…On the other hand, they showed that a combination of IMT and conventional rehabilitation decreased anxiety and depression. Several other studies [19][20][21] have also shown that a comprehensive approach, i.e. physiotherapy, education, and vocational counselling, may lead to an improvement in psychological status.…”

Section: Discussionmentioning

confidence: 99%

Quality of life in patients with chronic obstructive pulmonary disease improves after rehabilitation at home

Wijkstra¹,

Altena²,

Kraan³

et al. 1994

Eur Respir J

274

161

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Q Qu ua al li it ty y o of f l li if fe e i in n p pa at ti ie en nt ts s w wi it th h c ch hr ro on ni ic c o ob bs st tr ru uc ct ti iv ve e p pu ul lm mo on na ar ry y d di is se ea as se e i im mp pr ro ov ve es s a af ft te er r r re eh ha ab bi il li it ta at ti io on n a at t h ho om me e P.J. Wijkstra*, R. Van Altena*, J. Kraan* We studied 43 patients with severe airflow obstruction: forced expiratory volume in one second (FEV 1 ) 1.3±0.4 l (mean±SD), FEV 1 /inspiratory vital capacity (IVC) 37±7.9%. After stratification, 28 patients were randomly allocated in a home rehabilitation programme for 12 weeks. Fifteen patients in a control group received no rehabilitation. The rehabilitation group received physiotherapy by the local physiotherapist, and supervision by a nurse and a general practitioner. Quality of life was assessed by the four dimensions of the Chronic Respiratory Questionnaire (CRQ).We found a highly significant improvement in the rehabilitation group compared to the control group for the dimensions dyspnoea, emotion, and mastery. Lung function showed no changes in the rehabilitation group. The exercise tolerance improved significantly in the rehabilitation group compared to the control group. The improvement in quality of life was not correlated with the improvement in exercise tolerance.Rehabilitation of COPD patients at home may improve quality of life; this improvement is not correlated with an improvement in lung function and exercise tolerance.

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Section: Discussionmentioning

confidence: 99%

Quality of life in patients with chronic obstructive pulmonary disease improves after rehabilitation at home

Wijkstra¹,

Altena²,

Kraan³

et al. 1994

Eur Respir J

274

161

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“…Anxiety is closely associated with dyspnoea, and may be one of the most important factors determining quality of life in patients with severe COPD [4,5]. Attempts at improving dyspnoea, by means of psychotherapy, relaxation and retraining of breathing patterns, have met with varying success [6][7][8][9].The aim of the present study was to assess the effect of general cognitive and behavioural psychotherapy, directed by a psychiatrist, on the level of anxiety, quality of life, dyspnoea and exercise tolerance in patients with moderately severe COPD. …”

mentioning

confidence: 99%

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confidence: 99%

Effects of psychotherapy in moderately severe COPD: a pilot study

Eiser

West²,

Evans³

et al. 1997

Eur Respir J

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Anxiety is common in the "pink puffer" syndrome associated with chronic obstructive pulmonary disease (COPD). The degree of anxiety correlates well with perceived dyspnoea. This pilot study examines the effect of group psychotherapy on anxiety, exercise tolerance, dyspnoea and quality of life.Ten patients with moderately severe, stable COPD (mean forced expiratory volume in one second (FEV1)=1.15 L) had six 90 min sessions of cognitive and behavioural psychotherapy at weekly intervals. Patients completed the Hospital Anxiety and Depression Scale (HADS), Medical Research Council Questionnaire (MRCQ) and St George's Respiratory Questionnaires (SGRQ), 1 week before and after therapy. FEV1, forced vital capacity (FVC), slow vital capacity (SVC), blood gas tensions and 6 min walking distance (6MWD) were measured. Eight control patients attended weekly for lung function and 6MWD for 6 weeks, but had no psychotherapy.Mean baseline HADS score was significantly higher in the psychotherapy group (12) than in controls (7), but otherwise there were no differences in lung function, blood gas tensions, 6MWD, or the other questionnaire scores between groups. After treatment, the physiological and psychological parameters where unchanged in both groups with the exception of the mean 6MWD, which had improved in the psychotherapy group only, from 351 to 423 m (p<0.001), an increase of 24%. Three months after treatment, the 6MWD was still 16% above the baseline value (p=0.02).In conclusion, six sessions of cognitive and behavioural psychotherapy produced a sustained improvement in exercise tolerance in a group of 10 anxious patients with severe chronic obstructive pulmonary disease, without any change in anxiety scores on the Hospital Anxiety and Depression Scale. Further studies of more prolonged, intensive psychotherapy would establish whether better symptom and quality of life scores accompany more dramatic increases in exercise tolerance in "pink puffers". Eur Respir J 1997; 10: 1581-1584 In patients with chronic obstructive pulmonary disease (COPD), dyspnoea often correlates poorly with physiological impairment [1][2][3]. Anxiety is closely associated with dyspnoea, and may be one of the most important factors determining quality of life in patients with severe COPD [4,5]. Attempts at improving dyspnoea, by means of psychotherapy, relaxation and retraining of breathing patterns, have met with varying success [6][7][8][9].The aim of the present study was to assess the effect of general cognitive and behavioural psychotherapy, directed by a psychiatrist, on the level of anxiety, quality of life, dyspnoea and exercise tolerance in patients with moderately severe COPD. Methods PatientsHospital Anxiety and Depression Scale (HADS) questionnaires were completed by patients attending the monthly COPD clinic at Lewisham Hospital over a 3 month period. The HADS [10] is a self-administered questionnaire, comprising 14 questions, seven of which are aimed to detect anxiety. Questions are based on psychic symptoms only, without r...

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“…Zum anderen erfahren die Patienten eine verhal− tenstherapeutische Hilfestellung dergestalt, dass sie zentrale Be− schwerden wie z. B. Atemnot besser einschätzen und damit ihre Leistungsfähigkeit stärker ausschöpfen können [20,41]. Ein ver− stärktes Selbstvertrauen, eine verbesserte Compliance sowie er− weiterte Ressourcen zur Krankheitsbewältigung im Allgemeinen (Coping) sind in vielen Fällen die unmittelbare Folge [42,43].…”

Section: Trainingstherapieunclassified

“…Über eine Verbesserung der physiologischen Größen hinaus ist die Beeinflussung des Verhaltens des Patienten zentrales Ziel der Betreuung [41]. Bei Patienten mit COPD steht naturgemäß die Raucherentwöhnung an erster Stelle [82].…”

Section: Verhalten Des Patientenunclassified

Möglichkeiten und Perspektiven häuslichen Trainings bei Patienten mit chronisch-obstruktiven Atemwegserkrankungen

Wewel

Jörres²,

Kirsten³

2005

Pneumologie

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EinleitungChronische Atemwegserkrankungen stellen lang verlaufende Krankheitsprozesse dar, die in der Regel eine lebenslange Thera− pie erfordern. Die fachgerechte Versorgung der Patienten wird ± neben einer qualifizierten medikamentösen Therapie ± durch eine darüber hinausgehende langfristige Unterstützung und Be− treuung verbessert, die speziell auf die Charakteristika der jewei− ligen Atemwegserkrankung abgestimmt ist. In den letzten Jahren wurden neben den klassischen Verfahren der stationären Reha− AbstractIn Germany there is a long tradition of rehabilitation and exercise training programs to improve the clinical state and physical function of patients with chronic obstructive pulmonary dis− eases. This is particularly true regarding inpatient rehabilitation. Based on experiences gained in other countries, outpatient and home−based programs are currently getting more attention. One of the key components of pulmonary rehabilitation is exercise training which can be expected to exert direct and indirect bene− ficial effects on physical performance, health−related quality of life and even the progress of the disease. Most of the available ex− perience refers to patients with COPD ± besides those with bron− chial asthma. The data available so far suggest that exercise training programs can reduce exacerbation rates and that this ef− fect is achievable by minimal personal assistance. Thus the most important aim of future studies seems to be the development and evaluation of training programs which are efficient but also easy to implement and minimally expensive. Furthermore it needs to be studied whether such programs can be transferred to pulmonary disorders other than obstructive airway diseases. Übersicht 328Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.

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Multidiscipline Treatment of Chronic Pulmonary Insufficiency

Cited by 111 publications

References 0 publications

Quality of life in patients with chronic obstructive pulmonary disease improves after rehabilitation at home

Quality of life in patients with chronic obstructive pulmonary disease improves after rehabilitation at home

Effects of psychotherapy in moderately severe COPD: a pilot study

Möglichkeiten und Perspektiven häuslichen Trainings bei Patienten mit chronisch-obstruktiven Atemwegserkrankungen

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