Lone Helle Schou

Cognitive dysfunction in patients with chronic obstructive pulmonary disease--a systematic review.

BACKGROUND Substantial healthcare resources are spent on chronic obstructive pulmonary disease (COPD). In addition, the involvement of patients in monitoring and treatment of their condition has been suggested. However, it is important to maintain a view of self-care that takes differences in cognitive ability into account. The aim of this study was to determine the occurrence and severity of cognitive dysfunction in COPD patients, and to assess the association between severity of COPD and the level of cognitive function. METHODS We conducted a systematic review, and a search in the following databases: Medline, PsychINFO, Cochrane Library, EMBASE, CINAHL, and SweMed up to July 2010. The articles were included if participants were patients with COPD, relevant outcome was cognitive function investigated by a neuropsychological test battery, and the severity of COPD had been assessed. RESULTS Fifteen studies were included, involving 655 COPD patients and 394 controls. Cognitive function was impaired in COPD patients as compared to healthy controls, but the level of functioning was better than in patients with Alzheimers disease. There was a significant association between severity of COPD, as measured by lung function and blood gases, and cognitive dysfunction, but only in patients with severe COPD. CONCLUSIONS Cognitive impairment can be detected in severe COPD patients, but the clinical relevance of the cognitive dysfunction is not yet known. Future studies should concentrate on the consequences of cognitive dysfunction for daily living in these patients, and solutions involving a high degree of self-care might require special support.

Women's experiences with cardiac rehabilitation - participation and non-participation

Background: Coronary Heart Disease is a major cause of death in women. Evidence shows that Cardiac Rehabilitation can reduce morbidity and mortality while improving mental well-being and promotes a return to social roles. Little is known, however, about womens experiences with Cardiac Rehabilitation. Aim: To describe the experiences of women who participated, and those who did not participate in Cardiac Rehabilitation after myocardial infarction. Method: One year after discharge, six women treated for myocardial infarction took part in two focus group interviews. The interviews were tape-recorded verbatim, analysed and categorised using constant comparative analysis. Findings: The mean age of the women was 72 years. They had an education level of 7th Grade, and were all retired. All CR participants had undergone Coronary Artery By-pass Graft surgery, unlike the non-participants. Analysis revealed experiences related to crises, preventing another coronary, gender roles and family life. Conclusion: It seems that the women, who participated in Cardiac Rehabilitation, were able to eliminate their risk factors, including smoking, inactivity and unhealthy diet, in contrast to those who did not participate. The women in both groups had difficulties in accepting help. Therefore future Cardiac Rehabilitation programmes should challenge womens traditional role in the family.

Telemedicine-based treatment versus hospitalization in patients with severe chronic obstructive pulmonary disease and exacerbation: effect on cognitive function. A randomized clinical trial.

Abstract Objectives: Telemedicine is gaining ground in the treatment of patients with chronic obstructive pulmonary disease (COPD). Because telemedicine often requires both participation and engagement of the patients, it is important to take differences in cognitive ability into account, as there is evidence that cognitive dysfunction may be a limitation in patients with severe COPD. The aim of this study was to investigate whether cognitive performance is better after telemedicine-based treatment than after conventional hospitalization in patients with severe COPD and a mild to moderate exacerbation. Materials and Methods: This randomized study was a substudy of the “Virtual Hospital,” a multicenter, randomized controlled trial. The primary outcome in this substudy was cognitive function, evaluated 3 days and 6 weeks after discharge using a neuropsychological test battery comprising four tests and seven variables. Results: We included 44 patients consecutively. Baseline characteristics were as follows: ...

Telemedicine based treatment versus hospitalisation in patients with severe COPD and exacerbation – effect on cognitive function.

Abstract Objectives: Telemedicine is gaining ground in the treatment of patients with chronic obstructive pulmonary disease (COPD). Because telemedicine often requires both participation and engagement of the patients, it is important to take differences in cognitive ability into account, as there is evidence that cognitive dysfunction may be a limitation in patients with severe COPD. The aim of this study was to investigate whether cognitive performance is better after telemedicine-based treatment than after conventional hospitalization in patients with severe COPD and a mild to moderate exacerbation. Materials and Methods: This randomized study was a substudy of the “Virtual Hospital,” a multicenter, randomized controlled trial. The primary outcome in this substudy was cognitive function, evaluated 3 days and 6 weeks after discharge using a neuropsychological test battery comprising four tests and seven variables. Results: We included 44 patients consecutively. Baseline characteristics were as follows: ...