Yeonjung Lim

Nutritional status and disease severity in patients with chronic obstructive pulmonary disease (COPD)

The purpose of this study was to identify the relationship between nutritional status and the severity of the disease in patients with COPD in South Korea. This study used pretest data from a larger intervention study. Data were collected from March to October 2010, and 251 patients diagnosed with COPD from five hospitals in South Korea were included in the analysis. All participants were interviewed face-to-face. Actual dietary intake was measured by a 24-h dietary recall, and the body mass index (BMI), obstruction of the airway (FEV1% predicted), degree of dyspnea (modified Medical Research Council: MMRC), and exercise capacity (6min walking distance: 6MWD) (BODE) index was calculated to estimate the severity of the condition. Lower BODE index scores indicate lower risk of mortality. The data were analyzed by descriptive statistics, a χ(2) test, t-tests, analysis of variance (ANOVA), Pearson correlation, and hierarchical multiple regression using SPSS 18.0. The mean age of the participants was 66.83 years and 92.4% of the participants were men. The mean total energy intake was 1431.65kcal, and the mean BODE index score was 2.89. Total energy intake significantly explained additional variance in BODE, BMI, the severity of the perceived dyspnea, and the length of 6min walk after controlling for age, duration after diagnosed with COPD, and physical activities. The findings of this study emphasized the importance of calorie intake in the disease severity among COPD patients. Further research on the effects of nutritional intervention on the health outcomes of patients with COPD is warranted.

Depression and sleep disturbance in patients with chronic obstructive pulmonary disease.

The goal of this study was to examine the unique contributions of sleep disturbance to depression in patients with chronic obstructive pulmonary disease (COPD) after controlling for other contributing variables, including patient characteristics, self-efficacy, and physical activity. One hundred thirty-one outpatients diagnosed with COPD from 3 hospitals in South Korea participated in the study. Data were collected from March to June 2010 and analyzed with descriptive statistics, Pearson correlation, and hierarchical multiple regression using the SPSS WIN program. The level of depression reported in this study was 13.84. Sleep disturbance, not living with a spouse, and self-efficacy were all predictors of depression and accounted for 45% of the variance. These findings show the need to screen routinely for sleep disturbance in patients with COPD and support potential benefits of interventions to enhance self-efficacy and quality of sleep in reducing depression in COPD patients.

Accuracy of Inhaler Use in Patients With Chronic Obstructive Pulmonary Disease

Inaccurate use of medication inhalers can reduce effectiveness, patient adherence, and disease stability. Therefore, the accurate use of inhalers in patients with chronic obstructive pulmonary disease (COPD) is crucial. This cross-sectional study evaluated 196 Korean patients with COPD for step-by-step accuracy of inhaler use with four different types of inhalers (metered-dose inhaler [MDI], Turbuhaler, Diskus, and HandiHaler); differences in accuracy levels by sociodemographic or clinical characteristics were evaluated. Descriptive statistics and t tests were used for data analysis. The proportion of patients with completely accurate inhaler use was low, ranging from 21.9% (Turbuhaler) to 46.2% (MDI). Errors with all types of inhalers were most commonly seen in the “breathing out” steps, before and after medication inhalation. Personalized nursing educational programs, correcting errors individually for each patient, could dramatically increase the accuracy of inhaler use and the effectiveness of the inhaled medications in patients with COPD.

Predictors of low levels of self-efficacy among patients with chronic obstructive pulmonary disease in South Korea

The aim of this study was to identify related factors of low levels of self-efficacy in patients with Chronic Obstructive Pulmonary Disease (COPD). A cross-sectional research design used descriptive statistics, χ(2) test, t-test, and binary logistic regression. Two hundred and forty-five patients with COPD were recruited from five hospitals in South Korea. The COPD Self-Efficacy Scale, the Bristol COPD Knowledge Questionnaire, Personal Resource Questionnaire 2000, BODE index, and the International Physical Activity Questionnaire short version were utilized to assess self-efficacy, disease-related knowledge, social support, disease severity, and physical activity, respectively. The BODE index, affect-oriented coping, and duration since diagnosis of COPD were included as significant predictors of self-efficacy. These findings suggest possible screening methods to identify patients with low levels of self-efficacy and future intervention targeting for these patients would strengthen the efficiency of an intervention.