جستجوی مقالات مرتبط با کلیدواژه « بیماری مزمن انسدادی ریوی » در نشریات گروه « پزشکی »

Stigma, along with physical limitations due to respiratory symptoms of chronic obstructive pulmonary disease (COPD), can lead to social isolation and loneliness, poor self-management, and reduced engagement with health care providers. This study was conducted to determine the relationship between stigma and medication adherence in patients with COPD.

This correlational study was conducted on 140 patients with COPD hospitalized in Razi Hospital in Rasht city in 2023. Convenience sampling method was performed based on the inclusion criteria. Data collection tools were the demographic and clinical information form, Morisky Medication Adherence Questionnaire, and Stigma Scale for Chronic Diseases. The Data were analyzed using the Pearson correlation coefficient and multivariate regression model in SPSS-27 software.

The mean of stigma score was 73.38±24.29 and the mean of medication adherence score was 2.67 ±2.61. Pearson correlation coefficient showed a negative and statistically significant relationship between medication adherence and stigma scores in COPD patients (p=-0.591, p<0.001). In addition, based on the results of multivariate linear regression analysis, stigma, and use of drug and inhaler can predict the medication adherence score.

Based on the results of this study, the stigma in COPD patients was moderate and medication adherence was poor. Furthermore, a significant inverse relationship was observed between medication adherence and stigma scores in these patients. Therefore, it is necessary to plan interventions to prevent stigma and control stigma-related factors, such as medication non-adherence, in COPD patients.

Chronic Obstructive Pulmonary Disease patients are certainly the most challenging ones for weaning from mechanical ventilation. Mortality in these patients compared to others due to failure in the weaning process is more than seven times. The present study was performed on the population of ventilated chronic obstructive pulmonary disease purposes of determining cut-off points of New Integrative Weaning Index (NIWI) and conventional indexes and comparing differences between their predictive components.

The observational prospective, triple blinded study was conducted in 2012-2013 on 180 hospitalized COPD patients in critical care units of selected hospitals in Tehran in two groups including cut-off points determining group and determining different predicting weaning factors group. The process of weaning was based on the same and defined protocol. The ROC analysis was used to determine the cut-off points group and the predicting factors were used in the other group.

The highest area under the curves was devoted to Rapid Shallow Breathing Index (0.927) and NIWI (0.878). The highest sensitivity was related to NIWI with 100% and the highest specificity was related to RSBI index 90%, the positive predictive value to RSBI Index was 87.5%, the negative predictive value to NIWI with 100% and highest diagnostic accuracy related to RSBI was 98.67%. The cut-off point and the most desirable components predicting weaning were RSBI, NIWI, P0.1, and NIF indexes, respectively.

The NIWI index can be used as a complementary predictive indicator for weaning from mechanical ventilation in chronic obstructive pulmonary disease patients due to its good predictive components.

Anxiety is one of the common symptoms and complications in patients with chronic obstructive pulmonary disease that increases readmission and decreases the quality of life in these patients.

This study aimed to determine the effect of controlled breathing exercises on Anxiety and Arterial Oxygen Saturation in chronic obstructive pulmonary disease in the intensive care unit.

This study is a quasi-experimental study with statistical population consisting  of all patients with chronic obstructive pulmonary disease hospitalized in selected hospitals of Aja in the first half of 2019. The samples were divided into two intervention and control groups. For data collection, Demographic information, Beck Anxiety Inventory and Pulse Oximeter were used. The intervention group received controlled breathing exercises for four days. Data were analyzed using SPSS 23.

Mean scores of total anxiety and arterial oxygen saturation were not significantly different between the intervention and control groups before the intervention, but there was a significant difference between  both groups after the intervention, using independent samples t-test (P<0.001).

The results showed that controlled breathing exercises can  can reduce anxiety and improve arterial oxygen saturation level in patients with chronic obstructive pulmonary disease, Thus, it is recommended that they be used by nurses as a nursing intervention.

Today, epidemiological studies are of great importance for the organization of the disease at the community level, assessing the main risk factors of the disease, as well as the impact of the disease on individuals and society. The aim of this study was to investigate the epidemiological features of patients with chronic obstructive pulmonary disease (COPD) in an emergency department (ED) of one of the educational medical centers. This cross-sectional study was carried out during 6 months in Imam Hossein Hospital, Tehran, Iran. Sampling was performed via census method and all patients suffering from dyspnea referred to the ED, diagnosed as COPD based on clinical criteria and history, without age or sexual restriction were eligible. A checklist was used to collect baseline information and treatment measures administered in the ED. In addition, the length of hospital stay was also recorded. Of the 79345 patients refereed to the ED of the studied hospital, 87 cases (0.01%) were diagnosed with COPD, of which 62 cases (71.3%) were male and 47 cases (54.0%) were in the age range of 60-80 years old. The most common chief complaint in 48 patients (55.2%) was dyspnea. The duration of COPD diagnosis in 59 patients (67.8%) was less than 5 years. Also, 79 cases (90.8%) were under treatment, and 35 cases (40.2%) smoked more than 40 pack/year. The most commonly used drug in the ED was anticholinergic agents which was administered in 100% of the patients and beta-agonist inhalers were used in 98.9% of them. According to the results of this study, the prevalence of COPD was higher in men than in women. As with other chronic diseases, the prevalence of the disease has increased with age in both genders.

Pulmonary rehabilitation is an important part of the care of patients with respiratory diseases. Although there is enough evidences indicated that the various pulmonary rehabilitation techniques are useful, but less comparative studies about the effectiveness of these techniques has been conducted. The purpose of this study was to compare the effect of chest physiotherapy with and without respiratory exercises on the patients′ ability with chronic obstructive pulmonary disease to perform activities of daily living (ADL). This study is a randomized clinical trial. The study population included patients with COPD who admitted to the internal wards of hospitals affiliated to Yasuj University of Medical Sciences, 2015. Fifty one patients were selected through convenience sampling method, but randomly assigned among three groups of chest physiotherapy, respiratory exercises training and chest physiotherapy with respiratory exercises training. Interventions were performed for fourteen days, three times a day for patients. Data were gathered through questionnaire of the activities daily of life at three times before intervention, one and two weeks after the intervention. The collected data were analyzed using SPSS software using descriptive and inferential statistics such as Kruskal Wallis and Friedman with 95% confidence interval and significance level less than 0.05. The total mean of ADL in chest physiotherapy group before intervention was 43.6 ± 10.1, which increased to 57.1 ± 11.3 and 66.8 ± 8.8, one and two weeks after the intervention, respectively. The average total score of ADL for patients in respiratory exercises training group was 41.1 ± 7.7, 55.1 ± 6.9, and 65 ± 5.9 at three measuring times, respectively. In the group of chest physiotherapy combined with breathing exercises, the mean of ADL increased from 36.6 ± 4.5 (before intervention) to 54.3 ± 4.2 (second time) and to 65.7 ± 3.5 (third time). Although within group comparison for the mean difference in three measurement times indicated an increased ADL after interventions compared with before the intervention in three groups (P = 0.001), however, no statistical significant difference was observed in the effect of three interventions (P = 0.3). The effect of chest physiotherapy combined with respiratory exercises training was the same on the patients′ ability with COPD for performing ADL in comparison with the effect of each one.

The weaning process from mechanical ventilation in chronic obstructive pulmonary diseases (COPD) is a time-consuming process required for the care of these patients. This study aimed to: 1. decide cut-off points of combined and common indices RSBI, P0.1, NIF, CROP, and IWI in the population of COPD patients; and 2. compare different weaning factors from the mechanical ventilator of combined, RSBI, P0.1, NIF, CROP, and IWI indices in the population of COPD patients.
This observational, prospective multi-center triple-blinded study was conducted from January 2013 to March 2014 in the population of hospitalized COPD patients in the critical care units of selected Military hospitals in Tehran, Iran. Patients were divided into two groups with cut-off points determining the first group (n = 90) and different predictive weaning factors from the mechanical ventilator determining the second group (n = 90). The process of weaning from the mechanical ventilator was performed in the same way in both groups and was based on the defined protocol. ROC analysis was used to determine cut off points in the first group and predictive factors in the second group.
Six indices combined, RSBI, IWI, P0.1, NIF, and CROP were compared from different predicting weaning factor's view. Generally, RSBI, combined, IWI, P0.1, NIF, and CROP indices were devoted the most favorably factors to itself, respectively. The highest area under the curves were devoted to RSBI (0.927) and combined (0.891) indices.
Although the proposed index has more components than other common indices in weaning process from mechanical ventilator, the RSBI index in addition to simplicity, provided the most desirable characteristics of predictive weaning from mechanical ventilator. It is also suggested that corrected RSBI index (RSBI application alongside tight subjective and objective signs and symptoms of respiratory distress) be used in the population of chronic obstructive pulmonary patients.

Weaning from mechanical ventilator is one of the most challenging issues of hospitalized chronic obstructive pulmonary patients in intensive care unit. Introducing new index to anticipate the patient's weaning from mechanical ventilator with more successful probability is so paramount. The study had two-fold purposes including 1. Determining cut-off points of vahedian one and common indices RSBI, P0.1, NIF, CROP, and IWI in the population of chronic obstructive pulmonary patients; and 2. Comparing different weaning factors from mechanical ventilator of vahedian one and RSBI, P0.1, NIF, CROP, and IWI indices in the population of chronic obstructive pulmonary patients.
Present study was an observational, prospective multi center trible blinded clinical trial that conducted from January 2013 to March 2014 in the population of hospitalized chronic obstructive pulmonary patients in critical care unit's of selected hospitals in Tehran in two groups including cut off points determining group (n = 90) and determining different predicting weaning factors from mechanical ventilator group (n= 90). The process of weaning from mechanical ventilator conducted same in both groups and was based on the defined protocol. ROC analysis used to determine cut off points in the first group and predicting factors in the second group.
Six indices Vahedian one, RSBI, IWI, P0.1, NIF, and CROP were comparing from different predicting weaning factor's view. Generally, RSBI, vahedian one, IWI, P0.1, NIF, and CROP indices were devoted the most favorably factors to itself, respectively. The highest area under the curves were devoted to RSBI (0.927) and vahedian one (0.888) indices.
Although the proposed index than other common indices has more components in weaning process from mechanical ventilator, but RSBI index in addition to simply, devoted to itself the most desirable characteristics of predictive weaning from mechanical ventilator. Furthermore, it is suggested that RSBI index use along with subjective, objective, and respiratory distress symptoms monitoring in the population of chronic obstructive pulmonary patients.

Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation and progressive development of airflow limitation. Recently besides the typical pulmonary pathology of COPD, several effects occuring outside the lungs, for example weight loss and malnutrition have been described the so called systemic effects of COPD. In this study we evaluated body mass index (BMI), serum albumin and their relationship with pulmonary function. This descriptive study performed on 42 patients, referring to Ghaem Hospital Mashhad University of Medical Sciences, Mashhad, Iran at 2005, with the mean age of 62.82±10.54 years and the mean forced expiratory volume in the first second (FEV1) (1.38±0.76 lit.).This study was approved by the local ethics. Severity of disease was defined by global initiative for chronic lung disease (GOLD) guideline. BMI and serum albumin were measured. BMI was lower than normal in 9.5% of patients. There was a significant negative correlation between the severity of disease and BMI (p= 0.004, r= - 0.43). Furthermore the correlation between the severity of disease and serum albumin was significantly negative (p= 0.02, r= - 0.35). The results of this study indicate that BMI and serum albumin decreased as the severity of disease increased. Therefore, the nutritional status is closely linked to the severity of COPD.