OBJECTIVE: Describe the process of development and testing to reduce the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ) from 164 items to a modified questionnaire (the PFSDQ-M) ...consisting of 40 items.
DESIGN: Instrument development and testing for reliability, validity, and practicality.
SETTING: Hospital-based outpatients.
PATIENTS: Testing was done on three groups of clinically stable patients with chronic obstructive pulmonary disease: a secondary analysis of 131 subjects for item selection, reliability, and validity; 50 additional subjects evaluating the PFSDQ-M for internal consistency, test-retest correlations, and construct validity; and 34 subjects from a longitudinal study for responsiveness.
OUTCOME MEASURES: PFSDQ, PFSDQ-M, and spirometry.
RESULTS: The practicality of the PFSDQ-M was supported by its sixth- to seventh-grade reading level, ease of reading (Flesch-Kincaid 69.5), self-administration, brief period for testing (7 minutes initially, 6 minutes on repeated testing), and limited missing data (< 8%). Reliability of the three
components was supported by internal consistency
α = 0.93 for
change experienced by the patient with
activities (CA), 0.95 for
dyspnea with
activities (DA), and 0.95 for
fatigue with
activities (FA). Good stability of the PFSDQ-M was demonstrated on test-retest;
r = 0.70 for change, 0.83 for dyspnea, and 0.79 for fatigue (with activities). The usefulness of the PFSDQ-M in discriminating between dyspnea scores in patients based on their rate of deterioration in lung function was demonstrated.
CONCLUSIONS: The PFSDQ was modified by reducing the number of activities evaluated, standardizing scaling formats, and adding a fatigue component. Findings suggest that the PFSDQ-M demonstrates initial reliability; good validity estimates, as seen with the factor analysis, and the dyspnea and activity scores appear responsive to physiologic changes in lung function over time.
Breathing is a subjective experience that includes physical sensations, such as effort to breathe, and an affective element, such as breathing distress.
The overall purpose of this investigation was ...to evaluate whether measurement of the physical sensations (breathing effort) and affective response to these sensations of breathing (breathing distress) are consistent and valid.
A longitudinal repeated measures design was used to evaluate a 2-week daily breathing with a sub-sample (
n = 43) who also recorded their daily breathing during 4 weeks.
Age-matched, stable subjects (
n = 92) with an average age of 62 were evaluated. The sample consisted of 32 subjects with chronic obstructive pulmonary disease, 27 subjects with asthma, and 33 healthy subjects.
Visual Analogue Scales for breathing effort (VAS-E) and breathing distress (VAS-D) were scored daily.
The VAS-E and VAS-D mean, highest, and lowest scores were found to be stable over time in the sub-sample and a significant difference (F = 2.56,
P < .05) between VAS-E and VAS-D was found. Differences were found in mean and highest VAS-E and VAS-D by group, with the COPD group reporting the highest values.
This investigation provided initial evidence of the stability and validity of daily VAS-E and VAS-D measures and preliminary support for the use of daily VAS logs to evaluate differences in breathing effort and breathing distress.
Purpose: To review barriers to the successful use of inhalers in patients with chronic obstructive pulmonary disease (COPD), and the role of the nurse practitioner (NP) in facilitating optimum ...inhaler use.
Data sources: Review of the national and international scientific literature.
Conclusions: Pharmacologic treatment of COPD patients comprises mainly inhaled medications. Incorrect use of inhalers is very common in these individuals. Some of the consequences of poor inhaler technique include reduced therapeutic dosing, medication adherence, and disease stability, which can lead to increased morbidity, decreased quality of life, and a high burden on the healthcare system. Knowledgeable evaluation and frequent reassessment of inhaler use coupled with education of patients, caregivers, and healthcare professionals can significantly improve the benefits COPD patients derive from inhaled therapy.
Implications for practice: Patient education is vital for correct use of inhalers and to ensure the effectiveness of inhaled medications. The NP has a critical role in assessing potential barriers to successful learning by the patient and improving inhaler technique and medication management. The NP can also facilitate success with inhaled medications by providing up‐to‐date inhaler education for other healthcare team members, who may then act as patient educators.
Smoking Marijuana and the Lungs Drake, Matthew G; Slatore, Christopher G
American journal of respiratory and critical care medicine,
02/2017, Letnik:
195, Številka:
3
Journal Article, Reference
Insomnia Ebben, Matthew R; Kapella, Mary C
American journal of respiratory and critical care medicine,
2014-Dec-15, 2014-12-15, 20141215, Letnik:
190, Številka:
12
Journal Article
Dyspnea is a distressing and functionally limiting symptom that patients with heart failure commonly experience. A valid instrument to quantify dyspnea for comparison of groups and for illness ...management is important.
To validate the Chinese version of the Modified Pulmonary Functional Status and Dyspnea Questionnaire.
The Chinese version was developed by using translation and back translation and was tested in Taiwan in 88 patients who had heart failure but no pulmonary disease or comorbid conditions limiting physical function. Data on a Taiwanese subsample (n=30) were compared with data on 30 patients in the United States matched by sex, age, and severity of disease to determine the equivalence of the Chinese and English versions. Construct validity was assessed by testing the hypothesis that health-related quality of life measured by using the Minnesota Living With Heart Failure Questionnaire is associated with the score on the dyspnea questionnaire. Reliability was assessed by using the Cronbach alpha and item-total correlations.
Equivalence between the US and Taiwanese samples was high, from 0.67 to 0.91 for each item of the questionnaire and for the total score. Satisfactory correlations between the Chinese dyspnea and the Minnesota questionnaires, especially in the physical dimension (r=0.71, P<.001), provided support for the construct validity of the Chinese questionnaire. Reliability of the Chinese questionnaire was adequate (alpha=0.94).
The Chinese Modified Pulmonary Functional Status and Dyspnea Questionnaire is a reliable and valid measure for dyspnea that can be used in Taiwanese patients with heart failure.
Symptom Perspectives Michaels, Cathy; Lareau, Suzanne C.
Disease management & health outcomes,
01/2008, Letnik:
16, Številka:
5
Journal Article
Recenzirano
Current research indicates considerable variation in everyday breathing intensity for individuals with chronic obstructive pulmonary disease (COPD). This evidence highlights the importance of ...coaching patients to effectively manage breathing intensity, in particular, to recognize levels of breathing intensity, select the right action for the level of breathing intensity, and call for professional support when self-management does not work. As part of coaching, healthcare professionals evaluate breathing intensity and make treatment decisions, relying heavily on self-report. Patients use their own words (natural language) in self-reports, contributing rich information for self-management that is not captured by objective measurement of breathing intensity. Moreover, early evidence suggests that natural language offers other clues about breathing intensity, for example negative emotion words increase as breathing intensity increases. Using the patient’s natural language offers advantages to understanding the symptom experience, underlying cognitive representation for breathing intensity, and clues as to what level of breathing intensity the patient is experiencing. To increase communication, as well as data about breathing intensity, physicians and other healthcare professionals should ask patients with COPD to describe their breathing ‘in their own words’ and then use these words to evaluate and treat breathing intensity, as well as coach self-monitoring and self-management.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
40.
Life and Breath Suzanne C. Lareau
Chest,
04/2004, Letnik:
125, Številka:
4
Journal Article
Recenzirano
By Neil Schachter, MD. New York, NY: Broadway Books, 2003; 346 pp; $24.95
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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