• Title/Summary/Keyword: 만성 폐쇄성 폐질환

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A Study on Characteristics of Dyspnea in Patients with Chronic Obstructive Pulmonary Disease in the Emergency Department Visits (응급실에 내원한 만성 폐쇄성 폐질환 환자의 호흡곤란 속성에 관한 연구)

  • Yang, Jin-Ju
    • Korean Journal of Adult Nursing
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    • v.17 no.5
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    • pp.813-821
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    • 2005
  • Purpose: The purpose of this study was to examine descriptors of dyspnea and clinical characteristics in patients with COPD at ED visit. Method: The study design was a descriptive survey, and 46 patients with COPD complaining of dyspnea were participated during their visits to the ED of C university hospital in G city, from October 1, 2004 to April 8, 2005. Result: The qualitative characteristics of dyspnea at the time of decision to the ED visit were short of breath (71.7%), tight (32.6%), hard to breathe (15.2%), smothering or suffocating (10.9%), gasping (8.7%), couldn't breathe (6.5%), constricted (2.2%), and hunger for air (2.2%). In the item of dyspnea checklists, My chest felt tight was the most common description among subjects. As the result of factor analysis of dyspnea checklists, the first factor was characterized rapid and shallow, the second was suffocating/smothering, the third was hunger for air, and the fourth was constricted. Conclusion: This study suggests that a checklist of dyspnea descriptors based on this findings would be utilized as a tool of initial and ongoing assessment for dyspneic patients with COPD in the ED after identifying the validity and reliability of the checklist.

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The Mediating Effects of Nutritional Status on the Relationship between Symptom Experience and Functional Status in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 증상경험과 기능상태의 관계에 미치는 영양상태의 매개효과)

  • Jang, Jun Hee;Min, Hye Sook
    • Journal of muscle and joint health
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    • v.25 no.2
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    • pp.112-121
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    • 2018
  • Purpose: This study was conducted to explore the mediating effect of nutritional status on the relationship between symptom experience and functional status of patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: A total of 141 COPD patients visiting D hospital and I hospital in B city were enrolled in this study. Data were collected from January 2017 to July 2017. Outcome variables were measured by Mini Nutritional Assessment Short-Form (MNA-SF) for nutritional status, The Memorial Symptom Assessment Scale (MSAS) for symptom experience, and The Functional Performance Inventory Short Form (FPI-SF) for functional status. The data were analyzed with descriptive statistics, Pearson's correlation, and path analysis using SPSS/WIN 21.0 and AMOS 25. Results: There was a significant negative correlation between symptom experience and nutritional status (r=-.61, p<.001), a significant negative correlation between symptom experience and functional status (r=-.40, p<.001), and significant positive correlation between nutritional status and functional status (r=.47, p<.001). Symptom experience had indirect effects on functional status through nutritional status. Conclusion: For enhancing functional status in COPD patients, it is necessary to develop nursing intervention programs to enhance symptom management as well as nutritional status.

Symptom Experience, Self-Efficacy, Depression, and Medication Adherence in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 증상경험, 자기효능감, 우울과 약물복용 이행 간의 관계)

  • Park, Sumin;Kang, Younhee
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.2
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    • pp.170-178
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    • 2017
  • Purpose: This study was done to investigate the correlation among symptom experience, self-efficacy, depression, and medication adherence in patients with chronic obstructive pulmonary disease (COPD). Methods: Participants were 100 patients with COPD recruited in one general hospital in Seoul. A structured questionnaire was used to measure the study variables. Data were analyzed using descriptive statistics, t-test, ANOVA, and Spearman correlation coefficient. Results: Symptom experience and depression were positively correlated (r=.41, p<.001), symptom experience and self-efficacy were negatively correlated (r=-.21, p=.035). Depression was negatively correlated with self-efficacy (r=-.60, p<.001) and medication adherence (r=-.48, p<.001). Self-efficacy and medication adherence were positively correlated(r=.76 p<.001). Conclusion: Findings from this study indicate that depression and self-efficacy are important variables related to medication adherence in patients with chronic obstructive pulmonary disease. Therefore, depression and self-efficacy should be assessed, and customized nursing interventions should be provided in order to increase medication adherence.

The Resting and Exercise Related Oxygen Desaturation as the Associated Factor for Sleep Related Oxygen Desaturation in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 수면 중 산소포화도 감소에 대한 예측인자로서 안정시 및 운동시 산소포화도)

  • Shin, Chang-Jin;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.231-238
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    • 1999
  • Background: Nocturnal hypoxemia occurs in patients with chronic obstructive pulmonary disease(COPD) and the detection and treatment of nocturnal hypoxemia should be part of the management of COPD patients. We performed this study to evaluate the factors influencing to sleep related arterial oxygen desaturation($SaO_2$) in patients with COPD. Methods: Resting and exercise cardiopulmonary function test, polysomnography, and $SaO_2$ during resting, exercise and sleep were measured in 12 patients with COPD. Results: The $SaO_2$ fell twice as much during sleep as during maximal exercise($13.1{\pm}9.3%$ fall in nocturnal $SaO_2$ vs. $6.4{\pm}3.3%$, p<0.05). Fall in nocturnal $SaO_2$ was well correlated with mean exercise $SaO_2$(r=-0.78, p<0.05), minimum exercise $SaO_2$(r=-0.90, p<0.01), and resting $SaO_2$(Cr=-0.82, p<0.05). Lowest sleep $SaO_2$ was well correlated with mean exercise $SaO_2$(r=0.80, p<0.05), lowest exercise $SaO_2$(r=0.90, p<0.01), and resting $SaO_2$(r=0.84, p<0.05). Conclusion: Resting and exercise $SaO_2$ was well correlated with nocturnal $SaO_2$, but exercise study add no additional information to predicting the nocturnal oxygen desaturation in patients with COPD.

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A Case of Convulsive Seizure Following Spinal Anesthesia in a Geriatric Patient with COPO (만성 폐쇄성 폐질환자에서 척추 마취후 발생한 경련발작 1례)

  • Suh, III-Sook
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.213-219
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    • 1988
  • In the geriatric patient with COPD, incidence of postoperative pulmonary complication is higher than young patient. Therefore, some anesthesiologists preferred spinal anesthesia to general anesthesia for surgery of the perineum, lower extrimities, and pelvic extra peritoneal organs. But, during spinal anesthesia, the same careful observation is requiered as during general anesthesia. We experienced a case of the convulsive seizure at about 1 hour after spinal anesthesia for open prostatectomy in a 76-year-old male patient wit COPD. It was suspected that his convulsive seizure be resulted from hypercapnea combined with hypoxia following upper airway obstruction. This patient was treated successfully by ultrashort acting barbiturate and controlled ventilation.

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Does Home Oxygen Therapy Slow Down the Progression of Chronic Obstructive Pulmonary Diseases?

  • Han, Kyu-Tae;Kim, Sun Jung;Park, Eun-Cheol;Yoo, Ki-Bong;Kwon, Jeoung A;Kim, Tae Hyun
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.128-135
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    • 2015
  • Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

The Differences of the Smoking Habit Between Emphysema and Chronic Bronchitis (폐기종과 만성기관지염의 흡연습관 차이)

  • Mun, Yeung-Chul;Yu, Sung-Keun;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Jung-Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.693-703
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    • 2001
  • Background : Smoking is the most important and consistent determinant of the development and progression of COPD(Ed Note : Define COPD). The fact that cigarette smokers develop a different type of COPD, chronic bronchitis and emphysema, with different clinical and pathological aspects, suggests that the development of COPD has a relationship with other smoking-associated factors beyond just a simple smoking history. The aim of this was to analyze the smoking habits and history of patients with COPD and to evaluate the development of different types of COPD according to patient's smoking habits. Method : To evaluate the differences in the smoking patterns of patients with chronic bronchitis and emphysema, a pulmonary function test was conducted, and the smoking history and patterns was obtained through a smoking history questionnaire by a direct personal interview from 333 male cigarette smokers diagnosed with COPD, in the Yeungnam university medical center(190 patients diagnosed with chronic bronchitis, 143 patients diagnosed with emphysema). Result : The patients with emphysema smoked earlier and had a higher smoking history(ie, more packyears, more total amounts of smoked cigarette, and more deep inhalation and longer duration of plain cigarette exposure) than those with chronic bronchitis. The depth of inhalation was also significantly higher in the emphysema patients after taking into account age, cumulative cigarette consumption and the type of cigarette smoked. Conclusion : Emphysema was more associated with the increasing degree of inhalation as assessed by the depth of inhalation. A high alveolar smoke exposure may be a significant risk factor for the development of emphysema.

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The Prognostic role of Electrocardiographic Signs of Cor Pulmonale in Chronic Obstructive Pulmonary Disease (폐성심을 시사하는 심전도 소견 유.무에 따른 만성폐쇄성 폐질환 환자의 예후)

  • Shin, Moo-Chul;Park, Jae-Yong;Bae, Moon-Seob;Bae, Nack-Cheon;Chae, Po-Hee;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.944-955
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    • 2000
  • Background : In patients with chronic obstructive pulmonary disease(COPD), several factors have been associated with a poor prognosis. These include old age, low $FEV_1$ low diffusing capacity, high alveolar-arterial oxygen pressure difference, and finally cor pulmonale. This study was done to investigate if the ECG signs suggesting cor pulmonale were independent prognostic factors in patients with COPD. Method : We analyzed ECG, pulmonary function data and arterial blood gas values in 61 patients who were admitted through the emergency department with an acute exacerbation of COPD. The ECG signs reflecting cor pulmonale were right strial overloading(RAO), right bundle branch block, right ventricular hypertrophy and low-voltage QRS. The 61 patients were divided into 2 groups ; group I with no ECG signs(n=36) and group II with one or more ECG signs(n=25) suggesting cor, pulmonale. Results : Poor, prognostic factors by univariate analysis were low $FEV_1$, $FEV_1$ % pred., VC % pred., DLco, DLco % pred., $PaO_2$ and $SaO_2$ high $PaCO_2$ presence of ECG signs reflecting cor pulmonale, presence of mental status change, use of mechanical ventilator, and long term use of glucocorticoid. A multivariate analysis indicated that age(risk ratio=1.13, 95% confidence interval 1.05-1.23), DLco % pred. (risk ratio=0,97. 95% confidence interval 0.94-0.99), $PaO_2$ (risk ratio=0.95, 95% confidence interval 0.90-0.99) and RAO(risk ratio=5.27, 95% confidence interval 1.40-19.85) were independent prognostic factors of survival. There was a significant difference in survival between the patients with and without RAO(p=0.038). The survival rates at 1, 2, and 5 years were 94.5%. 81.4%, and 50.0% in patients without RAO and 82.4%, 70.6%, and 27.5% in patients with RAO, respectively. Conclusion : These results suggest that the presence of ECG signs reflecting cor pulmonale is a predictor of survival and that RAO of these ECG signs is a significant independent predictor of survival in patients with COPD.

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Living as Severe COPD Patient - Life of Stepping on the Thin Ice (중증 만성폐쇄성 폐질환 환자로 살아가기 -살얼음판 위를 걸어가는 삶-)

  • Kim, Sung-Reul;Kim, Yun-Ok;Kwon, Kyoung-Min
    • Korean Journal of Adult Nursing
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    • v.22 no.6
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    • pp.663-675
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    • 2010
  • Purpose: The purpose of this study was to explore the life experiences of patients with a severe Chronic Obstructive Pulmonary Disease (COPD). Methods: The data were collected through in-depth interviews of six patients suffering from severe COPD. The interviewed data were audio-recorded and transcribed verbatim and checked for accuracy. The Giorgi method of phenomenology was used for analyzing data. Results: Eight themes forming the, units of meaning, were: Repeated and Unpredictable Suffering of Dyspnea, Confidence Loss/Exhaustion Life due to non-efficient breathing, Gradually Deprived Liberty, Absolute Being to Sustaining my life, Source of Burden but Significant Person I am in the Family, Endless Tug-of-War-Capability/Endeavor to Breath, Longing for my Life, and Dead-end of breathing. Conclusion: The study results provide an in-depth understanding of life experiences of patients suffering from severe COPD. The findings will be useful to nurses caring for this population.