• Title/Summary/Keyword: 성폐쇄성폐질환

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Risk Factors for Unawareness of Obstructive Airflow Limitation among Adults with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 유소견 성인의 폐쇄성 기류제한 상태 비인지 영향요인)

  • Jo, Mirae;Oh, Heeyoung
    • Research in Community and Public Health Nursing
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    • v.29 no.3
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    • pp.290-299
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    • 2018
  • Purpose: The purpose of the present study is to examine risk factors for unawareness of obstructive airflow limitation among adults with chronic obstructive pulmonary disease. Methods: Secondary data analysis was performed with the data from the 6th Korea National Health and Nutrition Examination Survey (KNHANES; 2013-2014). The data were analyzed with the IBM SPSS 22.0 version using frequency, percentage, odds ratio, and logistic regression. Results: Ninety-eight percent of subject with a pulmonary function test score of $FEV_1/FVC$<0.7 (N=833) did not recognize that their lung function was impaired. The heavy drink, absence of tuberculosis or asthma diagnosis, and no symptom of expelling phlegm were identified as major risk factors for unawareness of airflow limitation. Conclusion: In order to increase awareness of airflow limitation and to prevent the worsening of the condition, the pulmonary function screening test should be provided to community residents including those who do not show symptoms of respiratory illness.

Effects of Combined Breathing Exercise and Neuromuscular Electrical Stimulation on Patients with Severe COPD (중증 만성폐쇄성폐질환 환자를 위한 복합호흡운동과 신경근전기자극의 효과)

  • Kang, Jeong-Il;Park, Jun-Su;Jeong, Dae-Keun
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.7
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    • pp.539-548
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    • 2019
  • This study was designed to examine the effects of complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle on pulmonary function and cerebral cortex activity in patients with severe chronic obstructive pulmonary disease. After collecting samples from 20 patients with severe chronic obstructive pulmonary disease aged 60 to 80, 10 patients each were randomly placed in an experimental group and a control group. The experimental group conducted complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle, and the control group only conducted complex breathing exercise. As a pretest, pulmonary function and cerebral cortex activity were measured. The intervention program was applied to each group for 30 minutes, once a day, for 4 days a week, for 6 weeks, and the posttest was carried out the same way as the pretest. As a result, both groups showed significant differences in FEV1.0(Forced Expiratory Volume in One Second)(p<.001)(p<.05), and there were significant differences between the groups as well(p<.05). When comparing alpha waves in each domain of cerebral cortex, both of the experimental and control groups showed significant differences in Fp1, Fp2, F3 and F4 domains (p<.01)(p<.05). During the 6-week experiment, complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle improved pulmonary function of patients with severe chronic obstructive pulmonary disease, and in relation to cerebral cortex activity, a positive breathing change was found due to the increase of alpha waves in the forehead domain. Therefore, it is considered that applying neuromuscular electrical stimulation of Quadriceps Femoris muscle to patients with severe chronic obstructive pulmonary disease additionally along with complex breathing exercise will bring a better therapeutic effect.

The Differences in Resting Pulmonary Function in Relation to the Nutritional status of Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자의 영양상태에 따른 안정시 폐기능 차이)

  • Mun, Yeung-Chul;Yu, Sung-Keun;Park, Hye-Jung;Park, Jong-Won;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Kwan-Ho;Kim, Jung-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.6
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    • pp.570-578
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    • 2001
  • Background: With cases of chronic obstructive pulmonary disease(COPD), weight loss and low body weight have been found to correlate with increased mortality and poor prognosis. Therefore, nutritional aspects are an important part of the treatment in cases of COPD. In Korea, there is only limited data available for the changes of resting pulmonary function in relation to nutritional status. This study was carried out to investigate the differences of resting pulmonary function in relation to the nutritional status of patients with COPD. Method : 83 stable patients, with moderate to severe COPD, were clinically assessed for their nutritional status and resting pulmonary function. The patients' nutritional status was evaluated by body weight and fat-free mass (FFM), which was assessed by bioelectrical impedance analysis. According to their nutritional status, the 83 patients were divided into two groups, designated as the depleted, and non-depleted, groups. Result : Of the 83 patients, 31% were characterized by body weight loss and depletion of FFM, whereas 28% had either weight loss or depleted FFM. In the depleted group, significantly lower peak expiratory flow rate(p<0.05) and Kco(p<0.01), but significantly higher airway resistance(Raw, p<0.05) were noted. There was no difference for the non-depleted group in forced expiratory volume at one second, residual volume, inspiratory vital capacity, or total lung capacity. Maximal inspiratory pressure($P_{Imax}$) was also significantly lower in the depleted group(p<0.05). Conclusion : We conclude, from our clinical studies, that nutritional depletion is significantly associated with the change in resting pulmonary function for patients with moderate to severe COPD.

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Chronic Obstructive Pulmonary Disease in a Dressage Horse (마장마술마에서 발생한 만성폐쇄성폐질환 증례)

  • Jeong, Hyo-Hoon;Ahn, Kei-Myung;Kim, A-Ram;Roh, Ha-Jung;Oh, Tae-Ho
    • Journal of Veterinary Clinics
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    • v.27 no.2
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    • pp.194-197
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    • 2010
  • A 14-year-old gelded dressage horse weighing 500 kg was presented to the Equine Medical Center of the Seoul Racecourse of Korea Racing Authority (KRA) due to coughing and mucopurulent nasal discharge. The horse was initiated with empirical antibiotic in the first place. However, the clinical signs did not improve but were rather exacerbated even after 3 weeks of therapy. Extensive diagnostic procedures including transtracheal wash (TTW) fluid cytology were undertaken. The localized wheezes and crackles were auscultated and an increase in the amount of mucopurulent exudate in trachea was observed at endoscopy. Infiltration of neutrophils was observed in the TTW fluid cytology implying chronic obstructive pulmonary disease (COPD). Therefore, the systemic glucocorticoid therapy was to be given for 3 weeks with improved ventilation provided at the same time. The respiratory symptoms started to improve in 7 days of therapy and were fully resolved by when the therapy was terminated. The horse is clinically normal now and being monitored for development of any signs of chronic obstructive pulmonary disease.

Effects of Self-Care Intervention Study on Chronic Obstructive Pulmonary Disease: Focusing on a Systematic Review of a Randomized Controlled Trials (만성폐쇄성폐질환의 자가간호 중재연구(RCT) 효과에 관한 체계적 문헌고찰)

  • Kyoung Mi Moon;Inhee Park;Hyun Joo Kim
    • Journal of Industrial Convergence
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    • v.21 no.8
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    • pp.97-110
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    • 2023
  • This study presents a systematic literature review aimed at integrating and analyzing the research findings regarding the components of various self-care intervention programs conducted for individuals with chronic obstructive pulmonary disease (COPD) both domestically and internationally. The paper selection criteria were established based on materials from PubMed, CINAHL, EMBASE, /MEDLINE, RISS, DBpia, KISS, and KMbase databases, covering the period from January 1, 2000, to September 30, 2022. The inclusion criteria included controlled pre-post experimental study designs. A total of 23 studies were included in this systematic review. The intervention-related factors examined included the sample size, type of intervention mediator, intervention frequency, and duration. Additionally, factors associated with intervention effects, such as measurement tools and variables, were analyzed. The findings of the analysis support the notion that self-care intervention programs for COPD can contribute to the prevention of symptom exacerbation and hospital readmissions among patients. Consequently, the development of a tailored self-care intervention program specifically designed for COPD patients in South Korea is warranted, considering aspects such as patient accessibility, convenience, and motivation for long-term sustainability.

Change of Lung Volumes in Chronic Obstructive Pulmonary Disease Patients with Improvement of Airflow Limitation after Treatment (치료 후 기류제한이 호전된 만성폐쇄성폐질환 환자에서 폐용적의 변화)

  • Park, Hun Pyo;Park, Soon Hyo;Lee, Sang Won;Seo, Yong Woo;Lee, Jeong Eun;Seo, Chang Kyun;Kwak, Jin Ho;Jeon, Young June;Lee, Mi Young;Chung, In Sung;Kim, Kyung Chan;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.2
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    • pp.143-147
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    • 2004
  • Background : It is important to predict the exercise capacity and dyspnea, as measurements of lung volume, in patients with COPD. However, lung volume changes in response to an improvement in airflow limitation have not been explored in detail. In the present study, it is hypothesized that lung volume responses might not be accurately predicted by flow responses in patients with moderate to severe airflow limitations. Methods : To evaluate lung volume responses, baseline and follow up, flow and lung volumes were measured in moderate to severe COPD patients. The flow response was defined by an improvement in the $FEV_1$ of more than 12.3%; lung volume changes were analyzed in 17 patients for the flow response. Results : The mean age of the subjects was 66 years; 76% were men. The mean baseline $FEV_1$, $FEV_1$/FVC and RV were 0.98L (44.2% predicted), 47.5% and 4.65 L (241.5%), respectively. The mean follow up duration was 80 days. The mean differences in the $FEV_1$, FVC, TLC and RV were 0.27 L, 0.39 L, -0.69 L and -1.04 L, respectively, during the follow up periods. There was no correlation between the delta $FEV_1$ and delta RV values(r=0.072, p=0.738). Conclusion : To appropriately evaluate the lung function in patients with moderate to severe airflow limitations; serial lung volume measurements would be helpful.

A Pilot Study of Bone Mineral Density in Men with Chronic Obstructive Pulmonary Disease (남자 만성폐쇄성폐질환 환자들의 골밀도에 대한 예비연구)

  • Bae, Yun Oh;Han, Minsoo;Lee, Seong-Kyu;Kim, Jeong Nyum;Kim, Jeong Sik;Kim, Jinho;Cho, Yongseon;Lee, Yang Deok
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.4
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    • pp.395-402
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    • 2003
  • Background : Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for osteoporosis, which has implications for mobility and even mortality. The goal of this pilot study was to evaluate bone mineral density (BMD) and risk factors for osteoporosis in a limited number of men with COPD. Methods : We checked BMD, $FEV_1$(% of predicted) and investigated risk factors for osteoporosis in 44 male patients with COPD who visited our hospital from January to August 2002. Results : Mean(${\pm}$) age was $69{\pm}9$ yrs, body mass index(BMI) $21{\pm}3kg/m^2$, $FEV_1$ $50{\pm}18%$ of predicted, lumbar spine T-score $-3.0{\pm}1.2$, lumbar spine Z-score $-2.0{\pm}1.2$, and lumbar spine BMD $0.76{\pm}0.13g/cm^2$. Osteoporosis(T-score below -2.5) was present in 27 patients(61.4%) and osteopenia(T-score between -1 and -2.5) in 17(38.6%). None of the patients had normal BMD. There was no relationship between BMD and $FEV_1$(% of predicted). There were significant differences in smoking, alcohol consumption, exercise, cumulative steroid dose, BMI and BMD among the three groups according to $FEV_1$(% of predicted) (group1 : ${\geq}65%$, group2 : 50-64%, group3 : ${\leq}49%$), except age. However, there were no significant differences in these variables between the osteopenia and osteoporosis groups, except BMI. Linear Regression(Stepwise) analysis showed that lumbar BMD was correlated with BMI & exercise. Conclusion : BMD is significantly reduced in men with COPD. There was no relationship between BMD and pulmonary function.

Prevalence and Risk Factors of Depression in Patients with Chronic Obstructive Pulmonary Disease (폐쇄성폐질환에서 우울증상의 빈도 및 위험 인자)

  • Chin, Hyun Jung;Lee, Kwan Ho;Park, Chan Soh;Son, Chang Woo;Lee, Hi-young;Yu, Sung Ken;Shin, Kyeong Cheol;Chung, Jin Hong;Kim, Jung Youp
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.191-197
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    • 2008
  • Background: Due to the irreversible nature of chronic obstructive pulmonary disease (COPD), the treatment aim in patients with COPD is not to cure but to reduce the symptoms, increase lung function, and improve the quality of life. It has been suggested that depression is a common emotional disturbance in patients with COPD who are faced with a major physical impairment and embarrassing symptoms. This study evaluated the prevalence and risk factors of depression in patients with chronic obstructive pulmonary disease. Methods: A total of 59 patients with a registered diagnosis of chronic obstructive pulmonary disease were selected. Depression was assessed using the Centers for Epidemiologic Studies Depression (CES-D) scale. The quality of life was assessed using the Korean version of the St. George's Respiratory Questionnaire. Results: The prevalence of depression was 17.0%. In the correlation model, the interaction of the $FEV_1%$ over predicted value and SGRQ score(symptom, activity, impact, overall score) was statistically significant. The interaction of the $FEV_1%$ over predicted value and depression scale(CES-D) was also statistically significant. There was a positive correlation between the SGRQ scores(symptom, activity, impact, overall score) and the depression scale. Conclusion: The prevalence of depression in patients with chronic obstructive pulmonary disease is relatively high. The pulmonary function and the living standards were found to be significant risk factors for depression.

Development and Evaluation of Motivational Interviewing Pulmonary Rehabilitation Program Based on Self-Determination Theory for Patients with Chronic Obstructive Pulmonary Disease (자기결정성 이론 기반 만성폐쇄성폐질환 환자를 위한 동기면담 호흡재활 프로그램의 개발 및 평가)

  • Jang, Jun Hee;Min, Hye Sook
    • Journal of Korean Academy of Nursing
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    • v.53 no.2
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    • pp.191-207
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    • 2023
  • Purpose: This study aimed to develop a motivational interviewing pulmonary rehabilitation program based on self-determination theory to maintain pulmonary rehabilitation-related health behaviors in patients with chronic obstructive pulmonary disease. The program was developed by reviewing the literature on pulmonary rehabilitation guidelines, drawing on the self-determinism theory to establish its contents, recruiting experts to test its validity, and conducting a preliminary survey. Methods: A quasi-experimental design was used to confirm the effect of the program. The participants were outpatients diagnosed with chronic obstructive pulmonary disease at three general hospitals in Busan. There were 33 subjects: 15 in the experimental group and 18 in the control group. The experimental group performed a motivational interviewing pulmonary rehabilitation program which comprised 11 sessions delivered over 10 weeks. The outcomes were measured using basic psychological needs, dyspnea, 6-minute walking distance, and functional status. Intervention effects were analyzed using repeated-measures ANOVA. Results: The analysis revealed significant differences between the experimental and control groups in competence among the subdomains of basic psychological needs, dyspnea during exercise, and functional status. Conclusion: The developed program affects physical conditions and can be applied as an effective clinical nursing intervention to continuously improve the pulmonary rehabilitation behavior of patients with chronic obstructive pulmonary disease.

Inspiratory Flow Rate for the Evaluation of Bronchodilator in Patients with COPD (만성폐쇄성폐질환 환자에서 기관지확장제 흡입에 대한 흡기환기지표의 반응)

  • Baik, Jae-Joong;Park, Keon-Uk;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.342-350
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    • 1995
  • Background: Although there are improvements of clinical symtoms after bronchodilator inhalation in COPD patients, it has been noted that there was no increase of $FEV_1$ in some cases. $FEV_1$ did not reflect precisely the improvement of ventilatory mechanics after bronchodilator inhalation in these COPD patients. The main pathophysiology of COPD is obstruction of airway in expiratory phase but in result, the load of respiratory system is increased in inspiratory phase. Therefore the improvement of clinical symptoms after bronchodilator inhalation may be due to the decrease of inspiratory load. So we performed the study which investigated the effect of bronchodilator on inspiratory response of vetilatory mechanics in COPD patients. Methods: In 17 stable COPD patients, inspiratory and expiratory forced flow-volume curves were measured respectively before bronchodilator inhalation. 10mg of salbutamol solution was inhaled via jet nebulizer for 4 minutes. Forced expiratory and inspiratory flow-volume curves were measured again 15 minutes after bronchodilator inhalation. Results: $FEV_1$, FVC and $FEV_1$/FVC% were $0.92{\pm}0.34L$($38.3{\pm}14.9%$ predicted), $2.5{\pm}0.81L$($71.1{\pm}21.0%$ predicted) and $43.1{\pm}14.5%$ respectively before bronchodilator inhalation. The values of increase of $FEV_1$, FVC and PIF(Peak Inspiratory Flow) were $0.15{\pm}0.13L$(relative increase: 17.0%), $0.58{\pm}0.38\;L$(29.0%) and $1.0{\pm}0.56L$/sec(37.5%) respectively after bronchodilator inhalation. The increase of PIF was twice more than $FEV_1$ in average(p<0.001). The increase of PIF in these patients whose $FEV_1$ was not increased after bronchodilator inhalation were 35.0%, 44.0% and 55.5% respectively. Conclusion: The inspiratory parameter reflected improvement of ventilatory mechanics by inhaled bronchodilater better than expiratory parameters in COPD patients.

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