• Tuberculosis and Respiratory Diseases
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• 제77권4호
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• pp.155-160
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• 2014

Chronic obstructive pulmonary disease (COPD) is characterized by a diverse array of pulmonary and nonpulmonary manifestations, but our understanding of COPD pathogenesis and the factors that influence its heterogeneity in disease presentation is poor. Despite this heterogeneity, treatment algorithms are primarily driven by a single measurement, forced expiratory volume in 1 second ($FEV_1$) as a percentage of its predicted value ($FEV_1%$). In 2011, a major shift in Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment recommendations was proposed that stratifies patients with COPD on the basis of symptoms and exacerbation history. This article reviews the work reported in 2013 that enlightens our understanding of COPD with respect to COPD classification systems, phenotype, biomarker, exacerbation, and management for patients with COPD.

• 대한간호학회지
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• 제47권4호
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• pp.488-498
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• 2017

Purpose: The focus of the study was on the selection-optimization-compensation (SOC) strategy to predict successful aging mediated by dyspnea symptoms in older adults with chronic obstructive pulmonary disease. The model was constructed based on the hypotheses that coping strategy and social support of the elders predict successful aging through the SOC strategies. Methods: Participants were 218 outpatients with chronic obstructive pulmonary disease recruited for the study. Data collection was done from March 25 to September 11, 2015, and analyzed using SPSSWIN 22.0 and AMOS 21.0. Results: The hypothetical model appeared to be fit to the data. Seven of eight hypotheses selected for hypothetical model were statistically significant. The SOC strategy has only significant indirect effects through dyspnea symptoms on successful aging. Coping strategy, social support, SOC strategies and dyspnea symptoms explained 62% of variance in successful aging. Conclusion: The SOC strategies with social support and dyspnea symptoms significantly explained successful aging among patients with chronic obstructive pulmonary disease. Nursing strategies should be focused on social support and coping strategies to optimize SOC strategies so that older adults with chronic obstructive pulmonary disease are able to manage dyspnea symptoms and eventually achieve successful aging.

• 대한간호학회지
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• 제53권2호
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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.

• 성인간호학회지
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• 제20권4호
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• pp.652-663
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• 2008

Purpose: This study was conducted to develop and test an explanatory model on functional capacity in patients with chronic obstructive pulmonary disease using path analysis. Methods: Data were collected from 149 chronic obstructive pulmonary disease patients using 6-minute walk test, measurement of oxygen saturation, pulmonary function test, and self-reported questionnaires from June to October, 2005. The collected data were analyzed using SPSS/WIN 12.0 program and AMOS/WIN 4.0 program. Results: The overall fitness indices of modified model were good($x^2$ = 14.324, p = .281 GFI = .981, RMSEA = .006, AGFI = .944, NFI = .927, NNFI = .999, CFI = .999, PNFI = .613, $x^2$/df = 1.194). Functional capacity was influenced directly by age(${\beta}$ = -.304, p = .000), dyspnea(${\beta}$ = -.278, p = .000), self-efficacy(${\beta}$ = .240, p = .000), social support(${\beta}$ = .175, p = .004), pulmonary function(${\beta}$ = .169, p = .008), and oxygen saturation(${\beta}$ = .099, p = .048). These variables explained 39.3% in functional capacity. Conclusion: The findings of this study suggest that comprehensive nursing interventions should focus on decreasing dyspnea and increasing self-efficacy, social support, and oxygen saturation. In this perspective, pulmonary rehabilitation would be an effective strategy for improving functional capacity in patients with chronic obstructive pulmonary disease.

• Tuberculosis and Respiratory Diseases
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• 제76권2호
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• pp.53-58
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• 2014

Chronic obstructive pulmonary disease (COPD) is a common airway disease that has considerable impact on disease burdens and mortality rates. A large number of articles on COPD are published within the last few years. Many aspects on COPD ranging from risk factors to management have continued to be fertile fields of investigation. This review summarizes 6 clinical articles with regards to the risk factors, phenotype, assessment, exacerbation, management and prognosis of patients with COPD which were being published last year in major medical journals.

• Tuberculosis and Respiratory Diseases
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• 제79권4호
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• pp.307-311
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• 2016

Pulmonary strongyloidiasis is an uncommon presentation of Strongyloides infection, usually seen in immunocompromised hosts. The manifestations are similar to that of acute exacerbation of chronic obstructive pulmonary disease (COPD). Therefore, the diagnosis of pulmonary strongyloidiasis could be challenging in a COPD patient, unless a high index of suspicion is maintained. Here, we present a case of Strongyloides hyperinfection in a COPD patient mimicking acute exacerbation, who was on chronic steroid therapy.

• 대한간호학회지
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• 제37권6호
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• pp.855-862
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• 2007

Purpose: The purpose of this study was to identify the factors influencing fatigue in patients with chronic obstructive pulmonary disease. Methods: A descriptive correlational study design was used. A convenience sample of 125 subjects was recruited from the outpatient respiratory clinic at a large university hospital. Data was collected from June to October, 2005 using structured questionnaires, an oxygen saturation test, a 6-minute walking test, and a pulmonary function test. Results: Subjects had a slightly low degree of fatigue. The fatigue showed a significant correlation with emotion(r=.589, p= .000), dyspnea(r=.304, p= .001), self-efficacy(r=-.278, p= .002), and symptom experience(r=.238, p= .008). Emotion(34.7%) and dyspnea(5.8%) were significant predictors to explain fatigue. Conclusion: This study provides comprehensive understanding of the influencing factors on fatigue in patients with chronic obstructive pulmonary disease. Nursing interventions to decrease negative emotion and dyspnea for management of fatigue is suggested.

• 농촌의학ㆍ지역보건
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• 제46권1호
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• pp.1-11
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• 2021

이 연구의 목적은 천식과 만성폐쇄성폐질환 환자들의 미세먼지에 대한 인식, 지식, 예방행위 수준과, 예방행위에 영향을 미치는 요인을 확인하기 위한 것이다. 이 연구는 서술적 조사연구로 연구대상은 대구광역시 소재 일개 대학병원 호흡기전문질환센터를 방문한 만 19세 이상, 만 80세 이하의 만성호흡기질환자를 편의표본추출하였고, 2019년 12월부터 2020년 1월까지 구조화된 자기기입식 설문조사로 자료를 수집하여, 총 212부의 자료를 분석 대상으로 하였다. 연구대상자는 212명이었으며, 이중 천식 112명(52.8%), 만성폐쇄성폐질환 100명(47.2%)이었다. 미세먼지에 대한 인식, 지식, 예방행위의 평균 점수(10점 만점)는 천식 환자는 각각 7.92점, 6.99점, 7.10점이었고, 만성폐쇄성폐질환자는 각각 7.72점, 6.24점, 6.80점 이었다.미세먼지 지식 점수는 천식환자가 만성폐쇄성폐질환자보다 유의하게 높았다(p=0.007). 미세먼지 예방행위 수준에 영향을 미치는 요인은 천식은 인식 점수, 지식 점수, 연령이며, 만성폐쇄성폐질환은 인식 점수가 유의한 요인이었다. 이상의 결과 천식과 만성폐쇄성폐질환 환자의 예방행위에 영향을 주는 요인은 천식은 인식 점수, 지식 점수, 연령이며, 만성폐쇄성폐질환은 인식점수였다. 미세먼지 예방행위 수준을 높이는 것은 미세먼지로 인한 만성호흡기질환의 악화를 막을 수 있으므로, 질환에 따른 대상자의 특성을 고려한 중재 프로그램의 개발과 지속적이고 반복적인 교육이 요구된다.

• Tuberculosis and Respiratory Diseases
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• 제76권4호
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• pp.169-174
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• 2014

Background: The Korean Obstructive Lung Disease (KOLD) Cohort Study is a prospective longitudinal study of patients with chronic obstructive pulmonary disease (COPD), asthma, or other unclassified obstructive lung diseases. It was designed to develop new classification models and biomarkers that predict clinically relevant outcomes for patients with obstructive lung diseases. Methods: Patients over 18 years old who have chronic respiratory symptoms and airflow limitations or bronchial hyper-responsiveness were enrolled at 17 centers in South Korea. After a baseline visit, the subjects were followed up every 3 months for various assessments. Results: From June 2005 to October 2013, a total of 477 subjects (433 [91%] males; 381 [80%] diagnosed with COPD) were enrolled. Analyses of the KOLD Cohort Study identified distinct phenotypes in patients with COPD, and predictors of therapeutic responses and exacerbations as well as the factors related to pulmonary hypertension in COPD. In addition, several genotypes were associated with radiological phenotypes and therapeutic responses among Korean COPD patients. Conclusion: The KOLD Cohort Study is one of the leading long-term prospective longitudinal studies investigating heterogeneity of the COPD and is expected to provide new insights for pathogenesis and the long-term progression of COPD.

• Tuberculosis and Respiratory Diseases
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• 제79권4호
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• pp.207-213
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• 2016

Chronic obstructive pulmonary disease (COPD) encompasses several clinical syndromes, most notably emphysema and chronic bronchitis. Most of the current treatments fail to attenuate severity and progression of the disease, thereby requiring better mechanistic understandings of pathogenesis to develop disease-modifying therapeutics. A number of theories on COPD pathogenesis have been promulgated wherein an increase in protease burden from chronic inflammation, exaggerated production of reactive oxygen species and the resulting oxidant injury, or superfluous cell death responses caused by enhanced cellular injury/damage were proposed as the culprit. These hypotheses are not mutually exclusive and together likely represent the multifaceted biological processes involved in COPD pathogenesis. Recent studies demonstrate that mitochondria are involved in innate immune signaling that plays important roles in cigarette smoke-induced inflammasome activation, pulmonary inflammation and tissue remodeling responses. These responses are reviewed herein and synthesized into a view of COPD pathogenesis whereby mitochondria play a central role.