Kronik Obstrüktif Akciğer Hastalığı (KOAH) Olanlarda Dispnenin Bilişsel Duruma Etkisi

Year 2023, Volume: 7 Issue: 1, 21 - 30, 28.04.2023

Döndü Şanlıtürk , Nurgül Kaplan

https://doi.org/10.29058/mjwbs.1174031

Abstract

Amaç: Bu çalışmada KOAH hastalarında dispnenin bilişsel duruma etkisini incelemek amaçlanmıştır.
Gereç ve Yöntemler: Tanımlayıcı tipte tasarlanan çalışmanın örneklemini 315 KOAH hastası
oluşturmuştur. Verilerin toplanmasında Kişisel Bilgi Formu, Medical Research Council Scale (MRCS)
ve Standardize Mini Mental değerlendirme testi (SMMT-E) kullanılmıştır. Verilerin değerlendirilmesinde;
yüzdelik, student t testi, tek yönlü varyans analizi, Pearson korelasyon testi, çoklu regresyon analizi ve
Tamhane T2 post-hoc testi kullanılmıştır.
Bulgular: Çalışmaya katılan hastaların yaş ortalaması 54.06 (11.41) yıldır. Hastaların %38’inin orta
düzeyde dispne (2.20±0.95) yaşadığı belirlenmiştir. Hastaların bilişsel durum puan ortalamalarının
düşük düzeyde (21.38±5.74) olduğu ve %58.7’sinde bilişsel durumda bozulma olduğu saptanmıştır.
Çoklu regresyon analizinde şiddetli dispne düzeyi, dispne yönetimindeki yetersizlik, dispneyi nefessizlik,
moral bozukluğu ve ölüm korkusu hissi ile ilişkilendirme, evde oksijen tüpü ve bibap kullanımının bilişsel
durumla ilişkili olduğu saptanmıştır. Hastaların bilişsel düzeyindeki varyansın %31’inin dispne ilişkili
bağımsız değişkenler tarafından açıklandığı saptanmıştır (R2 = 0.581; adjusted R2= 0. 311). Dispne
düzeyi ile bilişsel durum arasında negatif yönde, güçlü düzeyde ilişki olduğu saptanmıştır (r=-0.705,
p=0.000).
Sonuç: KOAH hastalarında dispne düzeyinin bilişsel durumu etkilediği ve bu nedenle hastalara
dispnenin azaltılmasına yönelik önlemlerin alınması önerilmektedir

Keywords

Bilişsel durum, Dispne, KOAH

The Effect of Dyspnea on the Cognitive Status in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Abstract

Aim: The aim of this study is to examine the effect of the dyspnea on cognitive status in patients with
chronic obstructive pulmonary diseases (COPD).
Material and Methods: The universe of this descriptive study consist of 315 COPD patients. Data were
collected with a Questionare, Medical Research Council Scale (MRCS) and Standardize Mini Mental
State Examination (SMMT-E). In the analyses of the data, descriptive statistics, independent t-test, oneway
analysis of variance and regression and Tamhane T2 analysis were employed.
Results: The mean age of the patients patricipating the study was 54.06 (11.41) years. 38% of the
patients were determined to experienced moderate dyspnea (2.20±0.95). The patients’ cognitive status
mean scores were found low (21.38±5.74) and 58.7% had cognitive impairment. It was determined
in multiple regression analysis that severe dyspnea level, inadequacy in dyspnea management,
associating dyspnea with breathlessness, feeling of low mood and fear of death, use of oxygen tube and
bipod at home were associated with cognitive status. Moreover, it was found that 31% of the variance in
the cognitive level of the patients was explained by the independent variables related to dyspnea (R2 =
0.581; adjusted R2= 0.311). It was found that there was a strong positive correlation between dyspnea
and cognition status (r=-0.705, p=0.000).
Conclusion: It was determined that dyspnea effects to SMMT-E and therefore it could be advised to
taking measures to reduce dyspnea COPD patients.

Keywords

Cognitive status, Dyspnea, COPD

References

• REFERENCES 1. Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1151-210.
• 2. Global Initiative for Chronic Obstructive Lung Disease (GOLD). The Global Strategy For The Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease 2022. Available at: https://goldcopd.org/2022-gold-reports-2/. Accessed 02.05.2022.
• 3. Austin V, Crack PJ, Bozinovski S, Miller AA, Vlahos R. COPD and stroke: Are systemic inflammation and oxidative stress the missing links?. Clin. Sci. 2016;130(13):1039-1050.
• 4. Kuo LC, Chen JH, Lee CH, Tsai CW, Lin CC. End-of-Life health care utilization between chronic obstructive pulmonary disease and lung cancer patients. J. Pain Symptom Manage. 2019;57(5), 933-943.
• 5. Degregory PR, Tapia J, Wong T, Villa J, Richards I, Crooks RM. Managing Heart Failure at Home with Point-of-Care Diagnostics. IIEEE J. Transl. Eng. Health Med. 2017;5:1-6.
• 6. De Schreye R, Smets T, Deliens L, Annemans L, Gielen B, Cohen J. Appropriateness of end-of-life care in people Dying from COPD. Applying quality indicators on linked administrative databases. J Pain Symptom Manage 2018;56:541-550.
• 7. Husted MG, Kriegbaum M, Kirkegaard N, Lange P. The use of healthcare resources in the last 3 years of life in pa- tients with COPD and lung cancer in Denmark. A retrospec- tive nationwide study. BMJ Support Palliat Care 2014;4:146-151.
• 8. Singh G, Zhang W, Kuo YF, Sharma G. Association of psychological disorders with 30-day readmission rates in patients with COPD. Chest, 2016;149(4):905-915.
• 9. Kapısız Ö, Eker F. Evaluation of the relationship between the levels and perceptions of dyspnea and the levels of anxiety and depression in chronic obstructive pulmonary disease (COPD) patients. J. Psychiatr. Nurs. 2018;9(2):88-95.
• 10. Harris S. COPD and coping with breathlessness at home: a review of the literature. Br J Community Nurs. 2007; 12:411-5.
• 11. Alvi T, Assad F, Aurang Zeb, Malik MA. Anxiety and depression in burn patients. J. Ayub Med Coll Abbottabad. 2009;21(1):137-41.
• 12. Ralph N, Norris P. Current opinion about surgery-related fear and anxiety. J. Perioper. Nurs. 2018;31(4):3.
• 13. Australian Institute of Health and Welfare (AIHW). Australia’s Health 2012: In Brief: AIHW; 2012.
• 14. Özalevli S, Uçan E. Farklı dispne skalalarının kronik obstrüktif akciğer hastalığında karşılaştırılması. Toraks Dergisi 2004; 2:90-4.
• 15. American Thoracic Society. Dyspnea –mechanisms, assessment, and management: a consensus statement. Am J Resp Crit Care Med 1999;159:321-40.
• 16. Eakin EG, Resnikoff PM, Prewitt LM, Ries AL, Kaplan RM. Validation of a New Dyspnea Measure: The UCSD Shortness of Breath Questionnaire. University of California, San Diego. Chest 1998; 113:619–24.
• 17. Dodd JW, Charlton RA, van den Broek MD, Jones PW. Cognitive dysfunction in patients hospitalized with acute exacerbation of chronic obstructive pulmonary disease (COPD). Chest. 2013; 144(1): 119-27. doi: 10.1378/chest.12-2099.
• 18. Hung WW, Wisnivesky JP, Siu AL, Ross JS. Cognitive decline among patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2009; 180(2): 134-7.
• 19. Fletcher CM. The clinical diagnosis of pulmonary empysema: An experimental study. Proc Res Soc Med 1952; 45: 577-84.
• 20. Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999; 54:581–6.
• 21. Güngen C, Ertan T, Eker E. Standardize Mini Mental Test’in Türk toplumunda hafif demans tanısında geçerlik ve güvenirliği. Türk Psik Derg. 2002; 13(4): 273-81.
• 22. Babacan Yıldız G, Ur Özçelik E, Kolukısa M, Turan Işık A, Gürsoy E, Kocaman G ve ark., Eğitimsizler için modifiye edilen mini mental testin (MMSE-E) Türk toplumunda alzheimer hastalığı tanısında geçerlik ve güvenilirlilik çalışması. Türk Psik Derg 2015;26: 1-8.
• 23. O'Conor R, Muellers K, Arvanitis M, Vicencio DP, Wolf MS, Wisnivesky JP, et al. Effects of health literacy and cognitive abilities on COPD self-management behaviors: A prospective cohort study. Respir Med. 2019 Nov-Dec;160:105630. doi: 10.1016/j.rmed.2019.02.006.
• 24. Ozyemisci-Taskiran O, Bozkurt SO, Kokturk N, Karatas GK. Is there any association between cognitive status and functional capacity during exacerbation of chronic obstructive pulmonary disease? Chronic Respiratory Disease. August 2015:247-255. doi:10.1177/1479972315589748
• 25. Roncero C, Campuzano AI, Quintano JA, Molina J, Pérez J, Miravitlles M. Cognitive status among patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis., 2016;11: 543–551. https://doi.org/10.2147/COPD.S100850
• 26. Antonelli-Incalzi R, Corsonello A, Trojano L, Pedone C, Acanfora D, Spada A, et al. Screening of cognitive impairment in chronic obstructive pulmonary disease. Dement Geriatr Cogn Disord 2007;23:264–270.
• 27. Thakur N, Blanc PD, Julian LJ, Yelin EH, Katz PP, Sidney S, et al. COPD and cognitive impairment: the role of hypoxemia and oxygen therapy. Int J Chron Obstruct Pulmon Dis. 2010;5: 263–269. https://doi.org/10.2147/copd.s10684
• 28. Cleutjens FAHM, Spruit MA, Ponds RWHM, Vanfleteren LEGW, Franssen FME, Dijkstra JB, et al. The Impact of Cognitive Impairment on Efficacy of Pulmonary Rehabilitation in Patients With COPD. J Am Med Dir Assoc. 2017;18(5):420-426. doi: 10.1016/j.jamda.2016.11.016.
• 29. Dal Negro RW, Bonadiman L, Bricolo FP, Tognella S, Turco P. Cognitive dysfunction in severe chronic obstructive pulmonary disease (COPD) with or without Long-Term Oxygen Therapy (LTOT). Multidiscip Respir Med. 2015;10(1):17-20. doi: 10.1186/s40248-015-0013-4.
• 30. Wen XH, Li Y, Han D, Sun L, Ren PX, Ren D. The relationship between cognitive function and arterial partial pressure O2 in patients with COPD: A meta-analysis. Medicine (Baltimore). 2018;97(4):e9599. doi: 10.1097/MD.0000000000009599.