The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

The HR-Qol of aged patients with COPD and the impacts of pulmonary rehabilitation

M.Kawamata, N.Zaitsu, S.Yamanoue, T.Tsuda, M.Tsuda, S.Ozaki, K.Machida, N.Narita, H.Senjyu* *Nagasaki University School of Health Sciences

Department of Rehabilitation and Department of Respiratory Medicine, Tsuda Hospital , Kitakyusyu, Fukuoka 802-0083 JAPAN

Background:
The HR-Qol of aged patients with COPD might be markedly impaired than those of relatives of older adults from the general population. The related medical and social demands are significant and rise as age and respiratory disability increase.

The SF-36 provides the best association to healthcare utilization data from among the three instruments (CRQ, SGRQ and SF-36) studied should be interpreted with caution given the small sample size and relatively brief duration of the study

OBJECTIVES: The purposes of this study were to compare health-related quality of life (HR-Qol) of COPD patients with those of Japanese general population and to investigate the impacts of pulmonary rehabilitation on HR-Qol.

Methods:
Fourteen stable patients with mild to sever COPD (FEV1=37.2% of predicted values) enrolled in pulmonary rehabilitaion program (PRP). HR-Qol was assessed with the St. George's Respiratory Questionnaire (SGRQ) and the Medical Outcomes Study Short-Form 36 Health Survey questionnaire (SF-36). Each sub-scale scores on the SF-36 were changed into Deviation Values (DV) and percentile value to compare with national-norm.

RESULTS:
The pre-reha DV of eight sub-scale scores on the SF-36 ranged from 33.7 to 42.6. The DV of Role-Physical(RF) score and that of Role-Emotional(RE) score were especially low(33.7, 33.8 respectively), but no significant differences were found among eight sub-scale scores (ANOVA). After PR, patients relieved significant improvements in the component scores for symptoms (p=0.002), activities (p=0.007), and impacts (p=0.009) and the total scores (p=0.003) on the SGRQ. All the DV for eight sub-scale scores on the SF-36 also improved: the DV ranged from 38.0 to 45.6.

Conclusions:
The results supported the tenet that older adults with COPD have difficulties with adjustment that may adversely affect social relationships. Although the scores for HR-QoL of mild to sever COPD patients in elderly were lower by 0.9~1.6 SD than that of Japanese general population, it can be improved to a level near its lowest limit for Japanese national-norm after PR.

PULMONARY REHAB PROGRAM:
6 weeks of Pulmonary Rehab Program on Admission
Exercise Training
Pulmonary Rehab Educational Class: 2/week
Anatomy and disease (MD), Smoking cessation (MD & MSW)
Medicine and inhaler (Pharmacist)
ADL, Panic control, Relaxation (PT)
Acute Exacerbation and infection control (RT & NS)
Nutrition (NT)
Social resources and patients' organization, Stress management (MSW& PSW)
Lung function tests, Sleep study (PSGT)
O2 devices, NPPV (Health care provider)

 

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