1,721,071 research outputs found
The role of expectations on the respiratory performance of people with Chronic Obstructive Pulmonary Disease
No full textIntroduction: Previous studies have investigated the effects of oxygen therapy both during sleep and daily life, investigating its influences in patients with hypoxaemia. However, there are no studies investigating the role of oxygen (O2) during the performance of the 6 Minute Walking Test (6MWT) compared to a placebo. The study aimed to investigate the role of the placebo effect during oxygen therapy in patients with moderate Chronic Obstructive Pulmonary Disease (COPD) (GOLD2). Methods: An experimental, randomised, two-arm, counterbalanced study was carried out, involving 95 people with COPD (68.4% male, average age 67). Participants were randomised and assigned to two groups: 1) Participants who usually use oxygen (O2): in addition to standard care, they underwent the 6MWT using compressed medical air (RA) cylinders, believing that O2 was inside the concentrator. The same, subsequently, underwent the 6MWT, thanks to the use of concentrators of O2, believing that inside the cylinder there was O2. The sequence of this group was thus characterised as follows: ABC (A=Baseline, B=Air, C=Oxygen). 2) Participants who do not usually use O2: the same methodology was used, with a different sequence (ACB). Mini-Mental Status Examination (MMSE), to assess cognitive impairment; Modified British Medical Research Council questionnaire (mMRC), to detect dyspnoea; Fatigue Severity Scale (FSS); Simple Spirometry, were taken at baseline. Saturation (SpO2), heart rate and blood pressure were measured at baseline, at 3':30'' and at the end of the 6MWT, from which the main outcome of the study was taken. Results: A repeated measures ANOVA was performed to compare the effect of oxygen usage on the 6MWT. There was no statistically significant difference in the 6MWT between the two groups (F(2, 1) = 0.113, p = 0.888). Discussion: Whilst oxygen therapy is and remains an important treatment for COPD patients, working on their beliefs and expectations can improve their care processes
Editorial: The psychological challenges of respiratory disease
Full text linkLives of people who suffer from respiratory diseases, such as complex asthma, pulmonary fibrosis, Chronic Obstructive Pulmonary Disease (COPD), are disturbed by many different factors. In addition to clinical comorbidities, psychological and neuropsychological problems are frequent in respiratory diseases and may affect the health care process as well as rehabilitation delivery and outcome. While the impact is unique for each individual, key areas of difficulty include fear of breathlessness, reduced activity levels, fatigue, lowered self-efficacy and energy, disrupted relationships, anxiety and significantly lowered mood. For many, the physical symptoms of breathlessness are exacerbated by anxiety and panic in a vicious cycle of escalating breathlessness, physiological arousal and further panic. The meaning of the lung condition for an individual can be informed by illness perceptions not necessarily supported by medical understanding, and thus misinterpretation of bodily sensations can fuel anxiety and fears. Finally, it is very complex to define the role of these factors in the management processes of medical therapies, as well as those requiring physical activity or the use of devices.
This article collection aims to present the most recent advances in research on the psychological factors involved in the respiratory diseases, as well as their implications in the health management process
PROMOTING ADHERENCE TO NON INVASIVE VENTILATION (NIV) IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) WITH A BRIEF PSYCHOLOGICAL INTERVENTION
No full textPersone con broncopneumopatia cronica ostruttiva (BPCO) possono avere diversi atteggiamenti verso la ventilazione non invasiva (NIV), inclusi il rifiuto o l’utilizzo inappropriato. Questo costituisce uno spreco di risorse pubbliche, comportando costi significativi per l'assistenza sanitaria. Lo studio mirava ad analizzare l'impatto di un breve intervento di supporto psicologico sull'aderenza alla NIV in pazienti con BPCO. E’stato condotto uno studio clinico controllato e randomizzato a due rami su 84 pazienti con BPCO e con indicazione per NIV. Il gruppo sperimentale ha ricevuto un breve supporto psicologico, che include colloqui clinici, esercizi di rilassamento e di mindfulness. I controlli hanno ricevuto cure standard e hanno guardato video educativi relativi alla gestione della malattia. Il percorso era strutturato in 4-8 sessioni in ospedale, a casa e/o in telemedicina. Sono stati valutati valori, credenze ed esperienze di NIV attraverso interviste semi-strutturate e colloqui clinici. L'intervento psicologico è risultato correlato a miglioramenti della qualità della vita e dell'aderenza. Ha permesso di delineare un modello teorico del processo di adattamento alla NIV in pazienti con BPCO. I risultati suggeriscono che questo intervento psicologico può incrementare l'accettazione e l'aderenza alla NIV nella BPCO nella pratica clinica e sottolinea l'importanza di determinare le ragioni sottostanti l’uso della NIV.People with chronic obstructive pulmonary disease (COPD) may have different attitudes toward non-invasive ventilation (NIV), including rejection and misuse. That is a waste of public resources and results in significant health care costs. The study aimed to analyze the impact of a brief psychological intervention on adherence to NIV among COPD patients. A two-branch randomized controlled trial was conducted with 84 COPD patients using NIV. The experimental group received psychological support, including counseling, relaxation and mindfulness-based exercises. Controls received standard care and were exposed to educational videos. The intervention was structured over 4 to 8 meetings at the hospital, at home and/or via telemedicine. Values, beliefs and experiences of NIV were assessed with semi-structured interviews. The psychological intervention was related to improvements in both adherence and quality of life. A theoretical model of the adaptation’s process to NIV in COPD patients emerged. The findings suggest that this psychological intervention could increase acceptance and adherence to NIV in COPD in clinical practice
Editorial: Psychosocial issues and interventions in pulmonary rehabilitation
No full textEditorial, abstract not availabl
Risk, vulnerability, and protective factors in living with a tracheostomy in times of Covid-19
No full textThe study aimed to explore the experiences of people with neuromuscular and chronic respiratory diseases and their caregivers concerning tracheostomy management at home during the Covid-19 health emergency in Italy. In a multiple case study approach, we sought perspectives through semi-structured interviews of caregivers and patients with neuromuscular or chronic respiratory diseases and tracheostomy. In addition, the following instruments were used: Connor and Davidson Resilience Scale (CD-RISC-25), to detect resilience; Acceptance and Action Questionnaire-II (AAQ-II), to detect flexibility; State-Trait Anxiety Inventory (STAI), to detect trait anxiety; Langer Mindfulness Scale (LMS), to measure dispositional mindfulness; Zarit Burden Interview (ZBI) to detect caregiver’s burden. Qualitative analyses, based on Interpretative Phenomenological Analysis (IPA), were used to identify themes, sub-themes, frequency of words and metaphors. Twenty-two patients [50% female, Mean age=50.2±21.2] and 52 caregivers [62.3% female, Mean age 52.2±1.22] took part in the study. The demonstration of a relationship between resilience, flexibility, anxiety, and dispositional mindfulness offers the opportunity to reinforce the management of tracheostomy at home, even in emergency periods
Psychological factors to promote acceptance and adherence to NIV in people with COPD
No full textPsychological factors to promote acceptance and adherence to NIV in people with COP
The Interaction Between Asthma, Emotions, and Expectations in the Time of COVID-19
Full text linkIntroduction: The main aim was to gain insight into the experience of adult people with a diagnosis of at least 6-months of mild or moderate persistent asthma according to the Global Initiative for Asthma (GINA), and their emotions, beliefs, and expectations during
the first wave of COVID-19.
Methods: Qualitative semi-structured interviews using the Interpretative Phenomenological Analysis (IPA) were carried out by phone involving 31 people (mean age=58.2; SD=16.2). Interviews were audio recording, transcribed verbatim and analysed through thematic analysis.
Results: Five superordinate themes and themes were dedicated to illness (symptoms of asthma; difficulties related to COVID-19), experienced emotions (lockdown period; medical changes; emotions COVID-19 related), beliefs (about asthma; about COVID-19), expectations (related to asthma; related to COVID-19) and behaviours (to protect; risk taken; adherence; contacts with General Practitioners; support). The prevalence of emotions such as fear, worry and anxiety emerged in the participants’ narratives. All are
accompanied by a preference for action and problem solving. A sense of protection, connection to self and other, and commitment to
life were revealed as central concepts for enhancing well-being even at a time of deterring.
Discussion: The common threads of the presence of uncertainty and vulnerability open the outlook of a treatment that ensures greater
continuity and ownership of care in the patient, preserving the sense of self-efficacy even in times of greater instability
A short Mindfulness intervention in telemedicine in severe post-COVID-19 patients
No full textThe present pilot randomised controlled trial compared the impact of a Mindfulness-based brief intervention conducted in telemedicine (n = 20) for a period of 5-6 sessions of 45 minutes each, for a total commitment of 3 weeks, to a wait-list control (n = 20), involving people who have been previously tested positive for COVID-19, admitted to intensive care or reanimation and subsequently in respiratory rehabilitation following negativization. The General Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), Impact of Event Scale (IES), Perceived Stress Scale (PSS), State Shame and Guilt Scale-8, Peritraumatic Perceptions of Fear and life threat, Psychological General Well-being Index (PGWBI), respiratory functions, oxygen saturation, haemogasanalysis were detected at baseline, 3 weeks, and 3 months. Semi-structured interviews conducted according to the Interpretative Phenomenological Analysis (IPA) approach detected the participants' emotional experiences, expectations, and beliefs about their experience of illness. This study showed the potential of an affordable and widely accessible Mindfulness-based brief intervention in clinical practice, offering a view of hospital-territory continuity following the acute phase of COVID-19 disease
The implementation of a psychological support during the adaptation to Non Invasive Ventilation (NIV) in Chronic Obstructive Pulmonary Disease (COPD): a Randomized Controlled Trial
No full textBackground: People with COPD may suffer from anxiety, depression, low quality of life and cognitive deficits that could play a role in their clinical conditions. These situations could be worsened during the adaptation’s process to a new treatment such as NIV, which is often rejected or inappropriately used. Aims and objectives: This study aims to investigate the impact of a brief psychological support on acceptance and adherence to NIV in COPD patients. Methods: Eighty-four COPD patients with an indication for NIV were recruited and involved in a two-branch randomised controlled trial, single-blind. The experimental group underwent a psychological support including counselling, relaxation and mindfulness-based exercises and neuropsychological rehabilitation exercises. Controls received standard care and watched educational videos related to the disease’s management. The interventions were delivered at the HD Respiratory Rehabilitation Unit of Fondazione Don Carlo Gnocchi in Milan (Italy), at home or via telemedicine. Results: The psychological intervention had an impact on the objected utility and quality of life rather than the subjective one as assessed by the EuroQoL-5D and contributed to improve the weekly NIV hours practiced (F(65.42)=14.63, p=.000). Moreover, illness perception as assessed with the Brief Illness Perception Questionnaire predicted changes in respiratory function (FEV1%; F(48, 18)=3.047, p<.05). Conclusions: These findings suggested that a brief psychological intervention is appropriate in order to promote acceptance and adherence to NIV in COPD in clinical practice
- …
