Predictors of Low-Level Disease-Specific Knowledge in Patients with Chronic Obstructive Pulmonary Disease.

Disease-specific knowledge is associated with outcomes of patients, but the knowledge level of chronic obstructive pulmonary disease (COPD) patients is known to be low. We measured the level of disease-specific knowledge and defined factors associated with poor disease knowledge in COPD patients. A cross-sectional survey was performed in five hospitals in South Korea. At enrolment, all patients completed the Bristol COPD Knowledge Questionnaire (BCKQ), Satisfaction with Life Scale (SWLS), Personal Resource Questionnaire (PRQ), St. George's Respiratory Questionnaire (SGRQ), 36-item Short-Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). The data were analyzed via linear regression to identify factors associated with low-level knowledge of COPD. A total of 245 COPD patients were enrolled in this study. The mean total BCKQ score was 28.1 (SD, 7.4). The lowest scores were seen for items exploring knowledge of "Oral steroids" and "Inhaled steroids". In univariate analysis, higher level of education (r = 0.17), low income (r = 0.13), the post-bronchodilator FEV1, % predicted (r = -0.24), the post-bronchodilator FEV1/FVC ratio (r = -0.13), SWLS (r = 0.15), PRQ (r = 0.16), SF-36 MCS (r = 0.13), HADS-A (r = -0.17), and HADS-D (r = -0.28) scores correlated with the BCKQ score (all p < 0.05). FEV1 (r = -0.25, p < 0.001) and HADS-D score (r = -0.29, p < 0.001) were significantly associated with the total BCKQ score in multivariate analysis. Our Korean patients with COPD lacked knowledge on oral and inhaled steroid treatments. In particular, patients with higher-level lung function and/or depressive symptoms exhibited poorer disease-specific knowledge; such patients may require additional education.

Lee SH ，Lee H ，Kim YS ，Park HK ，Lee MK ，Kim KU ... -  《International Journal of Chronic Obstructive Pulmonary Disease》

Social support is a strong determinant of life satisfaction among older adults with chronic obstructive pulmonary disease.

Older adults with chronic obstructive pulmonary disease (COPD) are frequently compromised in terms of social life and functional capacity, triggering reduced in life satisfaction (LS). We investigated the level of LS among elderly patients with COPD and factors associated with LS. This was a prospective cross-sectional survey enroling a sample of 160 COPD subjects aged 65 y or older. At enrolment, all patients completed measures of LS (the Satisfaction with Life Scale; SWLS) and social support (Personal Resource Questionnaire; PRQ). The health-related quality of life (HRQL) was measured using St. George's Respiratory Questionnaire (SGRQ) and 36-item Short-Form Health Survey (SF-36). Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). About 30.6% of the patients reported that they were satisfied or highly satisfied with their lives. In univariate analysis, post-bronchodilator FEV1, percentage predicted was significantly associated with SWLS score (r = 0.205, P = .009). Age (r = 0.207), diabetes (r = 0.209), osteoporosis (r = -0.190), PRQ (r = 0.388), SGRQ total (r = -0.291), SF-36 PCS (r = 0.233), SF-36 MCS (r = 0.274), HADS-A (r = -0.291) and HADS-D (r = -0.352) were also associated with SWLS score (all P < .05). Multivariate analysis revealed that FEV1 (r = 0.223, P = .04) and PRQ (r = .244, P = .002) were independently associated with SWLS score. Less than one-third of older adults with COPD reported that they were satisfied with their lives. Better lung function and greater social support were independently associated with high LS.

Lee SH ，Lee H ，Kim YS ，Park HK ，Lee MK ，Kim KU ... -  《-》

Correlates of disease-specific knowledge in Chinese patients with COPD.

Wong CK ，Yu WC 《-》

Factors associated with sleep disturbance in patients with chronic obstructive pulmonary disease.

Poor sleep quality in patients with chronic obstructive pulmonary disease (COPD) has been associated with poor health outcomes. However, there is a lack of research on factors associated with sleep disturbance in patients with COPD. We investigated patterns of sleep disturbance and factors associated with sleep impairment in patients with COPD. This was a prospective, multicenter cross-sectional study enrolling a sample of 245 COPD subjects. All patients completed the patient-reported measure, the COPD and Asthma Sleep Impact Scale (CASIS) to assess sleep impairment. The St. George's Respiratory Questionnaire (SGRQ), the 36-item Short-Form health survey (SF-36), Hospital Anxiety and Depression Scale (HADS), and the COPD Self-Efficacy Scale (CSES) were utilized to assess health-related quality of life (HRQL), anxiety/depression and self-efficacy, respectively. About 35.1% of the patients reported that they had a bad night's sleep. Univariate analysis showed that the CASIS total score was significantly correlated with the modified Medical Research Council dyspnea scale, SGRQ total score, SF-36 PCS, SF-36 MCS, HADS-A, HADS-D and CSES (all P < 0.05). In a multivariate analysis, SGRQ total (r = 0.19, P = 0.006), SF-36 PCS (r = 0.14, P = 0.037), HADS-D (r = 0.24, P ≤ 0.001), and CSES(r = -0.12, P = 0.010) were independently associated with the CASIS score. In this study, 35% of clinically stable patients with COPD reported poor sleep quality. Depression, poorer HRQL and self-efficacy were significantly associated with sleep disturbance in patients with COPD.

Lee SH ，Lee H ，Kim YS ，Kim KU ，Park HK ，Lee MK ... -  《-》

Patient outcomes according to COPD action plan adherence.

To identify the level of pulmonary function, number of unplanned hospital visits, knowledge level of chronic obstructive pulmonary disease (COPD), level of anxiety and depression, and level of health-related quality of life (HRQoL) according to COPD action plan (AP) adherence in Korean patients with COPD. Previous studies reported conflicting results about the effect of COPD AP on patient outcomes, with little descriptive information. A cross-sectional descriptive study design was used. A total of 126 patients with COPD were recruited from Chonnam National University Hospital in Gwangju city from September 2009 to March 2010. COPD action plan adherence and the levels of knowledge of COPD, anxiety and depression, and HRQoL were measured using a short COPD AP developed by the Family Physician Airway Group of Canada executive members, Bristol COPD Knowledge Questionnaire (BCKQ), the hospital anxiety and depression scale (HADS) and the St George's Respiratory Questionnaire (SGRQ), respectively. The score of COPD AP adherence was positively associated with the level of knowledge of COPD and negatively associated with the number of unplanned hospital visits and the level of anxiety and depression. Good adherence to COPD AP is likely related to better health outcomes in COPD. Healthcare providers may need to enhance COPD AP aspect in various COPD self-management programmes to improve the health status of patients with COPD. Chronic obstructive pulmonary disease AP aspect targeting frequent individual education with a written guideline would be helpful to enhance self-management in patients with COPD.

Choi JY ，Chung HI ，Han G 《-》