자연주의적 탐구조사(Naturalistic Inquiry)

国際生活機能分類(International Classification of Functioning, Disability and Health: ICF)にみた福祉・保健・医療の専門職協働における連携に関する貢献と課題

International Classification of Functioning, Disability and Health

Families, Illness, and Disability: An Integrative Treatment Model

British Sign Language Your household has been selected to take part in the Scottish Health Survey. This important study collects information on behalf of the Scottish Government and the National Health Service about the health and lifestyles of people who live in Scotland. If you would you like us to arrange for a BSL interpreter to help conduct the interview, or to explain more about what is involved, please give the person who has called at your address your telephone number so we can arrange this.

The Scottish Health Survey

Objective: This study explores the perspectives of both patients and family members regarding the impact of chronic obstructive pulmonary disease (COPD) in their family life.Design: An exploratory qualitative study was conducted with patients and their family members in the chronic phase of COPD. Individual interviews were performed to explore participants’ perspectives and submitted to thematic analysis.Results: Six major themes emerged from patients’ perspective: (1) impact of COPD symptoms on personal and family daily life; (2) (over)protective family support; (3) difficulties in couple communication; (4) sense of identity loss; (5) fear of COPD progression; and (6) coping resources. Five main themes emerged from the family members’ perspective: (1) restrictions in family’s social life; (2) emotional distress related to COPD exacerbations; (3) tension in couple relationship; (4) financial strain of COPD; and (5) coping resources.Conclusions: The overall findings illustrate the complex interaction betwe...

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Day-to-day living with severe chronic obstructive pulmonary disease: Towards a family-based approach to the illness impacts

Objectives: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of disability, morbidity and mortality in old age, representing a significant burden for families. However, information on the impacts of caring for relatives with COPD on carers’ psychological health is limited. This study aimed to analyse the subjective burden of family carers of people with early and advanced COPD and its predictor variables.Methods: A cross-sectional study was conducted. A structured questionnaire was used to collect socio-demographics and care-giving characteristics. Self-rated physical and mental health were measured by two items from the International Classification of Functioning, Disability and Health checklist. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Subjective burden was assessed with the Carers’ Assessment of Difficulties Index (CADI). Descriptive and inferential analyses were performed.Results: A total of 167 family carers participated: 113 were caring for pe...

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Caring for relatives with chronic obstructive pulmonary disease: how does the disease severity impact on family carers?

Background Chronic Obstructive Pulmonary Disease (COPD) can be highly incapacitating, imposing a significant burden on family members, however, limited research has been conducted on psychological health of family carers. Thus, this study examined anxiety and depression symptoms in family carers of people with COPD and their predictors. Methods A cross-sectional study was conducted with family carers and respective patients with COPD. The caregiving situation and the perceived burden, through the Carers' Assessment of Difficulties Index, were collected from family carers. Patients' COPD severity and activities limitation were assessed. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression symptoms in family carers and patients. Scores ≥8 were considered clinically significant. Results A total of 203 family carers (58.2 ± 14.8 years old; 75.4% female) and respective patients with COPD (69.2 ± 11.5 years old; 36.5% female) were included. Clinically significant anxiety symptoms (HADS-anxiety ≥8) were present in 63.5% (n = 129) of family carers, depression symptoms (HADS-depression ≥8) were in 34% (n = 69) and both were in 27.1% (n = 55). Perceived burden [odds ratio (OR) 1.04, 95% confidence intervals (CI) = 1.01-1.06; 1.05, 95% CI = 1.03-1.07] and patients' activities limitation (OR 1.32, 95% CI = 1.01-1.79; 1.41, 95% CI = 1.01-1.96) were significant predictors of anxiety and depression symptoms. Anxiety symptoms were also predicted by female gender (OR 0.33, 95% CI = 0.16-0.66) and depression symptoms by older age (OR 1.03, 95% CI = 1.01-1.06). Conclusion Family carers of patients with COPD experience anxiety and depression symptoms. Perceived burden, female gender, older age, and patient's activities limitation were predictors of these distressing symptoms. These findings highlight the need to address family carers' needs, namely by investigating the effectiveness of supportive interventions on family's psychological health.

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Predicting anxiety and depression among family carers of people with Chronic Obstructive Pulmonary Disease.

Family-Based Psychosocial Support and Education as Part of Pulmonary Rehabilitation in COPD: A Randomized Controlled Trial

Purpose Patients with chronic obstructive pulmonary disease (COPD) have balance impairments. However, pulmonary rehabilitation (PR) is associated with only minor improvements in functional balance. Therefore, there is a need to explore the role of balance training within PR. This study aimed at assessing the effects of a PR program, with a specific component of balance training, on functional balance of patients with COPD. Methods Outpatients with COPD (N = 22, age = 68.0 ± 11.8 years; forced expiratory volume in 1 second = 72.2 ± 22.3% predicted) participated in a 12-week PR program including exercise training and psychosocial support and education. Exercise training sessions comprised endurance, strength, and a specific component of balance training. The Timed Up and Go (TUG) test was used to assess functional balance before and after the PR. Health-related quality of life (St George's Respiratory Questionnaire), quadriceps muscle strength (10 repetition maximum), and exercise tolerance (6-minute walk test) were also assessed. Results Patients demonstrated significant improvements in TUG scores after PR (mean change -1.7 ± 1.4 seconds; P = .001; effect size = 1.249). Before PR, 9 (41%) participants and after PR only 1 (4.5%) participant had a TUG performance worse than the average performance of age-matched healthy peers (P = .008). The St George's Respiratory Questionnaire symptoms score (P = .012), quadriceps muscle strength (P = .001), and exercise tolerance (P = .001) were also improved. Conclusions Pulmonary rehabilitation with a specific component of balance training had a large effect on functional balance in patients with COPD. Findings highlight the value of including balance training in PR programs. Further research is needed to determine the optimal intervention to improve balance and its specific components among patients with COPD.

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Raquel Gabriel

Papers

Day-to-day living with severe chronic obstructive pulmonary disease: Towards a family-based approach to the illness impacts

Caring for relatives with chronic obstructive pulmonary disease: how does the disease severity impact on family carers?

Predicting anxiety and depression among family carers of people with Chronic Obstructive Pulmonary Disease.

Family-Based Psychosocial Support and Education as Part of Pulmonary Rehabilitation in COPD: A Randomized Controlled Trial

Effects of a pulmonary rehabilitation program with balance training on patients with COPD.