Fatigue, functional status, health and pulmonary rehabilitation in patients with chronic obstructive pulmonary disease
Notice bibliographique
Résumé
The aim of this thesis was to describe fatigue, functional limitations due to fatigue and health in patients with chronic obstructive pulmonary disease (COPD), as well as to compare patients with individuals from the general population and to test if pulmonary rehabilitation can reduce fatigue and functional limitations, and thus improve health. A further aim was to test the Fatigue Impact Scale (FIS) among patients with COPD. Two studies (I, II) had a descriptive comparative design with data from 36 and 151 patients with COPD respectively, and 37 and 95 individuals respectively, randomly selected from the general population. One study (III) was a randomised pre-test post-test study with 12 patients with COPD randomised to 12 weeks’ pulmonary rehabilitation and 14 patients in a control group. In a further study (IV), the FIS was tested for validity and reliability among 296 patients with COPD who reported fatigue. Assessments: Structured questions frequency, duration and severity of fatigue, functional limitations due to fatigue with FIS, six minutes’ walking distance, hand grip strength, functional performance and satisfaction with Canadian Occupational Performance Measure and health with St George’s Hospital Respiratory Questionnaire and Short Form-36. Almost half of the patients with COPD had a problem with fatigue every day and experienced fatigue as a severe symptom. More than 44% reported that fatigue was one of the worst symptoms. The experience of fatigue was related to the patients’ functional performance and health perceptions. Patients with COPD experienced a higher frequency, longer daily duration and greater severity of fatigue than individuals from the general population. After a 12 week pulmonary rehabilitation programme, there were no statistically significant differences between the patients randomised to the rehabilitation group and those in the control group. The patients in the rehabilitation group improved walking distances, performance and satisfaction with regard to their own selected activities compared with baseline. Confirmatory factor analysis on the three-factor model proposed for FIS showed that the fit of the model was not acceptable. Further validation of the FIS resulted in a removal of 15 items (FIS-25) and support for Pipers´ theoretical framework of subjective manifestations of fatigue including physical, emotional and cognitive dimensions and a general behavioural factor. The internal consistency, sensitivity and stability correlations of FIS-25 were satisfactory. In conclusion, fatigue is a major concern among patients with COPD, impacting on functioning and health. Interventions with 12 weeks’ pulmonary rehabilitation might not be effective enough to reduce fatigue and the functional limitations due to fatigue. More research is needed to solve the symptom burden of fatigue and its impact on functioning and health in patients with COPD.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».