Patient responses to COPD symptoms: The relationship of dyspnea and fatigue to activities of daily living, inhaler use, and self-care capability
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Background. Chronic obstructive pulmonary (COPD) disease is the fourth leading cause of death in the US. COPD care is concentrated in the outpatient setting and requires the complex management of activities of daily living (ADL's), inhaled medications, and self-care capability. Previous studies have not determined how daily dyspnea and fatigue affect care or alter activities when symptoms worsen.
Purpose. The goal of this study was to discover the influence of dyspnea and fatigue on ADL's, inhaler use, and self-care capability of COPD outpatients.
Methods. The study was a descriptive, non-experimental, and within subjects design. Participants were recruited from an outpatient pulmonary clinic at a midwestern Veterans Administration hospital (N = 66). The Self-As-Carer-Inventory (SACI) established appropriateness of the sample. Daily care practices were determined at enrollment (Baseline) with horizontal visual analogue scales (HVAS) to measure dyspnea, fatigue, and self-care, an ADL check list, and number of inhaler puffs. Participants completed these measures in-home when dyspnea and/or fatigue worsened (Day One) and again the following day (Day Two) even if there was improvement. Written survey comments and follow-up interviews enhance the understanding of the variables. Quantitative analyses included t-tests, correlations, repeated measures ANOVA, mulitvariate, and simple regression. Written comments and follow-up interviews were inductively analyzed and placed into categories.
Results. Participants discriminated between dyspnea and fatigue and rated fatigue higher (p = .001). Correlation of dyspnea and fatigue strengthen through Baseline. Day One, and Day Two measures. There was slight significance of ADL's with decreased snack and fluid intake, but grooming, dressing, and going outside remained unchanged. Dyspnea was a predictor for self-care cpability (R2 = .51; p = .001). Inhaler use remained unchanged. One half of the participants indicated Day One was a “typical” day in spite of the worsening dyspnea and fatigue. Only four sought emergency room intervention.
Conclusion. The influences of dyspnea and fatigue on daily self-care practices were established at Baseline. Increased levels of dyspnea and fatigue significantly influenced self-care, minimally altered some ADL's, and did not affect inhaler use. Future studies are needed to better understand how inhaler use and additional self-care tasks are managed by COPD outpatients.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3001680; ProQuest document ID: 231000496. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Descriptive/Correlational |
Research Approach | Quantitative Research |
Keywords | Patient Self-Care; Chronic Obstructive Pulmonary Disease (COPD); Fatigue; Dyspnea |
Grantor | Virginia Commonwealth University |
Advisor | Grap, Mary Jo; Corley, Mary C.; Boyle, Anne H.; Fairman, Paul |
Level | PhD |
Year | 2001 |
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