Bristol COPD Knowledge Questionnaire Research Articles

Effectiveness of smartphone application in increasing knowledge on COPD and its non-pharmacological management in COPD patients.

Chronic obstructive pulmonary disease (COPD) is among top ten of the world's causes of death. The development of the "Paru Sehat" smartphone application is a positive initiative and might have the potential to improve the disease management of COPD, improve patient's quality of life, and reduce complications associated with COPD. However, its effectiveness in improving the knowledge of the COPD patients is unknown. The aim of this study was to determine the effectiveness of "Paru Sehat" in increasing knowledge on COPD and its non-pharmacological management in COPD patients. A quasi-experimental study with a one-group pretest-posttest was conducted among stable COPD patients at Prof. Chairuddin Panusunan Lubis Hospital, Medan, Indonesia. Bristol COPD knowledge questionnaire (BCKQ) was used to assess the knowledge scores of the patients before and after exposure to the "Paru Sehat" twice a week for four weeks. A dependent Student t-test was used to compare the knowledge scores between pre- and post-intervention for both knowledge domains (i.e., knowledge on the disease and non-pharmacological management). Student t-test or one-way ANOVA were used to determine the association between patients' characteristics and the knowledge scores within pre- and posttreatment. Our data indicated a significant improvement of the knowledge scores on disease between pre- and post-treatment (15.92±3.79 vs 19.56±3.68, p<0.001). The knowledge score on non-pharmacological management also increased significantly post-treatment (7.52±2.02) compared to pre-treatment (10.08±2.379), p<0.001. In addition, this study found that educational attainment was associated with the scores of both knowledge domains of which individuals with senior high school or higher education level had significantly improvement of knowledge scores. This study highlights that although "Paru Sehat" application could improve the knowledge on COPD and its non-pharmacological management, its effects are less effective among individuals with low educational attainment.

A Survey of Community Nurses' Knowledge and Strategies Used to Relieve Breathlessness in People with Chronic Obstructive Pulmonary Disease.

Little is known about community nurses' knowledge of breathlessness and its management in chronic obstructive pulmonary disease (COPD). To explore the community registered nurses' knowledge of COPD and the strategies that they use to manage breathlessness in people with COPD. A cross-sectional survey study of community registered nurses was conducted using the 65-item Bristol COPD Knowledge Questionnaire and an open-ended item to outline breathlessness strategies. A total of 59 nurses participated. The total mean Bristol COPD Knowledge Questionnaire Score was 43. The breathlessness category was the lowest scoring category. There were three themes that synthesised: the community nurse's role in monitoring self-management of medications to relieve breathlessness; the use of non-pharmacological strategies to relieve breathlessness; the nursing skills used to monitor breathlessness in people with COPD.

Community pharmacist-driven interventions in COPD: improving knowledge, attitude and health status

Background: COPD is a chronic condition requiring care from a multidisciplinary team in which pharmacists play an important role. Aim: We aimed to evaluate the impact of structured pharmacist-patient counseling on patient’s knowledge, attitudes about medicines and the impact of COPD on patients’ health status. Methods: A prospective study was conducted in ten community pharmacies. Patients were counseled using detailed approach after completing validated questionnaires. The patients returned to a pharmacy for a follow-up after three months. Four validated questionnaires have been used to assess different aspects of patient’s knowledge about the disease, their attitudes about medicines and the impact of disease on patients’ health status: COPD Assessment Test (CAT), Modified Medical Research Council Dyspnea Scale (mMRC), Bristol COPD Knowledge Questionnaire (BCKQ), and The Beliefs about Medicines Questionnaire (BMQ). Results: Pharmacists recruited 83 COPD patients, from which 73 patients attended a follow-up visit. Before pharmacist intervention, the CAT median score was 20. After counseling, the CAT score decreased to 18 (p&lt;0.05). The highest improvement in patient’s knowledge was observed for inhaled bronchodilators (28.2%), vaccination (25.8%), oral steroids (24.4%), and smoking (24.2%). The median score for necessity increased, whereas the harm and concern median scores considerably decreased (p&lt;0.05). Conclusion: The results showed significant improvements in all aspects covered throughout pharmacist-patient counseling. Based on our results, proactive role of the pharmacist in the care of COPD patients may be beneficial to patients, to physicians and to healthcare: improving care, alleviating the strain on overloaded doctors with containing the costs.

A Retrospective Study of Diaphragmatic Breathing Training Combined with Discharge Care Bundles in Patients with Chronic Obstructive Pulmonary Disease.

Objective Both physical exercise and discharge care bundles can improve patient outcomes and reduce hospitalization rates among subjects with chronic obstructive pulmonary disease (COPD). The retrospective analysis aims to determine the advantages of care bundles combined with diaphragmatic breathing training (DBT) in COPD patients after discharge. Methods Of the 110 COPD patients, 55 patients received DBT alone (DBT group) and 55 participants received the combined intervention (care bundle + DBT group). Three months after discharge, we assessed the outcomes of patients using Bristol COPD Knowledge Questionnaire (BCKQ), Hospital Anxiety and Depression Scale (HADS), COPD Assessment Test (CAT), and St. George's Respiratory Questionnaire (SGRQ). Meanwhile, COPD-related hospital readmissions were also recorded. Results The BCKQ score for assessing the disease knowledge level was increased in patients at 3 months after the combined interventions as compared to the baseline values, which was higher in the care bundle + DBT group than the DBT group at 3 months. Moreover, improvements in negative emotion and clinical symptoms from baseline to 3-month follow-up were seen in both the two groups. Besides, the care bundle + DBT group showed the mitigation of depression and anxiety and the alleviation of clinical symptoms in comparison with the DBT group at 3 months. Participants who received combined interventions had lower SGRQ scores than those who received DBT alone. The time to first COPD-related readmission was shorter for patients in the care bundle + DBT group compared with the DBT group. Conclusions DBT combined with discharge care bundles for COPD patients resulted in improvements in disease-specific knowledge, negative emotions, and clinical symptoms with better HRQOL and lower readmission rate.

Disease-related knowledge in people with chronic obstructive pulmonary disease and their informal caregivers: A multilevel modelling analysis.

To assess the level of chronic obstructive pulmonary disease (COPD)-related knowledge within patient and informal caregiver dyads, and to identify factors influencing the knowledge level considering the interdependence within the dyads. Patients with COPD and their informal caregivers present poor disease knowledge and different characteristics are associated with their level of knowledge. Disease knowledge and related characteristics have been assessed separately in patients and informal caregivers, without considering possible influence within the dyads. Cross-sectional study. A convenience sample of dyads was recruited in outpatient and inpatient settings in Central and South Italy. The Bristol COPD Knowledge Questionnaire was used to measure disease knowledge. Sociodemographic, clinical and caregiving characteristics, self-efficacy and depression were measured in patients and caregivers. Multilevel modelling was used to analyse COPD knowledge at the level of the dyad to control for interdependency between patients and informal caregivers. The STROBE guidelines for cross-sectional studies were followed for study reporting. We recruited 133 dyads. The total level of correct knowledge shared by dyads was 32.89%. Dyads presented higher levels of correct knowledge about disease symptoms, smoking cessation and vaccination, and lower about COPD treatment. Younger patients with greater self-efficacy, who attended pulmonary rehabilitation and were cared for by a spouse/partner with low levels of depression, and informal caregivers who were patients' spouse/partner were more likely to have higher levels of disease-related knowledge. Our study advances dyadic research in COPD. Future studies should investigate the effects of shared knowledge and incongruent knowledge (where one member knows more than the other) on patient self-care and caregiver contribution to patient self-care. Our study shows what knowledge nurses should provide in educational programmes directed at patients and caregivers, and which dyads have greater knowledge deficits, to whom offer targeted educational interventions.

Validity and Reliability of Turkish Version of Bristol COPD Knowledge Questionnaire (BCKQTR)/

Giriş: KOAH hastaları için bilgi düzeyi değerlendirme formları incelendiğinde, Bristol KOAH Bilgi Düzeyi Soru Formu’nun Türkçeye uyarlanması ve psikometrik çalışmaların yapılması, KOAH hastalarının eğitiminde önemli bir gereksinimi karşılayacağı düşünülmektedir.&#x0D; Amaç: Bu araştırma Bristol KOAH Bilgi Düzeyi Soru Formu’nu Türkçeye uyarlamak, geçerliliğini ve güvenilirliğini test etmek için metodolojik bir çalışma olarak yürütülmüştür.&#x0D; Gereç ve Yöntem: Araştırma verileri bir üniversite hastanesinin acil servisine Mayıs ve Aralık 2019 arasında KOAH akut alevlenme belirtileri ile başvuran ve daha önce KOAH tanısı almış ve durumu acil serviste stabilize olmuş, çalışmaya katılmak için gönüllü olan 173 kişiden toplanmıştır. Dil geçerliliğinde ileri ve geri çeviriler kullanılmıştır. İçerik Geçerlilik İndeksini (CVI) belirlemek için uzman görüşleri alınmıştır. Güvenilirliği değerlendirmek için Cronbach’ın alfa ve test-tekrar test güvenilirliği kullanılmıştır.&#x0D; Bulgular: Form, analizler sonucunda CVI 0.88 (0.82-1.00), Cronbach Alpha değeri 0.75 ve test-tekrar test ICC değerin 0.95 olarak bulunmuştur&#x0D; Sonuç: Sonuç olarak formun Türk toplumu için yüksek geçerlilik ve güvenilirliğe sahip olduğuna karar verilmiştir.

The Effect of a web-based physical activity intervention on COPD knowledge: A secondary cohort study

BackgroundNovel strategies to complement current methods of education delivery by healthcare providers in clinic encounters or in pulmonary rehabilitation are needed to promote COPD self-management. MethodsWe developed a COPD web-based platform that delivers education as part of a physical activity intervention. We examined COPD knowledge in persons with COPD who used a web-mediated, pedometer-based physical activity intervention. Knowledge was assessed with the Bristol COPD Knowledge Questionnaire (BCKQ) at baseline, 3, 6, 9, and 12 months. Scores range from 0 to 100, with higher scores indicating greater knowledge. Repeated measures ANOVA (PROC MIXED, SAS 9.4) examined trends across the 12 months and identified changes from baseline at 3, 6, 9, and 12 months. ResultsWe enrolled 72 participants with COPD, 93% males with mean ± sd age of 69 ± 7 years and FEV1% predicted of 60 ± 23%. There was a significant increase from baseline to 9 months (p = 0.012), although this increase did not persist at 12 months. Among the 13 topics, participants scored the highest at baseline on smoking knowledge (65.3 ± 17.4) and the lowest on inhaled steroids (9.7 ± 15.4). Across the 12 months, there were significant increases in knowledge about inhaled bronchodilators (p = 0.011) and inhaled steroids (p = 0.035). At 12 months, there were significant improvements in knowledge about exercise (p = 0.004), vaccination (p = 0.027), inhaled bronchodilators (p = 0.002), and inhaled steroids (p = 0.002). ConclusionAn internet-mediated intervention may provide another option for COPD education delivery and support for disease self-management.

Web-Based Self-management Program (SPACE for COPD) for Individuals Hospitalized With an Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Nonrandomized Feasibility Trial of Acceptability.

BackgroundHospital admissions due to the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are costly for individuals and health services. Pulmonary rehabilitation (PR) is known to reduce hospital readmissions when delivered after hospitalization, but the uptake and completion of PR following hospitalization remains poor (<10% of those eligible in the UK audit data). A web-based platform of the SPACE (Self-management Program of Activity Coping and Education) for COPD (chronic obstructive pulmonary disease) has previously shown promising results in patients with stable COPD but has not been tested following an AECOPD.ObjectiveThis study aims to assess the feasibility and acceptability of a web-based self-management program.MethodsA nonrandomized feasibility study for patients with confirmed AECOPD who were deemed web literate was conducted. All patients consented during their hospitalization and received access to the website following discharge in addition to usual care. The program aims to facilitate patients to better understand and manage their condition through education and home-based exercises. Participants were asked to complete the Bristol COPD Knowledge Questionnaire at baseline and after 6 months. A total of 14 participants were also interviewed (n=8 completers; n=6 noncompleters) regarding their experiences with the web-based program and trial. The interviews were analyzed using thematic analysis.ResultsIn total, 2080 patients were screened for eligibility, of which 100 patients (age: mean 71.2 years, SD 9.3 years; male: 55/100, 55%; forced expiratory volume in 1 second/forced vital capacity ratio: mean 0.46, SD 0.14; pack-years: mean 50.2, SD 31.0; current smokers: 35/100, 35%) were recruited (4.8% of those screened). The main reason for ineligibility was a lack of web literacy (1366/1980, 68.98%). In total, 18% (18/100) of patients had completed the web program by 6 months, with others still registered in the program (27/100, 27%), and more than half did not register (55/100, 55%). There was a mean change in Bristol COPD Knowledge Questionnaire scores at 6 months of 7.8 (SD 10.2) points. Qualitative interviews identified three main themes: preparing for, engagement with, and benefits of the study and program. A total of 57% (57/100) accepted a referral to PR on discharge and 19% (19/100) had completed the program after 6 months.ConclusionsOn the basis of the challenges of recruiting, retaining, and engaging participants in a web-based self-management program, it is not a feasible approach to roll out widely. This study acknowledges that this is a challenging time for patients with an AECOPD to engage in exercise and self-management education. However, for patients who were able to engage in such an intervention, the completion rate of PR was double the previous audit estimates from the United Kingdom, disease knowledge improved, and the intervention was of value to patients.Trial RegistrationISRCTN Registry 13081008; https://www.isrctn.com/ISRCTN13081008

Level of Knowledge About COPD Among Patients and Caregivers.

Chronic obstructive pulmonary disease (COPD) represents a major health burden worldwide. COPD-specific education may positively affect the emotional distress associated with the disease and may contribute to the patients' poor health-related quality of life. Studies have shown that education regarding COPD is lacking among disease sufferers. The aim of our study was to evaluate the knowledge of COPD among patients and caregivers. We used the Bristol COPD Knowledge Questionnaire in hospitalized and nonhospitalized patients with COPD and other pulmonary diseases, their caregivers, and healthy volunteers. Mean total knowledge score of patients with COPD was 24.27±8.44, of patients with other respiratory diseases 25.53±7.93, of caregivers of patients with COPD 21.80±5.32, of caregivers of patients with other pulmonary diseases 23.50±8.79, and of healthy subjects 25.85±9.27 (p=0.071). Our data further indicate the lack of knowledge of COPD among patients and their carers and emphasize the need of education programs.

Assessment of the effectiveness of a pharmacist approach for improving disease-specific knowledge and treatment in patients with chronic obstructive pulmonary disease

ObjectiveAdequate knowledge is essential for the appropriate management of chronic conditions such as chronic obstructive pulmonary disease (COPD). However, some patients may not be able either to comprehend or obtain...

Technology-Enabled Self-Management of Chronic Obstructive Pulmonary Disease With or Without Asynchronous Remote Monitoring: Randomized Controlled Trial.

BackgroundChronic obstructive pulmonary disease (COPD) is a leading cause of mortality and leads to frequent hospital admissions and emergency department (ED) visits. COPD exacerbations are an important patient outcome, and reducing their frequency would result in significant cost savings. Remote monitoring and self-monitoring could both help patients manage their symptoms and reduce the frequency of exacerbations, but they have different resource implications and have not been directly compared.ObjectiveThis study aims to compare the effectiveness of implementing a technology-enabled self-monitoring program versus a technology-enabled remote monitoring program in patients with COPD compared with a standard care group.MethodsWe conducted a 3-arm randomized controlled trial evaluating the effectiveness of a remote monitoring and a self-monitoring program relative to standard care. Patients with COPD were recruited from outpatient clinics and a pulmonary rehabilitation program. Patients in both interventions used a Bluetooth-enabled device kit to monitor oxygen saturation, blood pressure, temperature, weight, and symptoms, but only patients in the remote monitoring group were monitored by a respiratory therapist. All patients were assessed at baseline and at 3 and 6 months after program initiation. Outcomes included self-management skills, as measured by the Partners in Health (PIH) Scale; patient symptoms measured with the St George’s Respiratory Questionnaire (SGRQ); and the Bristol COPD Knowledge Questionnaire (BCKQ). Patients were also asked to self-report on health system use, and data on health use were collected from the hospital.ResultsA total of 122 patients participated in the study: 40 in the standard care, 41 in the self-monitoring, and 41 in the remote monitoring groups. Although all 3 groups improved in PIH scores, BCKQ scores, and SGRQ impact scores, there were no significant differences among any of the groups. No effects were observed on the SGRQ activity or symptom scores or on hospitalizations, ED visits, or clinic visits.ConclusionsDespite regular use of the technology, patients with COPD assigned to remote monitoring or self-monitoring did not have any improvement in patient outcomes such as self-management skills, knowledge, or symptoms, or in health care use compared with each other or with a standard care group. This may be owing to low health care use at baseline, the lack of structured educational components in the intervention groups, and the lack of integration of the action plan with the technology.Trial RegistrationClinicalTrials.gov NCT03741855; https://clinicaltrials.gov/ct2/show/ NCT03741855

Conhecimento sobre doença pulmonar obstrutiva crônica em pacientes de diferentes níveis de atividade física

O objetivo deste estudo foi identificar e comparar o nível de conhecimento sobre a doença pulmonar obstrutiva crônica em indivíduos ativos, sedentários e severamente inativos. Trata-se de um estudo transversal com indivíduos com doença pulmonar obstrutiva crônica. Para a coleta de dados, foi utilizada uma ficha de avaliação clínica, o Bristol COPD Knowledge Questionnaire e pedômetros (contador de passos). Foram avaliados 75 indivíduos, 70,7% são severamente inativos. Verificou-se um baixo nível de conhecimento sobre a doença pulmonar obstrutiva crônica (48,51 ± 9,08%), e constatou que indivíduos ativos, sedentários e severamente inativos apresentam o nível de conhecimento sobre a doença semelhante (50,19 ± 11,18% vs 46,48 ± 8,16% vs 48,79 ± 9,06 %, p=0,68). Conclui-se, portanto, que indivíduos com doença pulmonar obstrutiva crônica ativos, sedentários e severamente inativos apresentam conhecimento semelhante e reduzido sobre a doença.&#x0D; Descritores: Doença Pulmonar Obstrutiva Crônica; Exercício Físico; Conhecimento.

Impact of an Educational Program on knowledge and Practice of Patients with Chronic Obstructive Pulmonary Disease

Background: Worldwide, chronic obstructive pulmonary disease (COPD) is in the spotlight because of its morbidity, mortality and high prevalence. In Egypt is highlighted as a major public health problem. The aim of the present study was to evaluate the impact of an educational program on knowledge, practice, and self-efficacy of patients with stable chronic obstructive pulmonary disease. Quasi- experimental research design was utilized in this study. The sample was consisted of all available patients with stable COPD during the time of data collection. Four tools were used to collect data: first; Structured interview questionnaire which consisted ofsocio-demographic characteristics, and medical history. Second; the Bristol COPD Knowledge Questionnaire (BCKQ), third; Observational checklist which consisted of breathing exercises& inhaler use, and fourth; Self-Efficacy Scale for Patients with COPD. The result of the study concluded that there was a highly statistically significant difference in patients' total knowledge and practice pre and post program & pre and follow up program. Concerning total Self Efficacy there was no statistically significant difference between pre and post & pre and follow up scores, but there was a highly statistically significant difference between pre and post program regarding all self-efficacy issues except with weather ∕environment, while there was no statistically significant difference between pre and follow up program in all self-efficacy issues except in negative affect issues. The study concluded that after implementation of the educational program, remarkable improvements were occurred in knowledge, practice, and self-efficacy sub scores. The study recommended Continuous monitoring and evaluation of self-efficacy for patients to enhance disease management through establishing a rehabilitation program for patient to improve their self-efficacy. Promotion and enhancement of the self-care modalities to the patient; a strict written instruction with pictures about disease process, allowed foods , rest and physical activities and follow up should be continued after termination of educational program.

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

BackgroundDisease-specific knowledge is associated with outcomes of patients, but the knowledge level of chronic obstructive pulmonary disease (COPD) patients is known to be low.ObjectiveWe measured the level of disease-specific knowledge and defined factors associated with poor disease knowledge in COPD patients.Materials and MethodsA 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.ResultsA 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.ConclusionOur 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.

Assessment of disease-related knowledge among patients with chronic obstructive pulmonary disease: a cross-sectional study

Introduction. The main task of this study was to study the level of knowledge of the Ukrainian patient about chronic obstructive pulmonary disease (COPD), and the factors that cause and affect this indicator, with the help of a validated instrument. Methods. 41 patients were involved in the study. Socio-demographic data, information on the duration, course of the disease and cooperation with a physical therapist were collected. Anthropometric measurements, spirometry, pulse oximetry, tonometry were performed. Patients were surveyed with Modified Medical Research Council Dyspnea Scale, Hospital Anxiety and Depression Scale, Clinical COPD Questionnaire score, and Bristol COPD Knowledge Questionnaire (BCKQ). Bristol COPD Knowledge Questionnaire was translated, cross-culturally adapted and validated. Regression analysis was performed to determine relationships between the level of knowledge about the disease, socio-demographic data, indicators of respiratory system functional status, and survey data. Results. The average total score for BCKQ was 24.71±9.62 points. Patients gave the least number of correct answers to the question related to medical treatment. The level of knowledge depends on the factors such as age (β=-0.557; 95% CI: -1.041–0.086, p=0.086), duration of the disease (β=-0.114; 95% CI: -0.077–0.055, p=0.048), respiratory ratings, functional limitations, and own psychosocial dysfunction according to the CCQ scale (β =-0.506; 95% CI: -0.007–0.752, p=0.053), and the HADS depression score (β =-0.655; 95% CI: -4.257– -0.085, p=0.043). Conclusion. The level of knowledge of Ukrainian patients about COPD is low. More experience of the disease did not affect the increase in the level of knowledge. Older patients had a lower level of knowledge about their disease. Impact of body mass index, spirometry results, level of severity of shortness of breath, and symptoms of the disease on the level of knowledge was not revealed.

Assessment of COPD-Related Knowledge Among Internal Medicine Nurses: A Cross-Sectional Study.

BackgroundSince most internal medicine nurses work with chronic obstructive pulmonary disease (COPD) patients daily, their ability to meet the needs of COPD patients is an important issue. Our study aimed to assess COPD-related knowledge in internal medicine nurses.MethodsA descriptive cross-sectional study including 175 participants was conducted to investigate COPD-related knowledge levels among internal medicine nurses in a large top-ranked tertiary hospital in China. The Bristol COPD Knowledge Questionnaire (BCKQ) was used to test COPD-related knowledge levels in the participants.ResultsOverall BCKQ score for all nurses in this study was 35.76 ± 5.49. In comparison with non-respiratory nurses, the overall score among respiratory nurses was significantly higher (39.01 ± 3.95 vs 33.32 ± 5.23, p < 0.001). The mean scores for four topics (epidemiology, breathlessness, oral steroids, and inhaled steroids) were less than 3 among both respiratory and non-respiratory nurses. Subgroup analysis of specialist respiratory wards showed that nurses in the chronic airway disease ward had the highest overall knowledge score (40.47 ± 4.03). Linear regression analysis demonstrated that the overall BCKQ score was significantly related to the population of nurses (β coefficient = 3.016, 95% confidence interval [CI]: 0.953–5.079, p < 0.01), education (β coefficient = 4.710, 95% CI: 1.979-7.440, p < 0.01) and previous rotation in respiratory wards (β coefficient = 3.871, 95% CI: 1.776-5.967, p < 0.001).ConclusionInternal medicine nurses at this tertiary hospital showed deficits in COPD-related knowledge. Appropriate and systematic education about COPD knowledge and strengthening rotation among different wards are necessary for improving COPD-related knowledge levels among internal medicine nurses.

Technology-Enabled Self-Monitoring of Chronic Obstructive Pulmonary Disease With or Without Asynchronous Remote Monitoring: Protocol for a Randomized Controlled Trial.

BackgroundChronic obstructive pulmonary disease (COPD) is the third leading cause of mortality worldwide. Reducing the number of COPD exacerbations is an important patient outcome and a major cost-saving approach. Both technology-enabled self-monitoring (SM) and remote monitoring (RM) programs have the potential to reduce exacerbations, but they have not been directly compared with each other. As RM is a more resource-intensive strategy, it is important to understand whether it is more effective than SM.ObjectiveThe objective of this study is to evaluate the impact of SM and RM on self-management behaviors, COPD disease knowledge, and respiratory status relative to standard care (SC).MethodsThis was a 3-arm open-label randomized controlled trial comparing SM, RM, and SC completed in an outpatient COPD clinic in a community hospital. Patients in the SM and RM groups recorded their vital signs (oxygen, blood pressure, temperature, and weight) and symptoms with the Cloud DX platform every day and were provided with a COPD action plan. Patients in the RM group also received access to a respiratory therapist (RT). The RT monitored their vital signs intermittently and contacted them when their vitals varied outside of predetermined thresholds. The RT also contacted patients once a week irrespective of their vital signs or symptoms. All patients were randomized to 1 of the 3 groups and assessed at baseline and 3 and 6 months after program initiation. The primary outcome was the Partners in Health scale, which measures self-management skills. Secondary outcomes included the St. George's Respiratory Questionnaire, Bristol COPD Knowledge Questionnaire, COPD Assessment Test, and modified-Medical Research Council Breathlessness Scale. Patients were also asked to self-report on health system usage.ResultsA total of 122 patients participated in the study, 40 in the SC, 41 in the SM, and 41 in the RM groups. Out of those patients, 7 in the SC, 5 in the SM, and 6 in the RM groups did not complete the study. There were no significant differences in the rates of study completion among the groups (P=.80).ConclusionsBoth SM and RM have shown promise in reducing acute care utilization and exacerbation frequencies. As far as we are aware, no studies to date have directly compared technology-enabled self-management with RM programs in COPD patients. We believe that this study will be an important contribution to the literature.Trial RegistrationClinicalTrials.gov NCT03741855; https://clinicaltrials.gov/ct2/show/NCT03741855International Registered Report Identifier (IRRID)DERR1-10.2196/13920

The Effect of Nursing Care Protocol on Health Outcomes of Patients with Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease (COPD) is the fourth most common cause of death in the world. COPD prevalence, morbidity, and mortality vary across countries and across different groups within countries. Aim: Examine the effect of nursing care protocol on health outcomes of patients with COPD. Study design: A quasi-experimental design was utilized to conduct this study. Setting: The study was conducted at outpatient clinics at Chest Hospital (AL masah ALbahary) in Port Said city. Subjects: A purposive sample of 45 patients with (COPD) disease was included. Methods: four tools were used as follow (1) Patients’ assessment sheet. (2)The Bristol COPD Knowledge Questionnaire (BCKQ) sheet.(3) Patients’ observational checklists.) (4) Health outcomes assessment sheet. Results: There was improvement in patients' total knowledge scores and all practices post nursing care protocol implementation with highly statistically significance whereas p ? .001,there were statistically significant difference between mean scores of total mood disturbance, sleep quality and fatigue for patients with COPD pre and post implementation of protocol of nursing care, with significant decrease in mean score whereas p ? .001 and there were improvement in level 4 of dyspnea (sever dyspnea) post implementation of nursing care protocol compared to pre nursing care protocol and there was highly statistically significant difference between levels of dyspnea pre and post implementation of nursing care protocol whereas p ? .001. Conclusion: Based on the study findings, it is concluded that, application of nursing care protocol for patients with COPD has positive effect on improving their knowledge about COPD and its management, practices related to pursed lip breathing, diaphragmatic breathing, deep breathing exercise, a metered dose inhaler and dry powder inhaler and improving their health outcomes regarding mood, fatigue, sleep quality and dyspnea. Recommendation: Continuous educational program for patients with chronic obstructive pulmonary disease should be applied periodically in order to improve knowledge, practices and health outcomes for those patients.

An observational cohort study of exercise and education for people with chronic obstructive pulmonary disease not meeting criteria for formal pulmonary rehabilitation programmes.

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Pulmonary rehabilitation (PR) is offered to patients with functional breathlessness. However, access to PR is limited. The objective of this study was to evaluate whether a 4-week education and exercise programme offered to COPD patients with Medical Research Council (MRC) dyspnoea 1–2 improves disease self-management. Patients were recruited by their GP to attend four weekly 2-h sessions provided by a multidisciplinary team. Patients completed outcome measures before and after the program. Forty-two patients entered the programme and 26 out of 42 (61.9%) completed all sessions. The Bristol COPD Knowledge Questionnaire and Patient Activation Measure improved (both p ≤ 0.001). Disease burden was not reduced according to the COPD assessment test. All patients accepted a referral for ongoing exercise. Fourteen current smokers (81.3%) accepted a referral for smoking cessation, three patients with anxiety or depression (37.5%) accepted a psychological therapies referral. The programme improved COPD disease knowledge, patient activation and stimulated referrals to further services supporting disease management. Randomised controlled trials are warranted for similar interventions for COPD patients with early stage disease.

Can Patients With COPD Assimilate Disease-Specific Information During an Acute Exacerbation?: Results of a Pilot Randomized Controlled Trial

The study aimed to determine the feasibility and effectiveness of an introductory disease-specific educational program delivered during an acute exacerbation of COPD (AECOPD) on objective measures of disease-specific knowledge. Patients admitted to a community hospital with an AECOPD were randomly assigned to a control group (standard care) or intervention group (standard care+ brief education). The intervention group received two 30-min education sessions in hospital or at home within 2weeks of hospital admission. Feasibility measures included the number of eligible patients, compliance with the sessions, and number of follow-up measures completed. Disease-specific knowledge and informational needs were measured using the Bristol COPD Knowledge Questionnaire (BCKQ) and the Lung Information Needs Questionnaire (LINQ), respectively, before and after the intervention period. Thirty-one patients (mean age, 72 ± 10 years) with an AECOPD participated in the study. Of 102 approached patients, 75 consented to screening (73.5%) and 67 (66%) were eligible for the study. Thirty-four patients declined participation. All intervention patients (n= 15) completed the educational sessions and follow-up measures. Three patients (control group) did not complete the follow-up measures. The mean changes and SDs for the BCKQ in the intervention and control groups were 8 ± 5.14 and 3.4 ± 4.9, respectively (P= .02). No difference between groups was found for the LINQ (P= .80). A brief educational program delivered at the time of hospitalization for an AECOPD was feasible for a subset of patients, resulted in improved disease-specific knowledge, and may be a bridge to more active approaches. ClinicalTrials.gov; No.: NCT02321215; URL: www.clinicaltrials.gov.