Faculty of Nursing, Sør-Trøndelag University College, Trondheim, Norway.
Chron Respir Dis. 2010;7(4):229-37. doi: 10.1177/1479972310374343.
The first objective of the study was to evaluate a 4-week inpatient pulmonary rehabilitation program on exercise capacity, health-related quality of life (HRQL) and psychological distress in patients with COPD. The second objective was to investigate the influence of gender, age, disease severity, co-morbidity, anxiety and depression on improved HRQL after rehabilitation. The study comprised 136 consecutive patients from baseline to follow-up with mild-to-severe COPD. Exercise capacity was measured by the 6-min walking distance test, disease severity by spirometric tests, HRQL by The St. George's Respiratory Questionnaire and psychological distress by the The Hospital Anxiety and Depression Scale. Variables on socio-demography and co-morbidity were self-reported. Exercise capacity was improved from baseline to follow-up with a score difference of +44 metres (p = 000). Except for the activity score, HRQL was significantly improved: a change of -3.5 for the symptom score (p = 014), -3.1 for the total score (p = 003) and a clinical significant change of - 4.0 for the impact score (p = 002). The anxiety score did not change significantly after rehabilitation (-0.1, p = 545), though there was a significant reduction of the depression score (-0.8, p = 002) and a 10.4% reduction in the prevalence of possible depression cases (p = 017). Patients with forced expiratory volume in 1 second ≥50% predicted were 4.2 times more likely to achieve a clinical significant improved HRQL after rehabilitation than patients with forced expiratory volume in 1 second <50% predicted (95% confidence interval [CI] 1.7-10.3, p = 002). A 4-week inpatient rehabilitation program improves HRQL and exercise capacity and reduces depression in COPD patients. Patients with mild or moderate disease are more likely to achieve an improved HRQL after rehabilitation than patients with severe or very severe disease.
这项研究的首要目标是评估为期 4 周的住院肺康复计划对 COPD 患者的运动能力、健康相关生活质量（HRQL）和心理困扰的影响。第二个目标是研究性别、年龄、疾病严重程度、合并症、焦虑和抑郁对康复后 HRQL 改善的影响。该研究纳入了从基线到随访的 136 例连续 COPD 患者。运动能力通过 6 分钟步行距离试验测量，疾病严重程度通过肺功能试验测量，HRQL 通过圣乔治呼吸问卷测量，心理困扰通过医院焦虑和抑郁量表测量。社会人口统计学和合并症相关变量为自我报告。与基线相比，运动能力在随访时有所提高，评分差异为+44 米（p = 0.000）。除活动评分外，HRQL 也有显著改善：症状评分变化-3.5（p = 0.014），总分变化-3.1（p = 0.003），影响评分变化-4.0（p = 0.002）。康复后焦虑评分无显著变化（-0.1，p = 0.545），但抑郁评分显著下降（-0.8，p = 0.002），可能存在抑郁的病例比例降低 10.4%（p = 0.017）。第 1 秒用力呼气量（FEV1）预测值≥50%的患者比 FEV1 预测值<50%的患者更有可能在康复后实现 HRQL 的显著改善（95%置信区间[CI] 1.7-10.3，p = 0.002）。为期 4 周的住院康复计划可改善 COPD 患者的 HRQL 和运动能力，并降低抑郁。轻度或中度疾病患者比重度或极重度疾病患者更有可能在康复后获得 HRQL 的改善。
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