Hirai Kuniaki, Tanaka Akihiko, Homma Tetsuya, Kawahara Tomoko, Oda Naruhito, Mikuni Hatsuko, Uchida Yoshitaka, Saito Haruhisa, Kaneko Keisuke, Fujiwara Akiko, Goto Yuiko, Uno Tomoki, Miyata Yoshito, Ohta Shin, Yamaguchi Fumihiro, Suzuki Shintaro, Ohnishi Tsukasa, Sagara Hironori
Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University School of Medicine, Tokyo, Japan.
Department of Medicine, Division of Respiratory Medicine, Yamanashi Red Cross Hospital, Yamanashi, Japan.
COPD. 2021 Feb;18(1):83-90. doi: 10.1080/15412555.2021.1874898. Epub 2021 Jan 27.
The current chronic obstructive pulmonary disease (COPD) management aims to improve the patients' quality of life and healthy life expectancy; however, few studies have evaluated the level of satisfaction with the patients' current respiratory status in COPD patients and their families. This study aimed to examine the level of patient and family satisfaction with the patients' current respiratory status and to identify the clinical factors closely linked to dissatisfaction.This multicenter, cross-sectional study included 454 outpatients with COPD and 296 family members. Patients and families were allocated to the satisfied and dissatisfied groups based on their satisfaction with the patients' current respiratory status. Patients' health status, dyspnoea, appetite, respiratory function, and mood disorders were assessed.Among the participants of this study, 67% of patients and 60% of their families were dissatisfied with the patients' current respiratory status. The COPD assessment test (CAT) was the most sensitive marker of dissatisfaction compared to other clinical factors (p < 0.01). The statistical cut-off value of CAT for predicting patient dissatisfaction was 11. CAT reflected patient dissatisfaction independent of age, sex, dyspnoea, appetite, mood disorders, body mass index, and respiratory function (odds ratio: CAT; 1.12 (1.07-1.19): p < 0.01).Many patients and families are dissatisfied with the patients' respiratory status, and the patients' CAT score is useful to predict dissatisfaction. Our findings are consistent with the Global Initiative for Chronic Obstructive Lung Disease indicating that treatment should be enhanced in patients with a CAT score ≥10. Furthermore, treatment strategies targeting CAT may contribute to an improved patient satisfaction.
目前慢性阻塞性肺疾病（COPD）的管理旨在提高患者的生活质量和健康预期寿命；然而，很少有研究评估COPD患者及其家属对患者当前呼吸状况的满意度水平。本研究旨在调查患者及其家属对患者当前呼吸状况的满意度水平，并确定与不满密切相关的临床因素。这项多中心横断面研究纳入了454例COPD门诊患者和296名家庭成员。根据患者及其家属对患者当前呼吸状况的满意度，将他们分为满意组和不满意组。评估了患者的健康状况、呼吸困难、食欲、呼吸功能和情绪障碍。
在本研究的参与者中，67%的患者及其60%的家属对患者当前的呼吸状况不满意。与其他临床因素相比，慢性阻塞性肺疾病评估测试（CAT）是不满的最敏感指标（p < 0.01）。预测患者不满的CAT统计临界值为11。CAT反映了患者的不满，与年龄、性别、呼吸困难、食欲、情绪障碍、体重指数和呼吸功能无关（优势比：CAT；1.12（1.07-1.19）：p < 0.01）。
许多患者及其家属对患者的呼吸状况不满意，患者的CAT评分有助于预测不满。我们的研究结果与慢性阻塞性肺疾病全球倡议一致，表明CAT评分≥10的患者应加强治疗。此外，针对CAT的治疗策略可能有助于提高患者满意度。
