Arslan Sedat, Bozkurt Canan, Arslan Mahir, Bulut Hülya
Nutrition and Dietetics, Faculty of Health Science, Bandirma Onyedi Eylul University, Balıkesir, Turkey.
Nursing Department, Faculty of Health Science, Bandirma Onyedi Eylul University, Balıkesir, Turkey.
Clin Nutr ESPEN. 2023 Apr;54:436-442. doi: 10.1016/j.clnesp.2023.02.019. Epub 2023 Feb 24.
BACKGROUND & AIMS: Fatigue is a commonly diagnosed symptom in cancers and many other chronic debilitating diseases. The second most important complaint after dyspnea in patients with Chronic Obstructive Pulmonary Disease (COPD) is the feeling of fatigue. Fatigue can have significant consequences on health status as it can limit patients' activities of daily living, lead to worsening prognosis, and is an indicator of mortality. It remains unclear how fatigue affects the daily life of COPD patients and what physical, social, and emotional challenges it brings. Some studies are showing that adhering to the Mediterranean diet significantly improves fatigue. In this study, the relationship between fatigue and adherence to a Mediterranean diet in COPD patients was investigated.
The present study is a descriptive, cross-sectional, and correlational study. The study population included ≥65-year-old patients with a diagnosis of COPD who were hospitalized in Chest Diseases Clinics of İzmir Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital and Chest Diseases Clinic of Sivas Cumhuriyet University Hospital. The Personal Information Form, Mediterranean Diet Adherence Screener (MEDAS), COPD and Asthma Fatigue Scale (CAFS), and KATZ Activities of Daily Living Scale (Katz ADL) were used as data collection tools.
Of the total 526 participants, 58.7% were men, 52.1% were overweight, 54.3% were ex-smokers, and 65.8% were non-drinkers. In the variables related to the disease, the mean duration of having COPD was 16.41 (SD 5.26) years. According to the GOLD classification of the participants, the severity of the disease was determined as Stage III in 57.4% of them, and the severity of dyspnea was determined as "3" (moderate severity) in 54.5% of them according to the mMRC scale. According to the results of the analysis, the mean MEDAS score was 7.84 (SD: 2.76). According to the participants' levels of adherence to the MD, of them, 43.8% had high adherence to MD and 29% had low adherence to MD. The mean CAFS score indicating the level of disease-related fatigue was 69.17 (SD: 15.73), and the lowest and highest scores were 25 and 100 respectively. According to the independence in activities of daily living of the participants, 77.3% were semi-dependent and 6.4% were independent. The comparison of the level of the participant's adherence to the MD according to their mean CAFS scores demonstrated that those who had high adherence to the MD obtained significantly lower scores than the participants in the other groups (p < 0.05). The comparison of the participants' mean MEDAS scores according to their KATZ ADL independence status demonstrated that there was a significant difference (p < 0.001).
Adherence to the MD was associated with fatigue and independence in older COPD patients. It was found that high adherence to MD is associated with decreased fatigue and increased independence in activities of daily living in older COPD patients.
疲劳是癌症及许多其他慢性消耗性疾病中常见的诊断症状。慢性阻塞性肺疾病(COPD)患者中,仅次于呼吸困难的第二大重要主诉是疲劳感。疲劳会对健康状况产生重大影响,因为它会限制患者的日常生活活动,导致预后恶化,并且是死亡率的一个指标。目前尚不清楚疲劳如何影响COPD患者的日常生活,以及它带来了哪些身体、社会和情感方面的挑战。一些研究表明,坚持地中海饮食可显著改善疲劳症状。在本研究中,我们调查了COPD患者疲劳与坚持地中海饮食之间的关系。
本研究为描述性、横断面和相关性研究。研究人群包括年龄≥65岁、诊断为COPD且在伊兹密尔苏阿特·塞伦胸科疾病与外科培训研究医院胸科疾病诊所和锡瓦斯 Cumhuriyet 大学医院胸科疾病诊所住院的患者。使用个人信息表、地中海饮食依从性筛查量表(MEDAS)、COPD 和哮喘疲劳量表(CAFS)以及卡茨日常生活活动量表(Katz ADL)作为数据收集工具。
在总共526名参与者中,58.7%为男性,52.1%超重,54.3%为既往吸烟者,65.8%为不饮酒者。在与疾病相关的变量中,COPD 的平均患病时长为16.41(标准差5.26)年。根据参与者的 GOLD 分类,57.4%的患者疾病严重程度为Ⅲ期,根据 mMRC 量表,54.5%的患者呼吸困难严重程度为“3”(中度严重)。根据分析结果,MEDAS 平均得分为7.84(标准差:2.76)。根据参与者对地中海饮食的依从程度,其中43.8%对地中海饮食有高依从性,29%对地中海饮食有低依从性。表明疾病相关疲劳程度的 CAFS 平均得分为69.17(标准差:15.73),最低分和最高分分别为25分和100分。根据参与者日常生活活动的独立性,77.3%为半依赖状态,6.4%为独立状态。根据参与者的平均 CAFS 得分对其地中海饮食依从程度进行比较,结果显示对地中海饮食有高依从性的参与者得分显著低于其他组的参与者(p < 0.05)。根据参与者的 Katz ADL 独立状态对其 MEDAS 平均得分进行比较,结果显示存在显著差异(p < 0.001)。
坚持地中海饮食与老年COPD患者的疲劳及独立性相关。研究发现,老年COPD患者对地中海饮食的高依从性与疲劳减轻及日常生活活动独立性增加相关。