Keywords
Exercise
Rehabilitation
Education
How to Cite
Abstract
Introduction: Chronic Obstructive Pulmonary Disease (COPD) causes physical, emotional and social limitation and deterioration in health-related quality of life (HRQL) in those who suffer from it. The educational component is essential in any Pulmonary Rehabilitation (RP) program, since it allows maintaining long-term intervention results.
Objective: To compare the effect of two educational strategies for COPD patients developed in two PR programs in Cali-Colombia. Methods: Longitudinal prospective study. Patients with COPD who agreed to sign the informed consent were selected, if convenient, during a period of 24 months. The patients belonged to two PR programs, one that carried out PR with individual education (PRIE) and another performed PR with individual education plus group (PRIG). Results: A total of 48 patients were admitted, dyspnea measured with the mMRC scale showed a statistically significant improvement at the beginning and at the end of the program for both groups, as well as the distance traveled in the 6MWT, with an improvement in meters of 85.9±12 in the PRIG group and 47.2±19 in the PRIE group. Regarding anxiety and depression, there were significant decreases in the HADS score only for the PRIG group (p=0.0120 and p=0.001, respectively). In the SGRQ questionnaire, all the domains showed significant changes for both groups, except for the activity domain, which only showed improvement for the PRIG group (p=0.000). Finally, in the LINQ questionnaire, both groups showed significant changes. Conclusion: Every PR program must develop an education component. In this study, COPD patients who received individual plus group education presented better results at the end of the intervention, especially in anxiety, depression and in the HRQoL activity domain.
References
WHO. Enfermedades no transmisibles. Centro de Prensa [Internet]. 2017 [citado 3 de mayo de 2022]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/noncommunicable-diseases
Caballero A, Torres-Duque CA, Jaramillo C, Bolívar F, Sanabria F, Osorio P, et al. Prevalence of COPD in five Colombian cities situated at low, medium, and high altitude (PREPOCOL study). Chest. 2008; 133(2): 343-349. doi: 10.1378/chest.07-1361
Lisboa C, Villafranca C, Caiozzi G, Berrocal C, Leiva A, Pinochet R, et al. Calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica e impacto del entrenamiento físico. Rev Médica Chile. 2001; 129(4): 359-366. doi: http://dx.doi.org/10.4067/S0034-98872001000400003
McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015; (2). doi: 10.1002/14651858.CD003793.pub3
Nakken N, Janssen DJ, van den Bogaart EH, Muris JW, Vercoulen JH, Custers FL, et al. Knowledge gaps in patients with COPD and their proxies. BMC Pulm Med. 2017; 17(1): 1-9. doi: 10.1186/s12890-017-0481-8
Rosero-Carvajal HE, Cuero-Campaz DF, AriasBalanta ÁJ, Wilches-Luna EC. Pilot study. Changes in the Score of the Lung Information Needs Questionnaire (linq) after an educational intervention in patients with chronic respiratory disease. Rev Cienc Salud. 2017; 15(2): 259-272. doi: http://dx.doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.5762
Stoilkova A, Janssen DJ, Wouters EF. Educational programmes in COPD management interventions: a systematic review. Respir Med. 2013; 107(11): 1637-1650. doi: 10.1016/j.rmed.2013.08.006
Effing T, Monninkhof EE, Van Der Valk PP, Zielhuis GG, Walters EH, Van Der Palen JJ, et al. Self‐management education for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2007;(4). doi: 10.1002/14651858.CD002990.pub2
Long H, Howells K, Peters S, Blakemore A. Does health coaching improve health‐related quality of life and reduce hospital admissions in people with chronic obstructive pulmonary disease? A systematic review and meta‐analysis. Br J Health Psychol. 2019; 24(3): 515-546. doi: 10.1111/bjhp.12366
Goldstein RS, Hill K, Brooks D, Dolmage TE. Pulmonary rehabilitation: a review of the recent literature. Chest. 2012; 142(3): 738-749. doi: https://doi.org/10.1378/chest.12-0188
Tymruk-Skoropad K, Pavlova I, Stupnytska S. Educational component in rehabilitation programs for persons with chronic obstructive pulmonary disease: a systematic review. Adv Rehabil. 2019; 33(4): 51-65. doi: 10.5114/areh.2019.89827
Graham B, Steenbruggen I, Miller M, Barjaktarevic I, Cooper B, Hall G, et al. An official American thoracic society and European respiratory society technical statement. Am J Respir Crit Care Med. 2019; 2019: e70-88. https://doi.org/10.1164/rccm.201908-1590ST
Ayora AF, Soler LM, Gasch AC. Analysis of two questionnaires on quality of life of Chronic Obstructive Pulmonary Disease patients. Rev Lat Am Enfermagem. 2019;27. doi: 10.1590/1518-8345.2624.3148
Betancourt-Peña J, Benavides-Córdoba V, AvilaValencia JC, Rosero-Carvajal HE. Differences between COPD patients of a pulmonary rehabilitation program according to the mmrc dyspnea scale. Curr Respir Med Rev. 2019; 15(1): 32-38. https://doi.org/10.2174/1573398X15666190404150703
Ferrer M, Alonso J, Prieto L, Plaza V, Monsó E, Marrades R, et al. Validity and reliability of the St George’s Respiratory Questionnaire after adaptation to a different language and culture: the Spanish example. Eur Respir J. 1996; 9(6): 1160-1166. doi: 10.1183/09031936.96.09061160
ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166: 111-117. doi: 10.1164/ajrccm. 166.1. at1102
Ávila-Valencia JC, Muñoz-Erazo BE, Sarria V, Cordoba VB, Betancourt-Peña J. Cambios en el Bode-Bodex de pacientes con EPOC al culminar un programa de rehabilitación pulmonar. Rev Colomb Rehabil. 2016; 15(1): 40-47. https://doi.org/10.30788/RevColReh.v15.n1.2016.7
Emtner M, Porszasz J, Burns M, Somfay A, Casaburi R. Benefits of supplemental oxygen in exercise training in non-hypoxemic COPD patients. Am J Respir Crit Care Med. 2003; 68: 1034-1042. doi: 10.1164/rccm.200212-1525OC
Egan C, Deering BM, Blake C, Fullen BM, McCormack NM, Spruit MA, et al. Short term and long term effects of pulmonary rehabilitation on physical activity in COPD. Respir Med. 2012; 106(12): 1671-169. doi: 10.1016/j.rmed.2012.08.016
Lacasse Y, Wong E, Guyatt GH, King D, Cook DJ, Goldstein RS. Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease. The Lancet. 1996; 348(9035): 1115-1119. doi: 10.1016/S0140-6736(96)04201-8
Rugbjerg M, Iepsen UW, Jørgensen KJ, Lange P. Effectiveness of pulmonary rehabilitation in COPD with mild symptoms: a systematic review with meta-analyses. Int J Chron Obstruct Pulmon Dis. 2015; 10: 791. doi: 10.2147/COPD.S78607
Bourbeau J, Nault D, Dang-Tan T. Self-management and behaviour modification in COPD. Patient Educ Couns. 2004; 52(3): 271-277. doi: 10.1016/S0738-3991(03)00102-2
Doyle T, Palmer S, Johnson J, Babyak MA, Smith P, Mabe S, et al. Association of anxiety and depression with pulmonary-specific symptoms in chronic obstructive pulmonary disease. Int J Psychiatry Med. 2013; 45(2): 189-202. doi: 10.2190/PM.45.2.g
Achury-Beltrán L, Garcia-Peñuela P. Efecto de una actividad grupal educativa en la calidad de vida de la persona con EPOC. Enferm Univ. 2019; 16(2): 171-84. doi: https://doi.org/10.22201/eneo.23958421e.2019.2.649
Garrote Garrote A, Arroyo C. La educación grupal para la salud: Reto o realidad. Ediciones Díaz de Santos. 1era edición. España: Ediciones Díaz de Santos, 2011: p. 248
Mozaffari M, Azami S, Naderi M. Determining the effect of implementing an educational package on quality of life among patients with chronic obstructive pulmonary disease referring to teaching hospitals affiliated with Ilam University of Medical Sciences in 2016. J Fam Med Prim Care. 2018; 7(3): 606. doi: 10.4103/jfmpc.jfmpc_304_17
Bourne CL, Kanabar P, Mitchell K, Schreder S, Houchen-Wolloff L, Bankart MJG, et al. A SelfManagement Programme of Activity Coping and Education-SPACE for COPD (C)-in primary care: The protocol for a pragmatic trial. BMJ Open. 2017; 7(7): e014463. doi: http://dx.doi.org/10.1136/bmjopen-2016-014463
Grimaldos FB, Cano Rosales DJ, Duran Sandoval JN, Albarracín Ruiz MJ, Rincón Romero K. Calidad de vida de pacientes con enfermedad pulmonar obstructiva crónica, participantes en un programa educativo integral. Rev Univ Ind Santander Salud. 2019; 51(4): 301-317. doi: https://doi.org/10.18273/revsal.v51n4-2019003
Cleutjens FA, Janssen DJ, Ponds RW, Dijkstra JB, Wouters EF. COgnitive-pulmonary disease. BioMed Res Int. 2014; 2014: 697825. doi:10.1155/2014/697825
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Julian Andrés Rivera-Motta , Stefanie Tonguino-Rosero, Beatriz Elena Muñoz-Erazo, Lina Marcela Orozco, Jhonatan Betancourt-Peña