Kronik Obstrüktif Akciğer Hastalığı (KOAH) Olanlarda Dispnenin Bilişsel Duruma Etkisi

Döndü Şanlitürk, Nurgül Kaplan
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Abstract

Aim: The aim of this study is to examine the effect of the dyspnea on cognitive status in patients with chronic obstructive pulmonary diseases (COPD). Material and Methods: The universe of this descriptive study consist of 315 COPD patients. Data were collected with a Questionare, Medical Research Council Scale (MRCS) and Standardize Mini Mental State Examination (SMMT-E). In the analyses of the data, descriptive statistics, independent t-test, oneway analysis of variance and regression and Tamhane T2 analysis were employed. Results: The mean age of the patients patricipating the study was 54.06 (11.41) years. 38% of the patients were determined to experienced moderate dyspnea (2.20±0.95). The patients’ cognitive status mean scores were found low (21.38±5.74) and 58.7% had cognitive impairment. It was determined in multiple regression analysis that severe dyspnea level, inadequacy in dyspnea management, associating dyspnea with breathlessness, feeling of low mood and fear of death, use of oxygen tube and bipod at home were associated with cognitive status. Moreover, it was found that 31% of the variance in the cognitive level of the patients was explained by the independent variables related to dyspnea (R2 = 0.581; adjusted R2= 0.311). It was found that there was a strong positive correlation between dyspnea and cognition status (r=-0.705, p=0.000). Conclusion: It was determined that dyspnea effects to SMMT-E and therefore it could be advised to taking measures to reduce dyspnea COPD patients.
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目的:本研究的目的是探讨呼吸困难对慢性阻塞性肺疾病(COPD)患者认知状态的影响。材料和方法:本描述性研究包括315例COPD患者。采用问卷、医学研究委员会量表(MRCS)和标准化迷你精神状态检查(SMMT-E)收集数据。数据分析采用描述性统计、独立t检验、单因素方差分析和回归分析以及Tamhane T2分析。结果:患者的平均年龄为54.06(11.41)岁。38%的患者被确定为中度呼吸困难(2.20±0.95)。患者认知状况平均得分较低(21.38±5.74),58.7%存在认知功能障碍。通过多元回归分析确定,严重呼吸困难程度、呼吸困难管理不足、呼吸困难伴呼吸困难、情绪低落和死亡恐惧、在家使用氧气管和两脚架与认知状况相关。此外,我们还发现,31%的患者认知水平差异可以用与呼吸困难相关的自变量来解释(R2 = 0.581;调整后R2= 0.311)。结果发现,呼吸困难与认知状态呈正相关(r=-0.705, p=0.000)。结论:确定SMMT-E对呼吸困难有影响,建议采取措施减少COPD患者呼吸困难。
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