Differences in Symptom Burden Among Patients With Moderate, Severe, or Very Severe Chronic Obstructive Pulmonary Disease
Differences in Symptom Burden Among Patients With Moderate, Severe, or Very Severe Chronic Obstructive Pulmonary Disease
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DOI：
10.1016/j.jpainsymman.2015.12.324
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发表时间：
2016-05-01
影响因子：
4.7
通讯作者：
Rustoen, Tone
中科院分区：
文献类型：
--
作者：
Christensen, Vivi Lycke;Holm, Are Martin;Rustoen, Tone
上下文。慢性阻塞性肺疾病（COPD）患者的症状经历极其复杂。它的特点是多重并发症状。然而，很少有研究描述了COPD患者的这种经历。本研究的目的是评估中度、重度和极重度copd患者（n = 267）症状发生率的差异，以及症状严重程度、频率和痛苦程度的评分。采用记忆症状评估量表对患者症状体验的多个维度进行评估。以疾病分期作为序贯预测变量，采用二元和有序逻辑回归分析来评估症状发生率以及症状严重程度、频率和痛苦程度评分的差异。无论疾病的严重程度如何，患者报告平均有12种同时出现的症状。呼吸短促和精力不足是三个疾病严重程度组中仅有的两种症状在发生、严重程度、频率和痛苦方面存在显著差异。非常严重的慢性阻塞性肺病患者在所有四个症状维度中报告的呼吸短促和缺乏能量的评分最高。无论疾病处于哪个阶段，本研究确定的高症状负担强调了对COPD患者进行多种并发症状筛查的必要性。(C) 2016年美国临终关怀与姑息医学学会。Elsevier Inc.出版。版权所有。
Context. The symptom experience of patients with chronic obstructive pulmonary disease (COPD) is extremely complex. It is characterized by multiple co-occurring symptoms. However, very few studies have described this experience in COPD patients.Objectives. The aims of this study were to evaluate for differences in symptom occurrence rates, as well as ratings of symptom severity, frequency, and distress among patients (n = 267) with moderate, severe, and very severe COPD.Methods. The Memorial Symptom Assessment Scale was used to evaluate the multiple dimensions of the patient's symptom experience. Binary and ordinal logistic regression analyses with stage of disease as an ordinal predictor variable were used to evaluate for differences in symptom occurrence rates and ratings of symptom severity, frequency, and distress.Results. Regardless of the severity of their disease, patients reported an average of 12 co-occurring symptoms. Shortness of breath and lack of energy were the only two symptoms that differed significantly among the three disease severity groups in terms of occurrence, severity, frequency, and distress. Patients with very severe COPD reported the highest ratings for shortness of breath and lack of energy across all four symptom dimensions.Conclusion. Regardless of stage of disease, the high symptom burden identified in this study underscores the need for COPD patients to be screened for multiple co-occurring symptoms. (C) 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.