COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

Figures & data

Table

Questions	Answers
1. Do you accept your disease?	Not at all	A little Enough	Much	Very much
2. Do you accept the limitation related to your disease?	Not at all	A little Enough	Much	Very much
3. Does your family help you manage your disease?	Not at all	A little Enough	Much	Very much
4. Do your friends and/or other people you know help you manage your disease?	Not at all	A little Enough	Much	Very much
5. Do you ever forget to take your medicines?	Not at all	A little Enough	Much	Very much
6. Do you ever change the time you take your medicines?	Not at all	A little Enough	Much	Very much
7. Do you ever change your treatment according to how you feel?	Not at all	A little Enough	Much	Very much
8. Do you ever change oxygen therapy prescriptions (amount and timing)? (If pertinent)	Not at all	A little Enough	Much	Very much
9. When you are at home, do you manage to follow the diet suggested to you?	Not at all	A little Enough	Much	Very much
10. When you are at home, do you manage to avoid smoking? (If pertinent)	Not at all	A little Enough	Much	Very much
11. When you are at home, do you manage to exercise at least three times a week?	Not at all	A little Enough	Much	Very much

Note: Data from Majani et al.¹

Table 1 Psychosocial and clinical characteristics of the study sample (n=84)

	n (%)
Sex
Male	63 (75.0)
Female	21 (25.0)
Education (school years)
≤5	30 (35.7)
6–8	37 (44.0)
9–13	16 (19.1)
≥14	1 (1.2)
Lives alone
No	66 (78.6)
Yes	18 (21.4)
Marital status
Married/common-law partner	46 (54.8)
Widower	15 (17.9)
Unmarried	12 (14.3)
Separated/divorced	11 (13.0)
Current occupation
Retired	79 (94.1)
Employed	5 (5.9)
Primary caregiver
Nobody	38 (45.2)
Husband/wife/partner	21 (25.0)
Daughter/son	19 (22.6)
Other family member/carer	6 (7.2)
Smoker
No	6 (7.1)
Yes	13 (15.5)
Ex-smoker	65 (77.4)
COPD – severity (GOLD)
I-Low (FEV1/FVC <70%, FEV1 ≥80%)	0
II-Moderate (50%≤ FEV1 <70%)	28 (33.3)
III-Severe (30%≤ FEV1 <50%)	31 (36.9)
IV-Very severe (FEV1 <30%)	25 (29.8)
LTOT
No	26 (31.0)
Yes	58 (69.0)

Abbreviations: GOLD, Global Initiative for Chronic Obstructive Lung Disease; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; LTOT, long-term oxygen therapy.

Table 2 Clinical characteristics of the study sample (n=84)

	Mean	SD
Age (years)	70.2	7.0
Months of illness	105.1	81.5
6MWT (minutes)	334.5	118.5
BMI (kg/m^2)	26.0	6.7
FEV1 (L)	1.1	0.5
FEV1%	44.2	18.6
FVC (L)	2.4	0.8
FVC%	76.3	20.5
FEV1/FVC	45.7	12.8

Abbreviations: 6MWT, 6-minute walking test; BMI, body mass index; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity.

Table 3 Psychological and neuropsychological characteristics of the study sample (n=84)

	n (%)
Anxiety symptoms (HADS-A)
None (0–7)	50 (59.5)
Mild (8–10)	20 (23.8)
Moderate (11–14)	11 (13.1)
Severe (15–21)	3 (3.6)
Depressive symptoms (BDI-II/GDS)
None	44 (53.3)
Mild	14 (16.9)
Moderate	13 (15.5)
Severe	12 (14.3)
Cognitive deterioration (MMSE)
18.3≥×≤23.8	3 (3.6)
>23.8	81 (96.4)
MCI (MoCA – ES*)
0	8 (9.5)
1	13 (15.5)
2	17 (20.2)
3	14 (16.7)
4	32 (38.1)

Notes:

* ES correspond to a five-point interval scale divided as follows: 0 indicates a performance to the worst 5% of the population; 4 indicates scores higher than the median value of the whole sample; 1, 2 and 3 are obtained by dividing into three equal parts the area of the distribution between 0 and 4 (37).

Abbreviations: HADS-A, Hospital Anxiety and Depression Scale-Anxiety; BDI-II, Beck Depression Inventory-second edition; GDS, Geriatric Depression Scale; MMSE, Mini Mental State Examination; MCI, Mild Cognitive Impairment; MoCA, Montreal Cognitive Assessment; ES, equivalent scores.

Table 4 ASiCOLD-R: item score frequencies and percentage (n=84)

ASiCOLD-R – items	Low n (%)	Moderate/high n (%)
Disease perception
Disease acceptance	26 (30.9)	58 (69.1)
Disease limitations acceptance	24 (28.6)	60 (71.4)
Perceived family support in disease management	9 (10.0)	73 (89.0)
Perceived social support in disease management	39 (46.0)	44 (53.0)
Self-efficacy
Autonomous LTOT modifications (LTOT, n=58)	51 (87.9)	7 (12.1)
Following dietary prescriptions	20 (24.1)	63 (75.9)
Avoiding smoking (smoking, n=16)	9 (56.2)	7 (43.3)
Exercising following medical advice	43 (51.8)	40 (48.2)

Abbreviations: ASiCOLD-R, Adherence Schedule in Chronic Obstructive Lung Disease – Revised; LTOT, long-term oxygen therapy.

Figure 1 Significant relations between clinical variables, psychological/neuropsychological factors, nonpharmacological adherence and disease perception.

Abbreviations: 6MWT, 6-minute walking test; BMI, body mass index; MCI, mild cognitive impairment; DA, disease acceptance; DLA, disease limitations acceptance.

MajaniGPierobonAGiardiniACallegariSValutare e favorire l’aderenza alle prescrizioni in riabilitazione cardiologica e pneumolog ica. [Screening and promoting the adherence in cardiological and pulmonary rehabilitation]I Manuali della Fondazione MaugeriPaviaPI–ME2007

 Google Scholar