Understanding and addressing loneliness in people with chronic obstructive pulmonary disease

了解和解决慢性阻塞性肺疾病患者的孤独感

基本信息

批准号：
ES/X005259/1
负责人：
Lisa Brighton
金额：
$ 14.27万
依托单位：
King's College London
依托单位国家：
英国
项目类别：
Fellowship
财政年份：
2022
资助国家：
英国
起止时间：
2022 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=ES%2FX005259%2F1
关键词：
Understanding addressing loneliness people chronic

项目摘要

Chronic Obstructive Pulmonary Disease (COPD) is a common lung condition, affecting over three million people in the UK[1] and over 325 million people worldwide[2]. Common and disabling symptoms include breathlessness, cough and fatigue, which increasingly limit individuals' daily activities[3], and contribute to social isolation and loneliness[4]. Related to this, people with COPD are at increased risk of depression[5], and have almost twice the odds of dying by suicide than someone without the disease[6]. While medications, vaccinations, exercise- and self-management interventions can help people with COPD to manage their condition, the disease and its symptoms worsen over time there is currently no cure. Psychosocial support for people with COPD as they live and die with this disease is an essential clinical priority, yet there is still a lack of research in this area.Throughout my PhD project I worked with people with COPD and frailty, and loneliness was raised a common concern by both research participants and service user representatives. For example, when exploring experiences of frailty and rehabilitation services[7], participants emphasised feelings of loneliness as their declining health limited their day-to-day activities, and how they often missed the social aspects of group rehabilitation when their programme came to an end. As I collaborated with additional service users to design a new approach, they again highlighted the need to address, and measure, social outcomes. While these influences led to a heightened focus on loneliness within my PhD work about COPD and frailty, it was clear that dedicated research is needed to fully address this important unmet need.People with COPD have described feeling isolated and lonely in previous interview studies [7-10], and although population data is currently limited, it appears between 10-35% [11, 12] of people with COPD may be experiencing loneliness. People with chronic respiratory disease are likely at particular risk of loneliness: they face a shrinking social world due to the impacts of their symptoms on mobility. This is compounded by societal issues of stigma and shame due to perceptions of their illness as 'self-inflicted' and more recently negative public reactions to symptoms like cough due to associations with Covid-19[13]. Given evidence outside of lung disease showing that loneliness is associated with worse physical and psychological health, including putting people at higher risk of suicidal thoughts and behaviours[14], plus economic consequences due to lost productivity and increased healthcare utilisation[15], addressing these concerns is of upmost importance to society. Within this fellowship, I aim to use the findings of my PhD as a bridge to a new, essential programme of work around loneliness and the wider psychosocial health of people with COPD. To consolidate my PhD and strengthen potential impact of this future work, my first two objectives are to improve my knowledge and research skills to support a future research career at the interface of psychology and respiratory health (objective 1), and to strengthen current and future impact opportunities through dissemination and networking with diverse stakeholders in respiratory psychology (objective 2). Activities to support these objectives include: structured training courses in behavioural science and statistics, mentoring by a health psychologist, a visit to international respiratory psychology experts, academic dissemination and networking through publications and conferences, and creating outputs specifically for policy-makers and the public. Alongside this, I will conduct further limited research on the role of loneliness in the physical and mental health of people with COPD through a secondary analysis of my PhD interview data (objective 3), and develop a competitive funding proposal to progress research in this area (objective 4).

慢性阻塞性肺疾病 (COPD) 是一种常见的肺部疾病，影响着英国超过 300 万人[1] 和全球超过 3.25 亿人[2]。常见的致残症状包括呼吸困难、咳嗽和疲劳，这些症状越来越限制个人的日常活动[3]，并导致社会孤立和孤独[4]。与此相关的是，患有慢性阻塞性肺病的人患抑郁症的风险增加[5]，并且自杀死亡的几率几乎是没有这种疾病的人的两倍[6]。虽然药物、疫苗接种、运动和自我管理干预措施可以帮助慢性阻塞性肺病患者控制病情，但这种疾病及其症状会随着时间的推移而恶化，目前尚无治愈方法。为慢性阻塞性肺病患者提供生活和死亡过程中的社会心理支持是一项重要的临床优先事项，但该领域仍缺乏研究。在我的博士项目中，我与患有慢性阻塞性肺病和虚弱的患者一起工作，孤独感被提出来作为研究的重点。研究参与者和服务使用者代表共同关心的问题。例如，在探索虚弱和康复服务的体验时[7]，参与者强调了孤独感，因为他们的健康状况每况愈下，限制了他们的日常活动，并且当他们的计划失败时，他们经常错过团体康复的社交方面。结尾。当我与其他服务用户合作设计一种新方法时，他们再次强调需要解决和衡量社会成果。虽然这些影响导致我在关于慢性阻塞性肺病和虚弱的博士研究中更加关注孤独感，但很明显，需要专门的研究来充分解决这一重要的未满足的需求。患有慢性阻塞性肺病的人在之前的访谈研究中描述了感到孤立和孤独的感觉[7 -10]，尽管目前人口数据有限，但似乎有 10-35% [11, 12] 的慢性阻塞性肺病患者可能正在经历孤独。患有慢性呼吸道疾病的人可能面临特别的孤独风险：由于症状对行动能力的影响，他们面临着日益缩小的社交世界。由于人们认为自己的疾病是“自己造成的”，导致耻辱和羞耻的社会问题，以及最近因与 Covid-19 相关而引起的咳嗽等症状的负面反应，使情况变得更加复杂[13]。鉴于肺部疾病之外的证据表明，孤独感与较差的身心健康有关，包括使人们面临更高的自杀念头和行为风险[14]，以及由于生产力下降和医疗保健利用率增加而造成的经济后果[15]，解决这些问题关注对社会来说是最重要的。在这项奖学金中，我的目标是利用我的博士学位研究结果作为桥梁，围绕孤独症和慢性阻塞性肺病患者更广泛的心理社会健康开展一项新的、重要的工作计划。为了巩固我的博士学位并加强未来工作的潜在影响，我的前两个目标是提高我的知识和研究技能，以支持未来在心理学和呼吸健康领域的研究生涯（目标 1），并加强当前和未来的研究通过与呼吸心理学领域的不同利益相关者进行传播和建立联系来影响机会（目标 2）。支持这些目标的活动包括：行为科学和统计学的结构化培训课程、健康心理学家的指导、拜访国际呼吸心理学专家、通过出版物和会议进行学术传播和网络，以及专门为政策制定者和公众创造产出。除此之外，我将通过对我的博士访谈数据（目标 3）的二次分析，对孤独感对慢性阻塞性肺病患者身心健康的作用进行进一步有限的研究，并制定一项有竞争力的资助提案来推进该领域的研究（目标 4）。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Meditative movement for breathlessness in advanced COPD or cancer: a systematic review and meta-analysis.

DOI：
10.1183/16000617.0243-2022
发表时间：
2023-06-30
期刊：
European respiratory review : an official journal of the European Respiratory Society
影响因子：
0
作者：
通讯作者：

Development and implementation of the lung volume reduction pulmonary rehabilitation tool to identify eligibility for lung volume reduction in people with chronic obstructive pulmonary disease during pulmonary rehabilitation.

DOI：
10.1177/14799731231198863
发表时间：
2023-01
期刊：
CHRONIC RESPIRATORY DISEASE
影响因子：
4.1
作者：
Buttery, Sara C.;Williams, Parris J.;Brighton, Lisa J.;Batista, Craig;Dewar, Amy;Hogg, Lauren;Ingram, Karen;Korff, Gemma;Koulopoulou, Maria;Lammin, Helen;Maddocks, Matthew;Mcdonnell, Lynn;Mehta, Bhavin;Meyrick, Victoria;Pritchard, Lisa;Smith, Oliver;Trivedi, Puja;Lawson, Rod A.;Hopkinson, Nicholas S.
通讯作者：
Hopkinson, Nicholas S.

What is Frailty?