TREATMENTS FOR DYSPNEA--EDUCATION, EXPOSURE OR TRAINING

呼吸困难的治疗——教育、暴露或培训

• 批准号: 2873103
• 负责人: VIRGINIA Lee CARRIERI-KOHLMAN
• 金额: $ 32万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-05-01 至 2002-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2873103
• 关键词: behavioral /social science research tag; behavioral medicine; chronic obstructive pulmonary disease; dyspneas; exercise; functional ability; health; health education; human subject; human therapy evaluation; longitudinal human study; nurses; perception; prognosis; quality of life; rehabilitation; self concept; sign /symptom; social status

DESCRIPTION: (adapted from applicant's abstract) Dyspnea, or shortness of breath, is the most frequent and severe complaint of patients with pulmonary disease. It disrupts activities of daily living and decreases quality of life. The investigators have shown that the sensory and affective dimensions of dyspnea can be significantly decreased in chronic obstructive pulmonary disease (COPD) patients by a self-paced exercise training program that provides exposure to dyspnea in a nurse- monitored environment. This reduction in dyspnea after a 12-session exercise program occurred because of both better exercise performance (increased efficiency and conditioning), which requires less ventilation, and desensitization (a decrease in the symptom relative to ventilation). The overall objective of this study is to determine whether dyspnea decreases as much with home walking as it does with short exposure to the symptom in a monitored environment or with typical high-intensity pulmonary rehabilitation exercise training. The primary aim is to test differences in the effectiveness of three treatments for dyspnea: education about dyspnea and a home walking prescription; nurse-coached exposure to dyspnea with education and a home walking prescription; and a model of pulmonary rehabilitation with high- intensity exercise, education, and a home walking prescription. Secondary aims are to determine if dyspnea decreases after as little as one incremental treadmill test and whether the treatment response depends on disease severity, gender, ethnicity, or adherence to a home walking prescription. The study also seeks to determine whether the duration of the response differs depending upon the treatment. The design is an experimental longitudinal study extending over one year. Ninety patients with COPD and limited by dyspnea will be assigned randomly to one of three treatment groups. All groups will receive education about strategies for dealing with dyspnea and a home exercise prescription. In addition, the exposure group will complete four self- paced sessions on a treadmill designed to allow nurse-coached exposure to dyspnea, and the high intensity training group will complete 24 sessions of high intensity treadmill training. Immediate and long-term outcomes include: a) sensory and affective dimensions of dyspnea with exercise; b) dyspnea with activities of daily living; c) exercise capacity; d) health status; e) health-related quality of life, including functional status, social status, and health perception; f) self- efficacy; g) perceived control of dyspnea; and h) mood state. If shorter and less intensive treatments for dyspnea prove to be as effective as a high-intensity exercise training program in decreasing the symptom of dyspnea and improving the quality of life, the impact on the care of patients with COPD will be substantial.

描述：（改编自申请人的摘要）呼吸困难或短促 呼吸困难是患者最常见、最严重的主诉 肺病。 它扰乱日常生活活动并减少 生活质量。 研究人员表明，感官和 呼吸困难的情感维度可以显着减少 慢性阻塞性肺病 (COPD) 患者可通过自定进度 为护士提供呼吸困难的运动训练计划 受监控的环境。 12 次疗程后呼吸困难减少 锻炼计划的出现是因为双方都有更好的锻炼表现 （提高效率和调节），这需要更少 通气和脱敏（症状相对于 通风）。 本研究的总体目标是确定 在家步行时呼吸困难的减轻是否与在家步行时一样减轻 在受监控的环境中或典型的情况下短暂暴露于该症状 高强度肺康复运动训练。 初级 目的是测试三种治疗方法的有效性差异 呼吸困难：有关呼吸困难的教育和家庭步行处方； 护士通过教育和回家步行指导暴露呼吸困难 处方;以及高肺康复模型 强度锻炼、教育和家庭步行处方。 次要目标是确定呼吸困难是否在经过一段时间后减轻 一项增量跑步机测试以及治疗是否有反应 取决于疾病的严重程度、性别、种族或对家庭的依从性 行走处方。 该研究还试图确定是否 反应持续时间因治疗而异。 这 设计是一项为期一年的纵向实验研究。 90 名因呼吸困难而患有慢性阻塞性肺病 (COPD) 的患者将被分配 随机分配到三个治疗组之一。 所有团体都会收到 关于应对呼吸困难策略和家庭锻炼的教育 处方。 此外，曝光组还将完成四项自我 在跑步机上进行有节奏的训练，旨在允许护士指导接触 至呼吸困难，高强度训练组完成24 高强度跑步机训练课程。近期和长期 结果包括： a) 呼吸困难的感觉和情感维度 锻炼; b) 日常生活活动时呼吸困难； c) 锻炼 容量; d) 健康状况； e) 与健康相关的生活质量，包括 功能状态、社会地位和健康认知； f) 自我 功效; g) 呼吸困难的感知控制； h) 情绪状态。 如果更短 事实证明，治疗呼吸困难的强度较低的治疗方法与治疗呼吸困难的方法一样有效 高强度运动训练计划可减轻症状 呼吸困难和改善生活质量，对护理的影响 患有慢性阻塞性肺病（COPD）的患者数量将会很大。

项目成果

Is Internet-based support for dyspnea self-management in patients with chronic obstructive pulmonary disease possible? Results of a pilot study.

是否有可能为慢性阻塞性肺病患者的呼吸困难自我管理提供基于互联网的支持？

• DOI: 10.1016/j.hrtlng.2004.06.005
• 发表时间: 2005
• 期刊: Heart & lung : the journal of critical care
• 作者: Nguyen,HuongQ;Carrieri-Kohlman,Virginia;Rankin,SallyH;Slaughter,Robert;Stulbarg,MichaelS
• 通讯作者: Stulbarg,MichaelS

Impact of brief or extended exercise training on the benefit of a dyspnea self-management program in COPD.

• DOI: 10.1097/00008483-200509000-00009
• 发表时间: 2005-09-01
• 期刊: Journal of cardiopulmonary rehabilitation
• 作者: Carrieri-Kohlman, Virginia;Nguyen, Huong Q;Stulbarg, Michael S
• 通讯作者: Stulbarg, Michael S

Dyspnea self-management in patients with chronic obstructive pulmonary disease: moderating effects of depressed mood.

慢性阻塞性肺疾病患者的呼吸困难自我管理：抑郁情绪的调节作用。

• DOI: 10.1176/appi.psy.46.5.402
• 发表时间: 2005
• 期刊: Psychosomatics.
• 作者: Nguyen,HuongQ;Carrieri-Kohlman,Virginia
• 通讯作者: Carrieri-Kohlman,Virginia