Symptoms and impact of symptoms on function and health in patients with chronic obstructive pulmonary disease and chronic heart failure in primary health care

Theander, Kersti; Hasselgren, Mikael; Luhr, K; Eckerblad, Jeanette; Unosson, Mitra; Karlsson, Ingela

doi:10.2147/copd.s62563

Cited by 56 publications

(50 citation statements)

References 52 publications

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“…While instruments like the Memorial Symptom Assessment Scale have been used to assess symptoms in patients with heart failure (68-70), COPD (71,72), and HIV disease (11,73), the most valid and reliable instrument to assess symptoms for symptom cluster research across a variety of chronic conditions is yet to be developed.…”

Section: Transferability To Other Chronic Conditionsmentioning

confidence: 99%

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Miaskowski

Barsevick

Berger

et al. 2017

JNCI J Natl Cancer Inst

340

330

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An overview of proceedings, findings, and recommendations from the workshop on "Advancing Symptom Science Through Symptom Cluster Research" sponsored by the National Institute of Nursing Research (NINR) and the Office of Rare Diseases Research, National Center for Advancing Translational Sciences, is presented. This workshop engaged an expert panel in an evidenced-based discussion regarding the state of the science of symptom clusters in chronic conditions including cancer and other rare diseases. An interdisciplinary working group from the extramural research community representing nursing, medicine, oncology, psychology, and bioinformatics was convened at the National Institutes of Health. Based on expertise, members were divided into teams to address key areas: defining characteristics of symptom clusters, priority symptom clusters and underlying mechanisms, measurement issues, targeted interventions, and new analytic strategies. For each area, the evidence was synthesized, limitations and gaps identified, and recommendations for future research delineated. The majority of findings in each area were from studies of oncology patients. However, increasing evidence suggests that symptom clusters occur in patients with other chronic conditions (eg, pulmonary, cardiac, and end-stage renal disease). Nonetheless, symptom cluster research is extremely limited and scientists are just beginning to understand how to investigate symptom clusters by developing frameworks and new methods and approaches. With a focus on personalized care, an understanding of individual susceptibility to symptoms and whether a "driving" symptom exists that triggers other symptoms in the cluster is needed. Also, research aimed at identifying the mechanisms that underlie symptom clusters is essential to developing targeted interventions.Patients with chronic conditions, such as cancer and other rare diseases, experience an array of multiple co-occurring symptoms (eg, pain, fatigue, sleep disturbance). When these symptoms remain underdiagnosed and undertreated, they have a negative impact on patient-reported outcomes (PROs) including functional performance, cognitive status, and quality of life (QOL). A reduction in symptom burden in these patients has the potential to improve their capacity to live well over their entire lives. To achieve this goal, a transformation is needed in how multiple co-occurring symptoms are assessed and managed in order to improve patient outcomes and stimulate a reduction in health care utilization and costs. A strategic plan that advances REVIEW

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Section: Transferability To Other Chronic Conditionsmentioning

confidence: 99%

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Miaskowski

Barsevick

Berger

et al. 2017

JNCI J Natl Cancer Inst

340

330

View full text Add to dashboard Cite

show abstract

“…Physiological, psychological, and situational factors affect the patient’s performance, including functional status, cognitive functions, and physical performance (Lenz, Suppe, Gift, Pugh, & Milligan, 1995). Impact of symptoms on function and health in patients with COPD are common (Theander et al, 2014). Symptoms can occur alone or in isolation from one another, but if multiple symptoms occur simultaneously they are likely to catalyse each other and further worsen the overall experience.…”

Section: Resultsmentioning

confidence: 99%

“…Nurses are responsible to optimize patients with COPD functional status by educating and encouraging participation in physical activities. When performing physical activity patients have to struggle with symptoms like breathlessness, cough, lack of energy, and so on (Theander et al, 2014). Nursing care is, among other things, based on six core competencies (Leksell & Lepp, 2013; QSEN, 2007): person-centred care (is based from the patient’s story), teamwork collaboration (to recognize gaps in the team and initiate inter-professional teamwork), evidence-based practice (to contribute in developing new guidelines and participate in research), quality improvement (to initiate development of quality in work), safety (to be responsible and lead systematic work in patient safety), and informatics (to support and guide the patients to sort digital information and participate in developing eHealth) which include satisfaction with care, involvement in care, feeling of well-being, and creating a therapeutic environment described as one in which decision-making is shared, staff relationships are collaborative, leadership is transformational, and innovative practices are supported (Leksell & Lepp, 2013; QSEN, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Patients with COPD have multiple symptoms, the most frequent being shortness of breath, cough, lack of energy, dry mouth, numbness or tingling in the hands and feet, and pain (Theander et al, 2014). Pulmonary rehabilitation is known to be one of the most effective treatments of COPD, and is defined by American Thoracic Society/European Respiratory Society (ATS/ERS) as being ‘designed to reduce symptoms, optimize functional status, increase participation and reduce health care costs through stabilizing or reversing systemic manifestations of the disease’ (ATS/ERS, 2006, p. 1391).…”

Section: Introductionmentioning

confidence: 99%

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Symptom-reducing actions: a concept analysis in the context of chronic obstructive pulmonary disease

Zakrisson

2017

International Journal of Qualitative Studies on Health and Well

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Patients with Chronic Obstructive Pulmonary Disease (COPD) have multiple symptoms. Nursing care is based on six core competencies and one of them is person-centred care that includes the aspect of professional symptom relief. The aim was to clarify a meaning of the concept of Symptom-reducing actions in the context of COPD. Databases MEDLINE and CINAHL were searched between 1982 and February 2016 and 26 publications were found. Two dictionaries and three books were investigated. The method of Walker & Avant was followed. The use of the concept of Symptom-reducing actions may be categorized by the sub-concepts of supervision, information, and patient education. Exploration of defining attributes was symptom management, instructions, support, motivation, explanation, advice, teaching, and learning. Antecedent occurrences were related to factors that affect the patient’s level of function such as physical performance and cognitive function. Symptom-reducing actions offer a way to support patients with COPD in self-management. Symptom-reducing actions can mediate facts in a purposeful process performed by the nurse to enable the patient to take control over and manage unpleasant symptoms by a person-centred, planned process. The nurse can achieve this via supervision, information, and patient education with an integrated emotional component. Evaluating the outcomes is needed.

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“…The participants said that living with a high symptom burden was very tiring; it was considered a too great of an effort to even try to do anything about their situation. Lack of energy or fatigue have been shown to be highly prevalent symptoms among people with chronic diseases (Theander et al 2014).These are symptoms with an impact on cognitive, physical and psychosocial functioning in the everyday lives of older people with heart failure and COPD Unosson 2004, Aldred et al 2005). …”

Section: Msas Subscale Scoresmentioning

confidence: 99%

Symptom burden among people with chronic disease

Eckerblad¹

2015

Linköping University Medical Dissertations

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Introduction: Chronic diseases tend to increase with old age. Older people with chronic disease are commonly suffering from conditions which produce a multiplicity of symptoms and a decreased health-related quality of life. Nurses have a responsibility to prevent, ease or delay a negative outcome through symptom management, or assist in achieving an acceptable level of symptom relief. Aim: The overall aim of the thesis was to describe different aspects of symptom burden from the perspective of community-dwelling people with chronic disease. Methods: This thesis is based upon four papers that used both quantitative and qualitative data to describe different aspects of symptom burden, experienced by people with chronic diseases. Paper (I) is a cross-sectional study with 91 participants diagnosed with chronic obstructive pulmonary disease. Papers (II and IV) are based upon secondary outcome data from a randomized controlled trial with 382 community-dwelling older people with multimorbidity. Paper (II) is a cross-sectional study and Paper (IV) has a descriptive and an explorative design reporting on the trajectory of symptom prevalence and symptom burden. Paper (III) is a qualitative study with participants from the AGe-FIT. Results: Among people diagnosed with COPD the most prevalent symptoms with the highest symptom burden scores were shortness of breath, dry mouth, cough, sleep problems, and lack of energy, with just a few differences between participants with moderate and severe airflow limitation (I). For older people with multimorbidity, pain was the symptom with the highest prevalence and burden. Other highly prevalent symptoms were lack of energy and a dry mouth. Poor vision, likelihood of depression, and diagnoses of the digestive system were independently related to the total symptom burden score (II). The symptoms experienced by the older people were persistent and the symptom burden remained high over time (IV). The experience of living with a high symptom burden was described as an endless struggle. The analysis revealed an overall theme, “To adjust and endure” and three sub-themes, “to feel inadequate and limited”, “to feel dependent”, and “to feel dejected” (III). Conclusions: The results of this thesis indicate the importance of early symptom identification. People with chronic diseases have an unmet need for optimized treatment that focuses on the total symptom burden, and not only disease specific symptoms. A large proportion of older people with multimorbidity suffer a high and persistent symptom burden, and the prevalence and trajectory of pain are high. Older people sometimes think their high age is the reason they experience a diversity of symptoms, and they do not always communicate these to their health-care provider

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Symptoms and impact of symptoms on function and health in patients with chronic obstructive pulmonary disease and chronic heart failure in primary health care

Cited by 56 publications

References 52 publications

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Advancing Symptom Science Through Symptom Cluster Research: Expert Panel Proceedings and Recommendations

Symptom-reducing actions: a concept analysis in the context of chronic obstructive pulmonary disease

Symptom burden among people with chronic disease

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