Use of time in people with chronic obstructive pulmonary disease – a systematic review

Abstract

“Physical inactivity” and “sedentary lifestyles” are phrases often used when describing lifestyles of people with chronic obstructive pulmonary disease (COPD). Evidence suggests activity types, independent of energy expenditure, influence health outcomes, so understanding patterns of time use is important, particularly in chronic disease. We aimed to identify reports of time use in people with COPD. Predefined search strategies were used with six electronic databases to identify individual activity reports (including frequencies and/or durations) in which community-dwelling people with COPD engaged. Eligible studies were assessed independently against predefined criteria and data were extracted by two reviewers. Data synthesis was achieved by aggregating activity reports into activity domains (sports/exercise, screen time, transport, quiet time, self-care, sociocultural, work/study, chores, and sleep). Twenty-six publications reported 37 specific daily activities. People with COPD were found to spend extended periods in sedentary behaviors (eg, standing [194 min/day]; sitting [359 min/day]; lying [88 min/day]), have limited engagement in physical activity (eg, walking [51 min/day]; exercising [1.2 episodes per week {ep/w}, 13 min/day]), have high health care needs (medical appointments [1.0 ep/w]), and experience difficulties associated with activities of daily living (eg, showering [2.5 ep/w, 60 minutes per episode]; preparing meals [4.7 ep/w]). Little data could be found describing how people with COPD use their time, and data synthesis was problematic because of variations in methodologies, population differences, and research emphases. Identified data largely referred to posture and were skewed according to country, assessment methods, and disease severity. Comparisons with age-matched population data showed people with COPD spent less time engaged in personal-care activities (self-care and sleeping) and chores than people in similar age groups. The incorporation of time-use outcomes in future research designs should be encouraged. Ideally, these tools should use consistent frameworks and comparable outcome measures in order to provide clearer descriptions of time use in chronic disease.

Sedentary Behavior Is an Independent Predictor of Mortality in Subjects With COPD

“…This was not surprising, since there was no difference in lying time/d between survivors and non-survivors (Table 1). A recent review about the use of time in daily life by subjects with COPD 14 found a median of time spent lying of 88 min/d, therefore very close to our cutoff point of 80 min/d. Perhaps a discriminative cutoff point for lying time was not detected in the present sample.…”

“…12 Patients with COPD typically do very little activity at moderate or vigorous intensities, 7,13 and sedentary behavior is predominant in their daily lives. 7,14 Previous studies have shown the association between physical activity profile and mortality among many other outcomes in these subjects. 1,[15][16][17] However, up to this moment, there is no study on COPD that has investigated the association between mortality and variables of sedentary behavior (instead of variables of physical activity), according to the above-mentioned definitions.…”

Patterns and correlates of time use and energy expenditure in older Australian workers: A descriptive study

“…However, the findings that less healthy participants in our study were more sedentary and did less even light physical activity are largely consistent with studies focused on disease populations. Such studies have similarly found that less healthy participants spent less time doing chores and more time watching television than healthy counterparts [10,31].…”

Drinking patterns and the distribution of alcohol-related harms in Ireland: Evidence for the prevention paradox

“…Healthcare and professional support Clinical support: Healthcare staff who care, feeling well looked after, having treatments explained (11,9) Good access: Being able to see a doctor or nurse when necessary (9,7)…”

“…The right medication when needed, feeling empowered to use it (6,9) Feeling safe: Receiving support to feel safe (4,0) Other themes reflected frustrations including I'm confused by conflicting advice from different people; I'm angry when there are errors (I felt angry when a nurse made a mistake-it made the results wrong and I was given the wrong information. They didn't say sorry); I feel rushed during appointments; I was ill-informed (I would have liked my condition explained more when I was diagnosed.)…”