4 results on '"Cafarella, Paul A."'
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2. A Reduction in the Use of Volunteered Descriptors of Air Hunger Is Associated With Increased Walking Distance in People With COPD.
- Author
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Williams, Marie T., Petkov, John, Olds, Timothy S., Cafarella, Paul, and Frith, Peter
- Subjects
OBSTRUCTIVE lung disease treatment ,CONFIDENCE intervals ,MENTAL depression ,DYSPNEA ,EPIDEMIOLOGY ,HELPLESSNESS (Psychology) ,LUNG diseases ,MEDICAL rehabilitation ,OBSTRUCTIVE lung diseases ,QUESTIONNAIRES ,RESEARCH funding ,STATISTICS ,T-test (Statistics) ,DATA analysis ,PRE-tests & post-tests ,DATA analysis software ,DESCRIPTIVE statistics ,DISEASE complications ,PSYCHOLOGY - Abstract
BACKGROUND: This study investigated whether descriptors of breathlessness differed after participation in an 8 week pulmonary rehabilitation program and whether changes in sensory quality would be reflected in responsiveness to pulmonary rehabilitation. METHODS: People with COPD provided descriptors for their sensation of breathlessness before and after an 8 week pulmonary rehabilitation program. Primary outcomes for responsiveness to pulmonary rehabilitation were the 6 minute walk distance (6MWD) and the St George Respiratory questionnaire. Significant proportional shifts for sensory categories after rehabilitation were identified using the McNemar test. Random effects mixed modeling was used to determine significance of differences for primary outcomes between subjects modifying or not modifying descriptors of breathlessness. RESULTS: Of the 107 people referred to the pulmonary rehabilitation program, 94 met the spirometric criteria for COPD, with 58 having data for pre and post assessments (36 males, 71 ± 9 years old, percent of predicted FEV
1 58 ± 24%). A significant proportion of subjects reduced descriptors of air hunger (P = .03, odds ratio 0.31, 95% CI 0.09-0.89) and depressed, regret, helpless (P = .04, odds ratio 0.36, 95% CI 0.10 -1.05) following rehabilitation. Subjects reducing their use of descriptors of air hunger had greater improvements in the 6MWD after rehabilitation (P = .006, mean increase 46 m). CONCLUSIONS: The sensory quality of breathlessness was modified for approximately one third of subjects after pulmonary rehabilitation, with significant improvements in the 6MWD for subjects who reduced their use of descriptors of air hunger. [ABSTRACT FROM AUTHOR]- Published
- 2012
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3. A Reduction in the Use of Volunteered Descriptors of Air Hunger Is Associated With Increased Walking Distance in People With COPD
- Author
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Marie T. Williams, Peter Frith, Tim Olds, John Petkov, Paul Cafarella, Williams, Marie T, Petkov, John, Olds, Timothy Stephen, Cafarella, Paul, and Frith, Peter
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Sensation ,Walking ,Critical Care and Intensive Care Medicine ,Air hunger ,Pulmonary Disease, Chronic Obstructive ,McNemar's test ,Physical medicine and rehabilitation ,Forced Expiratory Volume ,Surveys and Questionnaires ,Confidence Intervals ,Odds Ratio ,medicine ,COPD ,Humans ,Pulmonary rehabilitation ,Aged ,Language ,Aged, 80 and over ,Exercise Tolerance ,Rehabilitation ,Verbal Behavior ,business.industry ,breathlessness ,General Medicine ,Odds ratio ,dyspnea ,Middle Aged ,medicine.disease ,pulmonary rehabilitation ,Confidence interval ,Dyspnea ,Exercise Test ,Physical therapy ,Female ,business - Abstract
Background: This study investigated whether descriptors of breathlessness differed after participation in an 8 week pulmonary rehabilitation program and whether changes in sensory quality would be reflected in responsiveness to pulmonary rehabilitation. Methods: People with COPD provided descriptors for their sensation of breathlessness before and after an 8 week pulmonary rehabilitation program. Primary outcomes for responsiveness to pulmonary rehabilitation were the 6 minute walk distance (6MWD) and the St George Respiratory questionnaire. Significant proportional shifts for sensory categories after rehabilitation were identified using the McNemar test. Random effects mixed modeling was used to determine significance of differences for primary outcomes between subjects modifying or not modifying descriptors of breathlessness. Results: Of the 107 people referred to the pulmonary rehabilitation program, 94 met the spirometric criteria for COPD, with 58 having data for pre and post assessments (36 males, 71 ± 9 years old, percent of predicted FEV1 58 ± 24%). A significant proportion of subjects reduced descriptors of air hunger (P = .03, odds ratio 0.31, 95% CI 0.09-0.89) and depressed, regret, helpless (P = .04, odds ratio 0.36, 95% CI 0.10-1.05) following rehabilitation. Subjects reducing their use of descriptors of air hunger had greater improvements in the 6MWD after rehabilitation (P = .006, mean increase 46 m). The sensory quality of breathlessness was modified for approximately one third of subjects after pulmonary rehabilitation, with significant improvements in the 6MWD for subjects who reduced their use of descriptors of air hunger. Refereed/Peer-reviewed
- Published
- 2012
4. Cognitive Behavioral Therapy for Management of Dyspnea: A Pilot Study
- Author
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Paul Cafarella, Marie T. Williams, Catherine Paquet, Peter Frith, Williams, Marie T, Cafarella, Paul, Paquet, Catherine, and Frith, Peter
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,media_common.quotation_subject ,Psychological intervention ,Pilot Projects ,Walking ,Critical Care and Intensive Care Medicine ,Severity of Illness Index ,chronic obstructive pulmonary disease ,law.invention ,Pulmonary Disease, Chronic Obstructive ,McNemar's test ,Physical medicine and rehabilitation ,Randomized controlled trial ,law ,Perception ,Surveys and Questionnaires ,Sensation ,Medicine ,Humans ,Pulmonary rehabilitation ,media_common ,Aged ,Aged, 80 and over ,COPD ,Analysis of Variance ,psychological intervention ,Exercise Tolerance ,Cognitive Behavioral Therapy ,business.industry ,breathlessness ,Disease Management ,General Medicine ,respiratory system ,Patient Acceptance of Health Care ,medicine.disease ,cognitive behavioral therapy ,exercise capacity ,Cognitive behavioral therapy ,Dyspnea ,Physical therapy ,Exercise Test ,Feasibility Studies ,Female ,business ,Pulmonary Ventilation ,Program Evaluation - Abstract
BACKGROUND: In patients with COPD, psychological interventions usually target generalized anxiety and depression rather than the sensation of breathlessness. The objectives of this pilot study were to develop and implement a cognitive behavioral therapy (CBT) program specific to the perceptual experience of breathlessness, identify practical issues in the study protocol, and estimate beneficial effects of combining the CBT program with comprehensive pulmonary rehabilitation METHODS: The CBT program for the sensation of breathlessness (Breathing: Recognize sensations, Explore thoughts and beliefs, Validate thoughts as useful or harmful, Evolve and change behavior [BREVE]) was developed as a sequential series of 8 modules enabling it to be embedded within an 8-week comprehensive pulmonary rehabilitation program. When appropriate, outcomes from the pilot group (comprehensive pulmonary rehabilitation program + BREVE) were compared with those from a retrospective control group (comprehensive pulmonary rehabilitation program only). Outcomes included feedback provided by pilot study subjects, sensation of breathlessness (volunteered and endorsed descriptors of breathlessness), 6-min walk distance (6MWD), and St George Respiratory Questionnaire (SGRQ) total score. Within-group analyses were undertaken for descriptors of breathlessness (the McNemar test), whereas between-group analyses (repeated-measures analysis of variance, effect-size comparison) were conducted for the 6MWD and SGRQ total score RESULTS: Pilot (n = 11) and control (n = 58) groups were not significantly different at baseline. Feedback indicated that the program structure and content were positively received. No significant changes were evident for the sensation of breathlessness or the SGRQ score (
- Published
- 2015
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