5 results on '"Cafarella, Paul A."'
Search Results
2. Social Support and Social Networks in COPD: A Scoping Review.
- Author
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Barton, Christopher, Effing, Tanya W., and Cafarella, Paul
- Subjects
OBSTRUCTIVE lung disease treatment ,SOCIAL support ,SOCIAL networks ,PATIENT readmissions ,HEALTH outcome assessment - Abstract
A scoping review was conducted to determine the size and nature of the evidence describing associations between social support and networks on health, management and clinical outcomes amongst patients with COPD. Searches of PubMed, PsychInfo and CINAHL were undertaken for the period 1966–December 2013. A descriptive synthesis of the main findings was undertaken to demonstrate where there is current evidence for associations between social support, networks and health outcomes, and where further research is needed. The search yielded 318 papers of which 287 were excluded after applying selection criteria. Two areas emerged in which there was consistent evidence of benefit of social support; namely mental health and self-efficacy. There was inconsistent evidence for a relationship between perceived social support and quality of life, physical functioning and self-rated health. Hospital readmission was not associated with level of perceived social support. Only a small number of studies (3 articles) have reported on the social network of individuals with COPD. There remains a need to identify the factors that promote and enable social support. In particular, there is a need to further understand the characteristics of social networks within the broader social structural conditions in which COPD patients live and manage their illness. [ABSTRACT FROM PUBLISHER]
- Published
- 2015
- Full Text
- View/download PDF
3. Exercise training combined with psychological interventions for people with chronic obstructive pulmonary disease.
- Author
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Wiles, Louise, Cafarella, Paul, and Williams, Marie T.
- Subjects
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OBSTRUCTIVE lung disease treatment , *SYSTEMATIC reviews , *EXERCISE therapy , *LUNG disease treatment , *RANDOMIZED controlled trials - Abstract
Previous systematic reviews have confirmed the benefits of both exercise training and psychological interventions in people with chronic obstructive pulmonary disease (COPD).The objective of this systematic review was to examine the effect of interventions which combine exercise training and psychological interventions for a range of health outcomes in people with COPD. Database searches identified randomized controlled trials of people with COPD participating in interventions that combined exercise training with a psychological strategy compared with control (usual care, waiting list) or active comparators (education, exercise, psychological interventions alone). Health outcomes included dyspnoea, anxiety, depression, quality of life or functional exercise capacity. Standardized mean differences (SMD) were calculated for each intervention arm/control comparison. Across the 12 included studies (738 participants), compared with control conditions, SMD consistently favoured interventions which included both exercise + psychological components (SMD range dyspnoea -1.63 to -0.25; anxiety -0.50 to -0.20; depression -0.46 to -0.18; quality of life 0.09 to 1.16; functional exercise capacity 0.22 to 1.23).When compared with active comparators, SMD consistently favoured interventions that included exercise training + psychological component for dyspnoea (SMD range -0.35 to -0.97), anxiety (SMD range -0.13 to -1.00) and exercise capacity (SMD range 0.64 to 0.71) but were inconsistent for depression (-0.11 to 1.27) and quality of life (0.02 to -2.00). The magnitude of effect for most interventions was greater than the minimum required for clinical significance (i.e. > 0.32) in behavioural medicine. While interventions, outcomes and effect sizes differed substantially between studies, combining exercise training with a psychological intervention may provide a means of optimizing rehabilitation in people with COPD. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
4. 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
- Full Text
- View/download PDF
5. Treatments for anxiety and depression in patients with chronic obstructive pulmonary disease: A literature review.
- Author
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CAFARELLA, PAUL A., EFFING, TANJA W., USMANI, ZAFAR-AHMAD, and FRITH, PETER A.
- Subjects
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ANXIETY , *OBSTRUCTIVE lung disease treatment , *MENTAL depression , *INTERPERSONAL psychotherapy , *PALLIATIVE treatment , *SELF-management (Psychology) - Abstract
ABSTRACT Chronic obstructive pulmonary disease (COPD) is a serious contemporary health issue. Psychological co-morbidities such as anxiety and depression are common in COPD. Current evidence for treatment options to reduce anxiety and depression in patients with COPD was examined. There is evidence available for the efficacy of pharmacological treatments, cognitive behavioural therapy, pulmonary rehabilitation, relaxation therapy and palliative care in COPD. Therapeutic modalities that have not been proven effective in decreasing anxiety and depression in COPD, but which have theoretical potential among patients, include interpersonal psychotherapy, self-management programmes, more extensive disease management programmes, supportive therapy and self-help groups. Besides pulmonary rehabilitation that is only available for a small percentage of patients, management guidelines make scant reference to other options for the treatment of mental health problems. The quantity and quality of research on mental health treatments in COPD have historically been insufficient to support their inclusion in COPD treatment guidelines. In this review, recommendations regarding assessment, treatment and future research in this important field were made. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
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