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65. Effects of Self-Management Interventions in People With Interstitial Lung Disease.

Author

Freitas Dos Santos, Steve, Marques, Alda, Rebelo, Patrícia, Brooks, Dina, Benoit, Adam, and Oliveira, Ana

Subjects
ONLINE information services, SELF-management (Psychology), FUNCTIONAL status, SYSTEMATIC reviews, INTERSTITIAL lung diseases, HEALTH status indicators, MEDICAL screening, SELF-efficacy, QUALITY of life, MENTAL depression, MEDLINE, PULMONARY fibrosis, ANXIETY, PATIENT education, OVERALL survival
Abstract

BACKGROUND: People with interstitial lung disease (ILD) want to actively manage their condition; however, the effects of self-management interventions (SMIs) in this population have not been synthesized. This review summarizes the effects of SMIs on health-related quality of life (HRQOL), functional status, psychological and social factors, symptoms, exacerbations, health care utilization, and survival in people with ILD. METHODS: The protocol of this systematic review was registered (PROSPERO ID: CRD42022329199). Six digital databases were searched in May 2022 with monthly updates until August 2023. Studies implementing SMIs in people with any type of ILD were included. Risk of bias (RoB) and quality of evidence were assessed with the Cochrane tool for RoB assessment and the grading of recommendations, assessment, development, and evaluations. Meta-analysis was used to summarize the results. RESULTS: Four studies that examined 217 participants (81% male, 71 y old, 91% idiopathic pulmonary fibrosis) were included. SMIs were highly heterogeneous. Meta-analysis showed no difference in HRQOL (standardized mean difference: 0.08 [95% CI 20.21 to 0.37], P .58) nor in the secondary outcomes. No evidence for the effects of SMIs on functional capacity, exacerbations, and survival was found. The quality of evidence ranged from low to very low. CONCLUSIONS: There is low to very low-quality evidence that SMIs have no effect in people with ILD. However, this conclusion is limited by high methodological heterogeneity. A consensus definition of SMIs is needed to implement more comparable interventions and strengthen results. [ABSTRACT FROM AUTHOR]

Published
2024
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70. A non-pharmacological cough therapy for people with interstitial lung diseases: a case report

Author

Dasouki, Sabrina, Quach, Shirley, Mancopes, Renata, Chamberlain Mitchell, Sarah, Goldstein, Roger, Brooks, Dina, Oliveira, Ana, Dasouki, Sabrina, Quach, Shirley, Mancopes, Renata, Chamberlain Mitchell, Sarah, Goldstein, Roger, Brooks, Dina, and Oliveira, Ana

Abstract

Purpose: To explore the feasibility of a non-pharmacological cough control therapy (CCT) customized for a client with interstitial lung disease (ILD). Client Description: An 83-year-old female with hypersensitivity pneumonitis, and chronic cough for 18 years treated previously with pharmacological treatment for the underlying lung disease and gastroesophageal reflux disease, as well as lozenges and breathing and relaxation strategies. Intervention: Four cough education and self-management sessions (45–60 minutes each) facilitated by a physiotherapist and speech-language pathologist via videoconference were conducted. Session topics included mechanisms of cough in ILD, breathing and larynx role in cough control, trigger identification, cough suppression and control strategies, and psychosocial support towards behaviour change using motivational interviewing. Measures and Outcome: The following assessments were conducted prior to and one week after the intervention: semi-structured interviews, Leicester Cough Questionnaire, King's Brief Interstitial Lung Disease questionnaire, Functional Assessment of Chronic Illness Therapy Fatigue Scale, modified Borg Scale for severity and intensity of cough, and the Global Rating of Change Questionnaire. Implications: Implementing the CCT was feasible. The client reported increased perceived cough control, a reduction in exhaustion from coughing bouts, and a better understanding of the mechanisms behind cough management and suppression. Improvements were also observed in cough-related quality of life, severity, and intensity.

Published
2023

79. Rapid access rehabilitation after exacerbations of chronic obstructive pulmonary disease: A Delphi study

Author

Quach, Shirley, Oliveira, Ana, Brooks, Dina, Walker, Jan, and Goldstein, Roger

Abstract

AbstractBACKGROUNDPulmonary rehabilitation (PR) improves function and health-related quality of life following acute exacerbations of chronic obstructive pulmonary disease (AECOPD). There is increasing interest in initiating rapid access rehabilitation (RAR) within 48 h of AECOPD discharge, to facilitate transition to home and conventional PR. In this report, we identify the practical considerations for the design and implementation of a RAR program.METHODHealthcare professionals (HCP), policymakers (PM), and patients living with COPD were invited to participate in a 2-round e-Delphi process. They provided feedback on five RAR themes, identified from semi-structured interviews, using a 6-point Likert scale. The initial round 1 questionnaire included 196 statements for HCP and PM and 144 for patients.RESULTSA total of 38 participants were enrolled (17 HCP, 12 PM, and 9 patients). Participants agreed that RAR should be initiated within 1 to 3 weeks of discharge for motivated patients with frequent exacerbations and those with co-existing health conditions. The consensus was for a hybrid format, of 1 to 2-h sessions, several times a week for a total duration of 4 to 6 weeks, with the structure being modified by patients’ preferences. Factors to improve referral and uptake included educating patients and HCP about RAR benefits and having a patient ambassador to support patients.CONCLUSIONStakeholders reached consensus around characteristics for participant eligibility, program structure, treatment priorities, outcome measures, approaches to facilitate referral, uptake and implementation of RAR. Such information forms the basis of a testable RAR program for patients transitioning home from hospital or referred for PR following an AECOPD.

Published
2024
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84. Improving access to community-based pulmonary rehabilitation: 3R protocol for real-world settings with cost-benefit analysis

Author

Marques, Alda, Jácome, Cristina, Rebelo, Patrícia, Paixão, Cátia, Oliveira, Ana, Cruz, Joana, Freitas, Célia, Rua, Marília, Loureiro, Helena, Peguinho, Cristina, Marques, Fábio, Simões, Adriana, Santos, Madalena, Martins, Paula, André, Alexandra, De Francesco, Sílvia, Martins, Vitória, Brooks, Dina, and Simão, Paula

Published
2019
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93. Aceitabilidade e viabilidade da intervenção OnTRACK para a promoção da atividade física em pessoas com doença pulmonar obstrutiva crónica

Author

Morais, Nuno, Hipólito, Nádia, Flora, Sofia, Oliveira, Ana, Pimenta, Sara, Gordo, Jéssica, Pinto, Diogo, Silva, Cândida G., Ribeiro, José, Silva, Fernando, Brites-Pereira, Marcelo, Sargento, Ana, Simões, Paula, Brooks, Dina, Burtin, Chris, Marques, Alda, and Cruz, Joana

Abstract

Introdução: As estratégias atuais para a promoção de atividade física (AF) em pessoas com doença pulmonar obstrutiva crónica (DPOC) têm mostrado resultados inconsistentes. O uso de plataformas digitais para treino (coaching) de AF tem o potencial de acompanhar remotamente o doente e proporcionar feedback regular sem sobrecarregar os serviços de saúde, podendo alcançar um maior número de doentes. A plataforma digital OnTRACK (ref. POCI-01-0145-FEDER-028446) integra uma aplicação móvel, dirigida a doentes, que intercomunica com uma aplicação web, acessível aos profissionais de saúde, para definir metas individualizadas, monitorizar a progressão da AF e dar feedback motivacional. A OnTRACK foi desenvolvida atendendo às necessidades e expectativas dos utilizadores finais para facilitar a sua adesão a longo prazo, porém nunca foi testada em contexto de prática clínica. Objetivo: Avaliar a aceitabilidade e viabilidade (clínica e económica) da intervenção OnTRACK na promoção de AF na DPOC. Métodos: Este é um estudo de métodos mistos. O recrutamento de doentes clinicamente estáveis com DPOC decorrerá durante 2 semanas numa unidade de saúde do Centro. A avaliação inicial incluirá, o estado clínico (e.g., limitação do fluxo aéreo: espirometria, impacto da doença: COPD Assessment Test), desempenho físico (e.g., teste de marcha dos 6 minutos), estadio de mudança (e.g., Questionário de Mudança Comportamental) e AF habitual (acelerómetro Actigraph GT3X+, 7 dias). A média dos dados de AF desses 7 dias servirá de base para estabelecer a meta inicial de AF (passos/dia) através da OnTRACK. Os doentes levarão para casa a aplicação móvel, onde poderão acompanhar a progressão de AF e verificar o (não)cumprimento da meta definida. Semanalmente, receberão um contacto telefónico de um profissional de saúde para definirem a meta da semana seguinte, considerando o nível de autoconfiança do doente [0–10], até um máximo de 10% aumento. Após 6 semanas, os doentes farão uma nova avaliação, que incluirá as medidas da avaliação inicial, um focus group e um questionário de aceitabilidade da intervenção. Serão analisadas taxas de recrutamento e atrito (não-utilização, desistência e motivos), possíveis efeitos adversos (segurança) e custos da intervenção. Discussão: Os dados da aceitabilidade informarão ajustes necessários à intervenção. Conclusão: Este estudo permitirá avaliar a viabilidade e aceitabilidade da intervenção OnTRACK, para posterior implementação num estudo randomizado e controlado. published

Published
2022

100. Assessing the Measurement Properties of the Fitbit Zip® Among Adults Living With HIV.

Author

Dagenais, Matthieu, Salbach, Nancy M., Brooks, Dina, and O'Brien, Kelly K.

Subjects
PHYSICAL activity, HIV-positive persons, ACTIVITIES of daily living, REHABILITATION, DISABILITIES
Abstract

Purpose: To assess the criterion and construct validity of the Fitbit Zip® to measure physical activity among adults living with HIV. Methods: Participants were video recorded completing 2 walk tests while wearing the Fitbit Zip® and completed 3 selfreported physical activity questionnaires 1 week later. The authors calculated intraclass correlation coefficients (ICCs) to determine agreement between the number of steps taken and distance walked (Fitbit Zip®) with the visual count of number of steps taken and actual distance walked (walk tests). The authors tested 15 a priori hypotheses about predicted associations between questionnaire scores and physical activity measured by the Fitbit Zip®. Results: Among the 34 participants, there was "excellent" agreement between the number of steps taken measured by the Fitbit Zip® and visually counted number of steps taken (ICC = .99) and number of steps taken at slow (ICC = .75), moderate (ICC = .85), and fast (ICC = .78) walking speeds. There was "poor" agreement between the Fitbit Zip® recorded distance and actual determined distance walked (ICC = .20). Three (20%) construct validity hypotheses were confirmed. Conclusions: The Fitbit Zip® demonstrated criterion validity for its ability to measure number of steps taken but not distance walked, and did not demonstrate construct validity for measuring physical activity among adults with HIV. [ABSTRACT FROM AUTHOR]

Published
2020
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