Qualidade de vida e sobrecarga dos cuidadores de portadores de Doença Pulmonar Obstrutiva Crônica em oxigenoterapia

OBJECTIVE: to assess the quality of life and burden of caregivers to Chronic Obstructive Pulmonary Disease patients on Long-Term Oxygen Therapy and to investigate the factors influencing this burden. METHOD: this is an analytical, cross-sectional study of 80 persons with Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy who used the specialized outpatient center of the Federal University of São Paulo, and their carers. The following instruments were used: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS) and the Katz Index, along with socio-demographic and clinical variables. RESULTS: the most compromised scores on the carers' quality of life questionnaire were for Vitality and Mental Health. On the Caregiver Burden Scale, the domain which created the greatest burden for carers was the Environment. With the exception of Emotional Involvement, all the domains of quality of life were affected negatively by the domains of caregiver burden. CONCLUSION: it was shown that carers' quality of life was compromised and that they were overburdened with care tasks, confirming that assisting persons with Chronic Obstructive Pulmonary Disease is an important element in carers' quality of life.OBJETIVO: evaluar la calidad de vida y la sobrecarga de cuidados experimentada por cuidadores de portadores de la Enfermedad Pulmonar Obstructiva Crónica en uso de Oxigenoterapia Domiciliar Prolongada e investigar los factores que influencian esa sobrecarga. MÉTODO: se trata de estudio transversal analítico, con 80 portadores de la Enfermedad Pulmonar Obstructiva Crónica en uso de Oxigenoterapia Domiciliar en el ambulatorio especializado de la Universidad Federal de Sao Paulo y de sus respectivos cuidadores, aplicando los instrumentos: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS), índice de Katz y variables sociodemográficas y clínicas. RESULTADOS: los puntajes del cuestionario de calidad de vida de los cuidadores más comprometidos fueron la Vitalidad y la Salud Mental. El Ambiente fue el dominio del Caregiver Burden Scale que generó mayor sobrecarga de cuidados. Con excepción del Envolvimiento Emocional, todos los dominios de calidad de vida fueron influenciados de forma negativa por los dominios de sobrecarga de cuidados. CONCLUSIÓN: se demostró que la calidad de vida y la sobrecarga de cuidados, de los cuidadores, estaban comprometidos, confirmando que cuidar a los portadores de Enfermedad Pulmonar Obstructiva Crónica, es un importante interviniente en la calidad de vida del cuidador.OBJETIVO: avaliar a qualidade de vida e a sobrecarga de cuidados, vivenciada por cuidadores de portadores de Doença Pulmonar Obstrutiva Crônica, em uso de Oxigenoterapia Domiciliar Prolongada, e investigar os fatores que influenciam essa sobrecarga. MÉTODO: trata-se de estudo transversal analítico, com 80 portadores de Doença Pulmonar Obstrutiva Crônica em uso de Oxigenoterapia Domiciliar do ambulatório especializado da Universidade Federal de São Paulo e seus respectivos cuidadores, aplicando-se os instrumentos: Medical Outcomes Studies 36, Caregiver Burden Scale, índice de Katz e variáveis sociodemográficas e clínicas. RESULTADOS: os escores do questionário de qualidade de vida dos cuidadores mais comprometidos foram vitalidade e saúde mental. O ambiente foi o domínio do Caregiver Burden Scale que gerou maior sobrecarga de cuidados. Com exceção do envolvimento emocional, todos os domínios de qualidade de vida foram influenciados de forma negativa pelos domínios de sobrecarga de cuidados. CONCLUSÃO: demonstrou-se comprometimento da qualidade de vida e sobrecarga de cuidados dos cuidadores, confirmando que assistir portadores de Doença Pulmonar Obstrutiva Crônica é um importante interveniente na qualidade de vida do cuidador

Influence that sociodemographic variables, clinical characteristics, and level of dependence have on quality of life in COPD patients on long-term home oxygen therapy

OBJECTIVE: To evaluate and correlate the quality of life (QoL) of COPD patients on long-term home oxygen therapy (LTOT) with their sociodemographic/clinical characteristics and level of dependence. METHODS: This was a cross-sectional analytical study involving COPD patients on LTOT followed at the Oxygen Therapy Outpatient Clinic of the Federal University of São Paulo Hospital São Paulo, in the city of São Paulo, Brazil. Sociodemographic, clinical, and biochemical data were collected. We assessed QoL and level of dependence using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and the Katz index, respectively. Multiple linear regression models were constructed in order to determine the influence of these variables on QoL. RESULTS: We included 80 patients in the study. The mean age was 69.6 ± 9.1 years, and 51.3% were female. The lowest SF-36 scores were for the physical functioning and role-physical domains. All sociodemographic characteristics (except gender) were found to correlate significantly with the SF-36 domains mental health, vitality, role-physical, and social functioning. We also found that body mass index, PaO2, post-bronchodilator FEV1, hemoglobin, and Katz index correlated significantly with the physical functioning, mental health, role-physical, and bodily pain domains. In addition, oxygen flows were found to correlate negatively with the physical functioning, mental health, vitality, and role-emotional domains. CONCLUSIONS: Low scores for SF-36 domains, as well as the variables that negatively influence them, should be considered and analyzed during the development and implementation of strategies for improving the QoL of COPD patients on LTOT.OBJETIVO: Avaliar e correlacionar a qualidade de vida (QV) de pacientes com DPOC em uso de oxigenoterapia domiciliar prolongada (ODP) com suas características sociodemográficas/clínicas e o nível de dependência. MÉTODOS: Estudo transversal analítico com portadores de DPOC em ODP acompanhados no Ambulatório de Oxigenoterapia do Hospital São Paulo, Universidade Federal de São Paulo (UNIFESP), em São Paulo (SP). Os pacientes foram avaliados quanto aos dados sociodemográficos, clínicos e laboratoriais. A qualidade de vida e o nível de dependência foram avaliados pelo Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) e índice de Katz, respectivamente. Modelos de regressão linear múltipla foram construídos para verificar a influência dessas variáveis na QV. RESULTADOS: A média de idade dos 80 pacientes incluídos foi 69,6 ± 9,1 anos, e 51,3% eram do sexo feminino. Os escores dos domínios do SF-36 mais baixos foram capacidade funcional e função física. Correlações significantes foram encontradas entre características sociodemográficas (exceto gênero) e os domínios saúde mental, vitalidade, função física e aspectos sociais, assim como entre várias características clínicas/laboratoriais (índice de massa corpórea, PaO2, VEF1 pós-broncodilatador, hemoglobina e índice de Katz) e os domínios capacidade funcional, saúde mental, função física e dor corporal. Houve correlações negativas entre os fluxos de oxigênio e os domínios capacidade funcional, saúde mental, vitalidade e função emocional. CONCLUSÕES: Os baixos escores nos domínios do SF-36 e as variáveis que os influenciam negativamente devem ser considerados e analisados na elaboração e implementação de estratégias para a melhoria da QV de portadores de DPOC em ODP.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Hospital São PauloUNIFESP, Escola Paulista de Enfermagem (EPE)UNIFESP, EPM, Hospital São PauloSciEL

Quality of life and burden in carers for persons with Chronic Obstructive Pulmonary Disease receiving oxygen therapy

OBJECTIVE:to assess the quality of life and burden of caregivers to Chronic Obstructive Pulmonary Disease patients on Long-Term Oxygen Therapy and to investigate the factors influencing this burden.METHOD:this is an analytical, cross-sectional study of 80 persons with Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy who used the specialized outpatient center of the Federal University of São Paulo, and their carers. The following instruments were used: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS) and the Katz Index, along with socio-demographic and clinical variables.RESULTS:the most compromised scores on the carers' quality of life questionnaire were for Vitality and Mental Health. On the Caregiver Burden Scale, the domain which created the greatest burden for carers was the Environment. With the exception of Emotional Involvement, all the domains of quality of life were affected negatively by the domains of caregiver burden.CONCLUSION:it was shown that carers' quality of life was compromised and that they were overburdened with care tasks, confirming that assisting persons with Chronic Obstructive Pulmonary Disease is an important element in carers' quality of life.OBJETIVO:evaluar la calidad de vida y la sobrecarga de cuidados experimentada por cuidadores de portadores de la Enfermedad Pulmonar Obstructiva Crónica en uso de Oxigenoterapia Domiciliar Prolongada e investigar los factores que influencian esa sobrecarga.MÉTODO:se trata de estudio transversal analítico, con 80 portadores de la Enfermedad Pulmonar Obstructiva Crónica en uso de Oxigenoterapia Domiciliar en el ambulatorio especializado de la Universidad Federal de São Paulo y de sus respectivos cuidadores, aplicando los instrumentos: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS), índice de Katz y variables sociodemográficas y clínicas.RESULTADOS:los puntajes del cuestionario de calidad de vida de los cuidadores más comprometidos fueron la Vitalidad y la Salud Mental. El Ambiente fue el dominio del Caregiver Burden Scale que generó mayor sobrecarga de cuidados. Con excepción del Envolvimiento Emocional, todos los dominios de calidad de vida fueron influenciados de forma negativa por los dominios de sobrecarga de cuidados.CONCLUSIÓN:se demostró que la calidad de vida y la sobrecarga de cuidados, de los cuidadores, estaban comprometidos, confirmando que cuidar a los portadores de Enfermedad Pulmonar Obstructiva Crónica, es un importante interviniente en la calidad de vida del cuidador.OBJETIVO:avaliar a qualidade de vida e a sobrecarga de cuidados, vivenciada por cuidadores de portadores de Doença Pulmonar Obstrutiva Crônica, em uso de Oxigenoterapia Domiciliar Prolongada, e investigar os fatores que influenciam essa sobrecarga.MÉTODO:trata-se de estudo transversal analítico, com 80 portadores de Doença Pulmonar Obstrutiva Crônica em uso de Oxigenoterapia Domiciliar do ambulatório especializado da Universidade Federal de São Paulo e seus respectivos cuidadores, aplicando-se os instrumentos: Medical Outcomes Studies 36, Caregiver Burden Scale, índice de Katz e variáveis sociodemográficas e clínicas.RESULTADOS:os escores do questionário de qualidade de vida dos cuidadores mais comprometidos foram vitalidade e saúde mental. O ambiente foi o domínio do Caregiver Burden Scale que gerou maior sobrecarga de cuidados. Com exceção do envolvimento emocional, todos os domínios de qualidade de vida foram influenciados de forma negativa pelos domínios de sobrecarga de cuidados.CONCLUSÃO:demonstrou-se comprometimento da qualidade de vida e sobrecarga de cuidados dos cuidadores, confirmando que assistir portadores de Doença Pulmonar Obstrutiva Crônica é um importante interveniente na qualidade de vida do cuidador.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUniversidade Federal de São Paulo (UNIFESP) Hospital São PauloUNIFESP, Escola Paulista de Enfermagem (EPE)UNIFESP, Hospital São PauloSciEL

Gender and prognosis of chronic obstructive pulmonary disease

Univ Fed Sao Paulo, Sao Paulo, BrazilState Publ Hosp Sao Paulo, Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo, BrazilState Publ Hosp Sao Paulo, Sao Paulo, BrazilWeb of Scienc

Sex differences in survival of oxygen-dependent patients with chronic obstructive pulmonary disease

Rationale: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. the prevalence of COPID is rising among women and is approaching that of men, but it is not known if sex affects survival.Objectives: To measure the survival differences between men and women with oxygen-dependent COPD.Methods: We conducted a 7-yr prospective cohort study of 435 outpatients with COPD (184 women, 251 men) referred for long-term oxygen therapy (LTOT) at two respiratory clinics in São Paulo, Brazil. Baseline data were collected on enrollment into oxygen therapy, when patients were clinically stable.Measurements: We examined the effect of sex on survival using Kaplan-Meier survival curves, and then used Cox proportional hazards models to control for potential confounders.Main Results: in unadjusted analyses, we observed a nonsignificant trend toward increased mortality for women (hazard ratio, 1.28; 95% confidence interval, 0.98-1.68; p = 0.07). After accounting for potential confounders (age, pack-years smoked, Pa-O2, FEV1, body mass index), females were at a significantly higher risk of death (hazard ratio, 1.54, 95% confidence interval, 1.15-2.07; p = 0.004). Other independent predictors of death were lower Pa-O2 (P < 0.001) and lower body mass index (p < 0.05).Conclusions: Among patients with COPD on LTOT, women were more likely to die than men.State Publ Hosp, São Paulo, BrazilUniversidade Federal de São Paulo, Div Resp, São Paulo, BrazilJohns Hopkins Univ, Baltimore, MD USAOregon Hlth & Sci Univ, Portland, OR USACtr Hlth Res, Portland, OR USAUniversidade Federal de São Paulo, Div Resp, São Paulo, BrazilWeb of Scienc

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications