Abstract
Aims and objectives: To examine how subgroups of patients with chronic obstructive pulmonary disease, identified by ratings of symptoms (dyspnoea, anxiety, depression and fatigue), affect healthcare use and mortality. Background: People with chronic obstructive pulmonary disease often experience multiple symptoms. The importance of multiple symptoms and symptom clusters has received increased attention. However, little is known about symptom clusters and their effect on healthcare use and mortality in this population. Design: Descriptive cross-sectional study. Methods: This secondary data analysis used data from the National Emphysema Treatment Trial. Participants (n = 597) had severe chronic obstructive pulmonary disease. Descriptive and inferential statistics were used to analyse the data that were drawn from structured interviews, questionnaires and clinical measures. Results: Three subgroup clusters emerged based on four symptom ratings. Mean age, proportion with higher education, proportion using oxygen, disease severity, exercise capacity and quality of life differed significantly between subgroups. Participants with high levels of symptoms used healthcare services more and were more likely to have died at the five-year follow-up than those with low levels of symptoms. Symptom cluster subgroups had more significant relationship with mortality than single symptoms. Conclusion: Patients with high levels of symptoms require greater clinical attention. Relevance to clinical practice: Understanding subgroups of patients, based on symptom ratings and their adverse effect on outcomes, may enable healthcare providers to assess multiple symptoms and identify subgroups of patients at risk of increased healthcare use and mortality. Targeting modifiable symptoms within the cluster may be more beneficial than focusing on a single symptom for certain health-related outcome.
| Original language | English |
|---|---|
| Pages (from-to) | 2658-2671 |
| Number of pages | 14 |
| Journal | Journal of Clinical Nursing |
| Volume | 23 |
| Issue number | 17-18 |
| DOIs | |
| Publication status | Published - 2014 Jan 1 |
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ASJC Scopus subject areas
- Nursing(all)
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Symptom cluster, healthcare use and mortality in patients with severe chronic obstructive pulmonary disease. / Park, Sookyung; Larson, Janet L.
In: Journal of Clinical Nursing, Vol. 23, No. 17-18, 01.01.2014, p. 2658-2671.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Symptom cluster, healthcare use and mortality in patients with severe chronic obstructive pulmonary disease
AU - Park, Sookyung
AU - Larson, Janet L.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Aims and objectives: To examine how subgroups of patients with chronic obstructive pulmonary disease, identified by ratings of symptoms (dyspnoea, anxiety, depression and fatigue), affect healthcare use and mortality. Background: People with chronic obstructive pulmonary disease often experience multiple symptoms. The importance of multiple symptoms and symptom clusters has received increased attention. However, little is known about symptom clusters and their effect on healthcare use and mortality in this population. Design: Descriptive cross-sectional study. Methods: This secondary data analysis used data from the National Emphysema Treatment Trial. Participants (n = 597) had severe chronic obstructive pulmonary disease. Descriptive and inferential statistics were used to analyse the data that were drawn from structured interviews, questionnaires and clinical measures. Results: Three subgroup clusters emerged based on four symptom ratings. Mean age, proportion with higher education, proportion using oxygen, disease severity, exercise capacity and quality of life differed significantly between subgroups. Participants with high levels of symptoms used healthcare services more and were more likely to have died at the five-year follow-up than those with low levels of symptoms. Symptom cluster subgroups had more significant relationship with mortality than single symptoms. Conclusion: Patients with high levels of symptoms require greater clinical attention. Relevance to clinical practice: Understanding subgroups of patients, based on symptom ratings and their adverse effect on outcomes, may enable healthcare providers to assess multiple symptoms and identify subgroups of patients at risk of increased healthcare use and mortality. Targeting modifiable symptoms within the cluster may be more beneficial than focusing on a single symptom for certain health-related outcome.
AB - Aims and objectives: To examine how subgroups of patients with chronic obstructive pulmonary disease, identified by ratings of symptoms (dyspnoea, anxiety, depression and fatigue), affect healthcare use and mortality. Background: People with chronic obstructive pulmonary disease often experience multiple symptoms. The importance of multiple symptoms and symptom clusters has received increased attention. However, little is known about symptom clusters and their effect on healthcare use and mortality in this population. Design: Descriptive cross-sectional study. Methods: This secondary data analysis used data from the National Emphysema Treatment Trial. Participants (n = 597) had severe chronic obstructive pulmonary disease. Descriptive and inferential statistics were used to analyse the data that were drawn from structured interviews, questionnaires and clinical measures. Results: Three subgroup clusters emerged based on four symptom ratings. Mean age, proportion with higher education, proportion using oxygen, disease severity, exercise capacity and quality of life differed significantly between subgroups. Participants with high levels of symptoms used healthcare services more and were more likely to have died at the five-year follow-up than those with low levels of symptoms. Symptom cluster subgroups had more significant relationship with mortality than single symptoms. Conclusion: Patients with high levels of symptoms require greater clinical attention. Relevance to clinical practice: Understanding subgroups of patients, based on symptom ratings and their adverse effect on outcomes, may enable healthcare providers to assess multiple symptoms and identify subgroups of patients at risk of increased healthcare use and mortality. Targeting modifiable symptoms within the cluster may be more beneficial than focusing on a single symptom for certain health-related outcome.
KW - Chronic obstructive pulmonary disease
KW - Healthcare use
KW - Mortality
KW - National emphysema treatment trial
KW - Symptoms
UR - http://www.scopus.com/inward/record.url?scp=84904745208&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904745208&partnerID=8YFLogxK
U2 - 10.1111/jocn.12526
DO - 10.1111/jocn.12526
M3 - Article
C2 - 24460846
AN - SCOPUS:84904745208
VL - 23
SP - 2658
EP - 2671
JO - Journal of Clinical Nursing
JF - Journal of Clinical Nursing
SN - 0962-1067
IS - 17-18
ER -