Palliative Intervention for Mitigating Fatigue and Sleep Inefficiency among Chronic Obstructive Pulmonary Disease Clients

Amany Mohamed Saad^1, and Enas Ebrahiem E. Abo Elfetoh²

¹Community Health Nursing Department, Faculty of Nursing, Helwan University, Egypt

²Adult Health Nursing Department, Faculty of Nursing, Helwan University, Egypt

Cite this paper

Amany Mohamed Saad and Enas Ebrahiem E. Abo Elfetoh. Palliative Intervention for Mitigating Fatigue and Sleep Inefficiency among Chronic Obstructive Pulmonary Disease Clients. American Journal of Nursing Research. 2019; 7(4):509-518. doi: 10.12691/AJNR-7-4-13

Abstract

Chronic obstructive pulmonary disease is a public health problem cause mortality. Palliative intervention is supportive in managing, and helping clients living with chronic obstructive pulmonary disease. Aim: This study aims to evaluate the effect of palliative care intervention for mitigating fatigue and sleep inefficiency among chronic obstructive pulmonary disease clients. Design: A quasi-experimental design was used. Setting: The study was conducted in Chest Outpatient Clinic, Ain Shams University Hospitals. Sample: A purposive sample comprised of 70 clients. Tools: A structured interview questionnaire was used to collect the data and included three parts: Part I. Client's demographic characteristics. Part II. The Pittsburgh Sleep Quality Index. Part III. Fatigue Severity Scale. Results: The sleep quality index was improved from 7.1% of clients had good sleep quality pre intervention to 85.7% post intervention and also fatigue severity was improved from 90% of them had high fatigue pre intervention to 4.3% post intervention with highly statistically significant positive correlation between total fatigue and sleep quality index among chronic obstructive pulmonary disease clients (p= <0.001). Conclusion: The palliative care intervention had a positive effect on chronic obstructive pulmonary disease clients and helped them to mitigate sleep inefficiency, which led to reduce fatigue. Recommendations: An illustrated booklet containing information about benefits of gradual relaxation exercises should be available in all chest outpatient clinics. Training of the nurses on how to apply the palliative care intervention to chronic obstructive pulmonary disease clients.

Keywords

palliative, mitigating fatigue, sleep inefficiency, chronic obstructive pulmonary disease

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Badway, M.Sh., Hamed, A.F., & Yousef, F.M.A. (2016): Prevalence of chronic obstructive pulmonary disease (COPD) in Qena Governorate. Egyptian Journal of Chest Diseases and Tuberculosis 65: 29-34.
[2]	World Health Organization (WHO). (2015): Chronic obstructive pulmonary disease (COPD). Retrieved from: http://www.who.int.
[3]	Centers for Disease Control and Prevention. (2017). Chronic obstructive pulmonary disease (COPD). Available at: https://www.cdc.gov/copd/index.html. Accessed on: February 6, 2018.
[4]	Said, A.F., Ewis, A.A., Omran, A.A., Magdy, M.E., & Saleeb, M.F. (2015). Prevalence and predictors of chronic obstructive pulmonary disease among high-risk Egyptians. Egyptian Journal of Broncholog, 9 (1):27-33.
[5]	Tashkin, D.P. (2015): Does marijuana pose risks for chronic airflow obstruction? Annals of the American Thoracic Society, 12(2), 235-6.
[6]	Fabbri, L.M. (2016). Smoking not COPD, as the disease. N. Engl. J. Med., 374: 1885-1886.
[7]	Lewko, A., Bidgood, P.L., Jewell, A., & Garrod, R. (2014). Evaluation of multidimensional COPD-related subjective fatigue following a pulmonary rehabilitation program. Respiratory Medicine., 108(1): 95-102.
[8]	Aydin, H.T. (2014): Chronic obstructive pulmonary disease and sleep quality. Chapter 6, COPD Clinical Perspectives. Licensee In Tech. Accessed at: 7/7/2018.
[9]	Sajadi, A., Farsi, Z., & Rajai, N. (2014). The relationship between sleep quality with fatigue severity and academic performance of nursing students. Nursing Practice Today; 1(4): 213-220.
[10]	Soler, X., Diaz-Piedra, C., & Ries, A. L. (2013): Pulmonary rehabilitation improves sleep quality in chronic lung disease. Journal of Chronic Obstructive Pulmonary Disease; 10(2): 156-63.
[11]	Cancelliero-Gaiad, K.M., Ike, D., Pantoni, C.B., Borghi-Silva, A., & Costa, D. (2014): Respiratory pattern of diaphragmatic breathing and Pilates breathing in COPD subjects. Brazilian Journal of Physical Therapy; 18(4):291-9.
[12]	Campion, E.W., Kelley, A.S., & Morrison, R.S. (2015): Palliative care for the seriously ill. New England Journal of Medicine; 373(8): 747-55.
[13]	Lobato, S., & Alises, S. (2015): Palliative care in COPD patients: A challenge in modern medicine. Lung India, 32: 6.
[14]	The American Lung Association. (2017): Lung health & diseases, palliative care and COPD. Available at: https://www.lung.org/lung-health - and - diseases/lung - disease-lookup/copd/diagnosing - and -treating/palliative-care-and-copd.html. Date of access: March 13, 2018.
[15]	Nursing Management. (2017): Chronic obstructive pulmonary disease. Chapter 27, respiratory problems, unit 6, pp. 680-684. Accessed date: 16/12/2017.
[16]	Nurse Registry. (2018). The role of the nurse in palliative care. What is Palliative Care? Available at: https://www.nurseregistry.com/blog/palliative-care-nursing/ accessed date: 1/9/2018
[17]	McCarthy, B. D., Casey, D., Devane, K., Murphy, E., Murphy, Y., & Lacasse. (2015): Pulmonary rehabilitation for chronic obstructive pulmonary disease, Cochrane Library Syst. Rev. 2.
[18]	Egypt Ministry of Health Conference. (2018): Three million Egyptians at risk of chronic obstructive pulmonary disease and early diagnosis lifeline for patients, Elmogaz Journal. Available at: http://www.elmogaz.com/node/454737. Accessed date: 29 March 2018.
[19]	Liu, X.L., Tan, J.Y., Wang, T., Zhang, Q., Zhang, M., & Yao, L.Q. (2014): Effectiveness of home based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials. Rehabilitation Nursing; 39(1):36-59.
[20]	Chow, S.C., Shao, J., & Wang, H. (2007): Sample size calculation in clinical research, Second edition. Chapman and Hall/CRC Biostatistics Series, pp. 389-405.
[21]	Buysse, D.J., Reynolds, C.F., Monk, T.H., Berman, S.R., & Kupfer, D.J. (1989): The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice. Psychiatry Research; 28:193-213.
[22]	Krupp, L.B., LaRocca, N.G., Muir-Nash, J., & Steinberg, A.D. (1989): The Fatigue Severity Scale. Application to patients and measures fatigue severity in a variety of medical and neurologic disorders Arch Neurol. Oct; 46(10):1121-3.
[23]	Wong, C.J.D. Goodridge, D.D., Marciniuk, D., & Rennie. (2010): Fatigue in patients with COPD participating in a pulmonary rehabilitation program. Int. J. Chron. Obstruct. Pulmon. Dis; 5: 319-326.
[24]	Disler, R., Inglis, S.C., Currow, D.C., Davidson, P.M. (2012): Palliative and supportive care in chronic obstructive pulmonary disease: Research Priorities to Decrease Suffering. 1:301. 1: 6.
[25]	Maarouf, M. (2016): Effect of care protocol on the knowledge, practice and clinical outcomes of patients with chronic obstructive pulmonary disease, Doctorate thesis, Faculty on Nursing, Ain Shams University.
[26]	Hyland, M.E., Halpin, D.M., Blake, S., Seamark, C., Pinnuck, M., Ward, D., & Seamark, D. (2016): Preference for different relaxation techniques by COPD patients: Comparison between six techniques, International Journal of Chronic Obstructive Pulmonary Disease; 11(1): 2315-2319.
[27]	Zamzam, M., Azab, N., El Wahsh, R., Ragab, A., & Allam, E., (2012): Quality of life in COPD patients, The Egyptian Journal of Chest Diseases and Tuberculosis; 61: 281-289.
[28]	Talwar, A., Sahni, S., Verma, S., Garcia, J., & Kohn, N. (2014): Effect of pulmonary rehabilitation on Fatigue Severity Scale in patients with lung disease. Pneumonol. Alergol.; 82: 534-540.
[29]	Center for Disease Control and Prevention. (2013): Chronic obstructive pulmonary disease among adults-United States. Morbidity and Mortality Weekly Report; 61(46): 938- 43.
[30]	Lamers, F., Jonkers, B. H., & Chavannes, J. (2010). Improving quality of life in depressed COPD patients: Effectiveness of a minimal psychological intervention. COPD: Journal of Chronic Obstructive Pulmonary Disease; 7: 315-322 ISSN: 1541-2555. Accessed at: January 2019.
[31]	Cedano, S., Belasco, A.G., Traldi, F., Malchado, M.C., & Bettencourt, A.R. (2012): Influence that sociodemographic on quality of life in COPD patients on long-term home oxygen therapy. National Center for Biotechnology Information, U.S. National Library of Medicine; 38(3): 331-8. Accessed at: January 2019.
[32]	Mohamed, D., Ahmed, S.S., Mohamed, A.H., & Abdel Rahman, A.A. (2017): Effect of care protocol on the knowledge, practice and clinical outcomes of patients with chronic obstructive pulmonary disease. Journal of Nursing Education and Practice; 7:2. Accessed date: 21/1/2019.
[33]	Volpato, E., Banfi, P., Rogers, S. & Pagnini, F., (2015): Research article relaxation techniques for people with chronic obstructive pulmonary disease: A systematic review and a meta-analysis article. ID 628365, 22 pages. Accessed at: December 2018.
[34]	Zakerimoghadam, M., Tavasoli, K., Nejad, A., & Khoshkesht, S. (2011). The effect of breathing exercises on the fatigue levels of patients with chronic obstructive pulmonary disease. Acta Med Indones-Indones J Intern Med; 43 (1): 29-32.
[35]	Salem, G., Mahdy, N., & Abdelatief, D. (2017): Chronic obstructive pulmonary disease: Effect of nursing intervention protocol on clinical patients' outcomes post-weaning from mechanical ventilation. The 9th International Scientific Nursing Conference, Helwan University.
[36]	Sahin, Z. A., & Dayapoglu, N. (2015). Effect of progressive relaxation exercises on fatigue and sleep quality in patients with chronic obstructive lung disease (COPD). Complementary Therapies in Clinical Practice; 21: 277-281. Journal homepage: www.elsevier.com/locate/ctcp. Accessed at: December 2018.
[37]	Andersson, M., Stridsman, C., Ronmark, E., Lindberg, A, & Emtner, M. (2015): Physical activity and fatigue in chronic obstructive pulmonary disease. A population based study. 0954-6111. Elsevier Ltd. Available online at: www.sciencedirect.com. Accessed date: 22 May 2015.
[38]	Chegeni, P.S., Gholami, M., Azargoon, A., Pour, A.H., Birjandi, M., & Norollahi, H. (2018): The effect of progressive muscle relaxation on the management of fatigue and quality of sleep in patients with chronic obstructive pulmonary disease: A randomized controlled clinical trial. 1744-3881. Complementary Therapies in Clinical Practice; 31: 64-70.