scholarly journals Trends in Mortality from Chronic Obstructive Pulmonary Disease in Alberta: Back to the Future?

1995 ◽  
Vol 2 (2) ◽  
pp. 97-103
Author(s):  
Tee L Guidotti

Trends in mortality from chronic obstructive pulmonary disease (COPD) in Alberta over 60 years, from 1927 to 1987, for ages 15 and above or both sexes, were examined. There was a striking decline in mortality among older adults in the 1930s and 1940s. a nadir that lasted almost 10 years in the 1950s, and a striking increase thereafter. By 1970, most age groups had returned to levels of the 1930s. This overall trend was observed in both the younger age groups (aged 15 to 50) and older adults, although mortality from COPD in the former disproportionately reflected asthma-related deaths. Subsequently, mortality climbed still higher in older age groups, but not in the younger age groups. The sustained rise in mortality in older age groups after the Second World War is presumably related to smoking habits. Historical trends in Alberta were then compared with Canada as a whole for both sexes over 50 years of age. Although Alberta had a much lower mortality from COPD than Canada as a whole, this difference disappeared by 1980. There is no obvious explanation that would explain all of the observed trends, but they appear more likely to be a consequence of social and environmental conditions, including changes in health-related behaviour, than of major changes in medical management at the time.

Author(s):  
Karen Jackson ◽  
Nelly D. Oelke ◽  
Jeanne Besner ◽  
Alexandra Harrison

RÉSUMÉBeacoup de patients, surtout les patients plus âgés, interagissent avec fournisseurs multiples, tout en avant accès aux services des soins de santé dans une variété de milieux divers pendants longues périodes. Comprendre les expériences des patients plus âgés pendant leurs voyages à travers le système de santé est essentielle pour améliorer l’intégration des services et la qualité des soins. Dans cette étude, nous avons résumé les expériences de quatre patients vivant avec la maladie pulmonaire obstructive chronique en interaction avec le système des soins de santé pendant une période de trois mois après la sortie de l’hôpital. Guidé par la méthodologie d’étude de cas, on a réunis les données par le biais des entretiens semi-structurés et des journaux de patients. Trois grands thèmes - le soutien social, la navigation à travers le système, et l’accès aux soins – ont émergé à partir des données. L’attention à la communication entre fournisseur-patient et prestataire-fournisseur, ainsi que le soutien social du patient, et les besoins des soins auto-administrés, pourraient améliorer l’intégration et les résultats des soins. Pour réaliser de ce que les patients perçoivent comme une système integrée et efficace, il faudra du temps et de l’engagement.


2007 ◽  
Vol 135 (9-10) ◽  
pp. 547-553 ◽  
Author(s):  
Branislav Gvozdenovic ◽  
Sasa Mitic ◽  
Vladimir Zugic ◽  
Aleksandar Gvozdenovic ◽  
Nada Lazovic ◽  
...  

Introduction Dyspnoea is a characteristic symptom of chronic obstructive pulmonary disease (COPD), which impairs everyday functioning of patients. Objective The aim of our study was to evaluate the relationship between the degree of dyspnoea of COPD patients and their health-related quality of life. Method We measured the degree of dyspnoea and health-related quality of life in 85 COPD outpatients (46 male; mean age was 58 ? 12 years; mean forced expiratory volume in one second (FEV1) was 47.9?18.6% predicted). The degree of dyspnoea was assessed by Baseline Dyspnoea Index (BDI), List of Daily Activities (DAL), Visual Analogue Scale (VAS), Modified MRC Dyspnoea Scale, and Borg Category Scale (BCS). The patients filled two standardized questionnaires for measuring health-related quality of life: the generic one - 15D, and the respiratory specific one - the St George?s Respiratory Questionnaire (SGRQ). Total 15D and SGRQ scores, as well as the scores for individual domains of SGRQ (symptoms, activity and impact scores) for each patient were calculated. In 40 out of 85 patients, the same procedure was repeated at the follow-up, with a mean 4-week interval between the visits. Results There were statistically highly significant correlations (p<0.01) between values of all dyspnoea scale scores evaluated and all the health-related quality of life scores. The highest degree of correlation of both total SGRQ and 15D scores was found for the values of BCS (r=0.731 and -0.776, respectively). A statistically significant correlation between the changes of all SGRQ (but not 15D) scores and all dyspnoea score changes (except for MRC) were also recorded. Conclusion The degree of dyspnoea of COPD outpatients that could be well-determined by the scales used in our study clearly reflects the impairment of their health-related quality of life as assessed by the instruments used. All of the questionnaires we used in this study have good measurement properties for their purposes.


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