Fatigue and Quality of Life after Pulmonary Rehabilitation Program
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Department of Psychology, University of Central Lancashire, UK
Faculty of Human Movement and Quality of Life, Department of Nursing, University of Peloponnese, Sparta, Greece
First Department of Respiratory Medicine, National and Kapodistrian University of Athens, Sotiria General Chest Hospital, Athens, Greece
Department of Nursing, Technological Educational Institute of Crete, Heraklion, Crete, Greece
Department of Nursing, Alexander Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
College for Humanistic Sciences, Athens, Greece
Ministry of Health, Athens, Greece
Victoria Alikari   

Efstathiou & Stamatikis Valioti and Plateon, Sparta, 23100, Greece
Pneumon 2019;32(3):72–80
Fatigue and poor quality of life can play an important role in chronic obstructive disease and treatment outcomes. The aim of this study was to examine the levels of fatigue and quality of life (QoL) among chronic obstructive pulmonary disease patients before and after a pulmonary rehabilitation program.

In this experimental study, 31 chronic obstructive pulmonary disease patients at a large hospital of Athens were randomly followed a pulmonary rehabilitation program and completed two questionnaires pre- and post-intervention: the Fatigue Assessment Scale designed for measuring fatigue and the Missoula-Vitas Quality of Life Index-15 designed for measuring QoL. Statistical analysis of the data was performed via the Statistical Program SPSS version 19.0. The statistical significance was set up at 0.05.

The results showed decreased levels of fatigue after the completion of the Pulmonary Rehabilitation Program compared to pre-intervention. Moreover, although QoL did not seem to change after the intervention, however the dimension “Transcendent” seemed to be increased for the majority of the participants. After the participation in the rehabilitation program a statistically significant and negative correlation was observed between mental fatigue and total score of quality of life (r= -0.436, p=0.014 <0.05) as well as between physical fatigue and the dimensions of “Interpersonal” (r= -0.470 p=0.008), “Well-Being” (r= -0.615, p=0.000), “Transcendent” (r= -0.636, p=0.000) and total score of QoL (r= -0.543, p=0.002).

A pulmonary rehabilitation program seems to be a successful and innovative clinical prevention program leading to a lower level of fatigue for those patients who suffer from chronic obstructive pulmonary disease. Pneumon 2019, 32(3):72-80.

COPD: Chronic Pulmonary Obstructive Disease, FAS: Fatigue Assessment Scale, MVQoLI-15: Missoula Vitas Quality of Life Index, PRP: Pulmonary Rehabilitation Program
The authors would like to acknowledge patients who participated in this study.
The authors declare that they have no conflict of interest.
This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors.
Ethical approval was granted by the Scientific Council of General Hospital of Athens “Sotiria”. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.Informed consent was obtained from all individual participants included in the study.
Lewko A, Bidgood PL, Jewell A, Garrod R. Evaluation of multidimensional COPD-related subjective fatigue following a pulmonary rehabilitation programme. Respir Med 2013; 108:95-102. doi: 10.1016/j.rmed.2013.09.003.
Miravitlles M, Ribera A. Understanding the impact of symptoms on the burden of COPD. RespirRes 2017; 18:67. http://doi. org/10.1186/s12931-017-0548-3.
Chen YW, Camp PG, Coxson HO, et al. A comparison of pain, fatigue, dyspnea and their impact on quality of life in pulmonary rehabilitation participants with chronic obstructive pulmonary disease. COPD 2018; doi: 10.1080/15412555.2017.1401990.
Spruit MA, Burtin C, De Boever P, et al. COPD and exercise: does it make a difference? Breathe 2016; 12:e38–49. http:// doi.org/10.1183/20734735.00391....
Zamzam MA, Azab NY, El Wahsh RA, Ragab AZ, Allam EM. Quality of life in COPD patients. Egypt J Chest Dis Tuberc 2012; 61:281-9.
Russell S, Ogunbayo OJ, Newham JJ, et al. Qualitative systematic review of barriers and facilitators to self-management of chronic obstructive pulmonary disease: views of patients and healthcare professionals. NPJ Prim Care Respir Med 2018; 28:2. doi.org/10.1038/s41533-017-006....
Papageorgiou D, Mitsiou P, Sidiropoulou M, Tsiakou O, Sampani CA, Paulatou, M. Quality of life in chronic obstructive pulmonary disease patients. Hellenic Journal of Nursing Science 2018; 11:51-62.
Zwerink M, Brusse-Keizer M, van der Valk PD, et al. Self-management for patients with chronic obstructive pulmonary disease. The Cochrane Database of Syst Rev 2014; 19: CD002990. doi: 10.1002/14651858.CD002990.pub3.
Mirza S, Clay RD, Koslow MA, Scanlon PD. COPD Guidelines: A review of the 2018 GOLD Report. Mayo Clin Proc 2018; 93:1488- 502. doi: 10.1016/j.mayocp.2018.05.026.
Baltzan MA, Scott AS, Wolkove N, et al. Fatigue in COPD: Prevalence and effect on outcomes in pulmonary rehabilitation. Chron Respir Dis 2011; 8:119-28. doi: 10.1177/1479972310396737.
Arnold R, Ranchor AV, Koter GH, et al. Changes in personal control as a predictor of quality of life after pulmonary rehabilitation. Patient Educ Couns 2005; 61:99-108. DOI: 10.1016/j.pec.2005.02.
Blánquez Moreno C, Colungo Francia C, Alvira Balada MC, Kostov B, González-de Paz L, Sisó-Almirall A. Effectiveness of an educational program for respiratory rehabilitation of chronic obstructive pulmonary disease patients in primary care in improving the quality of life, symptoms, and clinical risk. Aten Primaria 2018;50:539-46. doi: 10.1016/j.aprim.2017.03.019.
Porto EF, Castro AAM, Cortopassi F, de Souza GF, Jardim JR. Variability in quality of life outcomes following a pulmonary rehabilitation program in patients with COPD. J Cardiopulm Rehabil Prev 2018; 38:118-23. doi: 10.1097/HCR.0000000000000292.
Alikari V, Fradelos E, Sachlas A, et al. Reliability and validity of the Greek version of the fatigue assessment scale. Archives of Hellenic Medicine 2016; 33:231-8.
Zyga S, Alikari V, Sachlas A, et al.Assessment of fatigue in end stage renal disease patients undergoing hemodialysis: Prevalence and associated factors. Med Arch 2015;69:376-80.
Byock IR, Merriman MP. The Missoula-VITAS Quality of Life Index (MVQOLI): An outcome measure for palliative care. Guide to Using the MVQOLI. Byock and Merriman, Palliative Medicine 1998;12:231-44.
Theofilou P, Aroni A, Ralli M, Gouzou M, Zyga S. Measuring Health: Related quality of life in hemodialysis patients. Psychometric properties of the Missoula-VITAS Quality of Life Index (MVQOLI-15) in Greece. Health Psychol Res 2013;18;1(2):e17.
Theofilou P, Zyga S. Psychometric properties of the Missoula - VITAS Quality of Life Index in Greek patients undergoing chronic periodical haemodialysis. HJN 2014;53:166-74.
Spruit MA, Vercoulen JH, Sprangers MAG, Wouters EFM; FAntasTIGUE consortium. Fatigue in COPD: an important yet ignored symptom. The Lancet. Respir Med 2017;5:542-4. doi:10.1016/ S2213-2600(17)30158-3.
Antoniu SA, Ungureanu D. Measuring fatigue as a symptom in COPD: From descriptors and questionnaires to the importance of the problem. Chron Respir Dis 2015; 12:179-88. doi: 10.1177/1479972315575716.
Krok D. The role of meaning in life with in the relations of religious coping and psychological well-being. J Religion Health 2015; 54:2292–308. http://doi.org/10.1007/s10943-....
Rassoulian A, Seidman C, Löffler-Stastka H. Transcendence, religion and spirituality in medicine: Medical students’ point of view. Medicine 2016; 95:e4953. http://doi.org/10.1097/ MD.0000000000004953.
Da Silva GP, Nascimento FA, Macêdo TP, Morano MT, Mesquita R, Pereira ED. Religious coping and religiosity in patients with COPD following pulmonary rehabilitation. Int J Chron Obstruct Pulmon Dis 2018; 13:175–81. http://doi.org/10.2147/COPD. S146400.
Kayahan B, Karapolat H, Atyntoprak E, Atasever A, Ozturk O. Psychological outcomes of an outpatient pulmonary rehabilitation program in patients with chronic obstructive pulmonary disease. Respir Med 2006; 100:1050-7.
Reinert KG, Koenig HG. Re-examining definitions of spirituality in nursing research. J Adv Nurs 2013; 69:2622–34. doi: 10.1111/ jan.12152.