Originally Published in: Kazuya Tanimura, Susumu Sato, Yoshinori Fuseya, Koichi Hasegawa, Kiyoshi Uemasu, Atsuyasu Sato, Tsuyoshi Oguma, Toyohiro Hirai, Michiaki Mishima and Shigeo Muro. Quantitative Assessment of Erector Spinae Muscles in Patients with COPD: Novel Chest CT-derived Index for Prognosis. Annals of the American Thoracic Society. [Year];[Volume]:[Pages]. DOI: [Number] Copyright© 2015 by the American Thoracic Society The final publication is available at http://www.atsjournals.org/journal/annalsats/ / 京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19621号 / 医博第4128号 / 新制||医||1015(附属図書館) / 32657 / 京都大学大学院医学研究科医学専攻 / (主査)教授 福原 俊一, 教授 今中 雄一, 教授 松田 秀一 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20987号 / 医博第4333号 / 新制||医||1027(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 伊達 洋至, 教授 長船 健二, 教授 一山 智 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13555号 / 論医博第2284号 / 新制||医||1067(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 森信 暁雄, 教授 中本 裕士, 教授 永井 純正 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Pulmonary function testing (PFT) is recommended by guidelines for the diagnosis of chronic obstructive pulmonary disease and the diagnosis and monitoring of asthma. Portable in-office tests offer rural patients and providers information previously more difficult to obtain because of hospital closures, transportation barriers, and cost. This article describes the successful implementation and measurement of in-office PFT in 3 rural primary care offices. Providers were more likely to order a PFT for patients with asthma (33%) than a patient with chronic obstructive pulmonary disease (9.7%). Recommendations include increased staff involvement and repeat education midimplementation.

COPD (Chronic Obstructive Pulmonary Disease) is one of the most widespread lung diseases today and is a growing cause for suffering and mortality worldwide. It is considered to be the third leading cause of death in the near future. Smoking is the most important risk factor for this disease and about 50% of smokers develop COPD. The purpose of this study was to mediate the experience of not being able to stop smoking described by persons diagnosed with mild or moderate COPD. The study involved five women and five men. Data was collected by semi-structured interviews and analyzed using qualitative latent content analysis. The analysis resulted in two themes: Life is governed by a long smoking history that is difficult to break and To be aware of and enlightened, but lacking ability to make a decision, and in five categories: That it is the wrong time in life to stop; To break a lifelong pattern is almost impossible; That plans to stop does not lead to results; Being aware of the consequences of continued smoking and to have received help and support but not liking to be patronized. Participants' lives were governed by a lifelong smoking habit which was difficult to break, although they had knowledge about the harmful effects of smoking. Individuals life situation is very important if the cessation of smoking can be successfully implemented and with lasting results. To have plans to stop smoking is not enough it is also necessary to get motivation and support from the environment and at the right time. Participants that where reluctant to smoking cessation where also critical to the information and support that was given to them. This indicates that health professionals should be more sensitive and provide an individually tailored support when an individual decides to stop smoking. / <p>Validerat; 20110102 (ysko)</p>

Bakgrund Kronisk obstruktiv lungsjukdom (KOL) är en kronisk inflammation i lungorna som förstör lungvävnaden och minskar lungkapaciteten. Sjukdomen går inte att bota. År 2030 beräknas sjukdomen utgöra den tredje största dödsorsaken samt patientgruppen i världen. KOL medför ett stort lidande och försämrad livskvalité för den drabbade. Syfte Syftet med litteraturöversikten är att beskriva personers upplevelser av att leva med kronisk obstruktiv lungsjukdom (KOL). Metod Examensarbetet genomfördes som en strukturerad litteraturöversikt. 13 artiklar från databaserna Cinahl och PsycINFO analyserades och sammanställdes med Fribergs analysmetod. De inkluderade artiklarna var av kvalitativ design. Resultat Resultatet delades in i två huvudkategorier: Förändring av förutsättningar och hantering av förändringarna. De centrala fynden var de fysiska förändringar som upplevdes, att fokus låg på andningen och känslor av att vara begränsad socialt var särskilt framträdande. Känslor av skam och skuld men också kunskapsutbyte och stöd hos andra personer i liknande situation. Att använda fysisk aktivitet som en strategi och ta ansvar för egenvård. Slutsats Resultatet visar att personer med sjukdomen KOL upplever begränsningar i det dagliga livet både gällande den sociala samvaron och fysiska aktiviteter. Hjälpmedel ansågs minska isolering och de dagliga aktiviteterna kunde upprätthållas bättre. Känslor av skuld och skam som har en inverkan på personernas upplevelser av hälsa framträder. Det finns upplevelser om attityder gentemot personer med KOL och att detta kunde leda till att man undvek att söka vård. / Background Chronic obstructive pulmonary disease (COPD) is a chronic inflammation of the lungs that destroys the lung tissue, reduces lung capacity and cannot be cured. In 2023, the disease is estimated to be the third biggest patient group in the world and the third largest cause of death. COPD causes suffering through shortness of breath, limited mobility and are duced quality of life. Aim The purpose of this thesis is to describe people's experiences of living with chronic obstructive pulmonary disease (COPD). Method The thesis was carried out as a structured literature review containing 13 articles from the database CINAHL and PsycINFO. The articles were analyzed and compiled using Friberg´s analysis method. The included articles were of qualitative design. Results The results were divided into two main categories: Change in conditions and management of the changes. The central findings were the physical changes experienced, a focus on breathing and feelings of being socially restricted were particularly prominent. Feelings of shame and guilt but also exchange of knowledge and support from other people in a similar situation. Using physical activity as a strategy and taking responsibility for selfcare. Conclusions The results show that people with the disease COPD experience limitations in daily life both regarding social interaction and physical tasks. The study also reveals feelings of guilt and shame, which are significant for the persons' health. Experiences that there is a certain attitude towards people who suffer from the disease are described.

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