Biomedical subjects

Rosemarie Arnold

Publications and source records attributed to Rosemarie Arnold.

4 recordsLinked to original sources

PubMed2006

Evidence-based treatment and quality of life in heart failure.

OBJECTIVES: To explore whether prescription of evidence-based drug therapy is associated with better quality of life (QoL) in patients with heart failure (HF). METHODS: Patients (n = 62) were recruited in the outpatient clinic of Groningen University Hospital. Inclusion criteria were previous diagnosis of HF, age 40-80 years; ejection fraction of less than 45%, free from other serious disease (such as cancer) and psychiatric problems in the last year. QoL was assessed with the RAND 36-item health survey questionnaire, on five scales: physical functioning, mental health, social functioning, vitality and general health perception. Medication prescribed for 1 to 6 months before the QoL assessment was classified as either evidence-based treatment or under-treatment, according to the 2001 European guidelines on optimal HF treatment. The study had a cross-sectional design. RESULTS: QoL did not differ significantly between evidence-based and under-treated patients, unadjusted or after adjustment for significant patient imbalances. CONCLUSIONS: Conventional step-up medication approach in HF may have a positive impact on survival or morbidity, but it seems not beneficial in relation to QoL. Other interventions should be designed to improve QoL of patients with HF.

Adrenergic beta-Antagonists↗

PubMed2005

Changes in personal control as a predictor of quality of life after pulmonary rehabilitation.

OBJECTIVE: Perceptions of mastery and self-efficacy may be related to better outcomes in pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). This study examined (1) whether patients with COPD improved during a rehabilitation programme with respect to quality of life (QoL) and perceptions of self-efficacy and mastery, and (2) whether increased perceptions of mastery and self-efficacy contributed to a higher QoL after rehabilitation. METHODS: Thirty-nine consecutive COPD patients (aged 60.5 +/- 9.0) were included from a rehabilitation centre and completed self-report questionnaires assessing symptoms, QoL, and perceptions of personal control. RESULTS: COPD patients improved during rehabilitation in overall QoL and self-efficacy, although no significant changes were found in QoL domains and mastery. Changes in self-efficacy during rehabilitation contributed to the explanation of the social and psychological functioning QoL domains. CONCLUSION: Even in seriously impaired COPD patients in advanced stages of illness, positive changes in self-efficacy and overall well-being can be established during rehabilitation. Changes in self-efficacy were related to a better QoL, suggesting the importance of personal control in the adjustment to COPD. PRACTICE IMPLICATIONS: Focussing more explicitly on the enhancement of perceptions of personal control in COPD patients may be an important aim of pulmonary rehabilitation.

Aged↗

PubMed2005

Consequences of chronic obstructive pulmonary disease and chronic heart failure: the relationship between objective and subjective health.

This study investigates whether the relationship between objective health parameters and general health perceptions was mediated by symptoms of dyspnoea and physical functioning in patients with chronic obstructive pulmonary disease (COPD) and patients with chronic heart failure (CHF). The different health parameters were organised according to Wilson and Cleary's conceptual model of patient outcomes (Wilson & Cleary (1995). Journal of the American Medical Association, 273, 59-65). Second, we investigated whether perceptions of personal control were related to the health parameters in the model. Consecutive patients with COPD and CHF were included from the outpatient clinics of a university hospital and a general hospital, and from a rehabilitation centre, all in the Netherlands. Ninety-five COPD patients (aged 65.0+/-9.3; forced expiratory volume in 1s (FEV1)<70%) were included and compared with 90 CHF patients (aged 59.6+/-10.0; left ventricular ejection fraction (LVEF)<45%). The relationship between objective health parameters (FEV1 or LVEF) and subjective health (self-reported physical functioning) was not mediated by symptoms of dyspnoea. FEV1 or LVEF and symptoms of dyspnoea were independently related to self-reported physical functioning, which was directly related to general health perceptions. Perceived health competence was related to symptoms of dyspnoea and general health perceptions in patients with either COPD or CHF. Although patients with COPD reported lower levels in all self-reported health parameters in the model than the patients with CHF, this study showed that the relations between the health parameters in the model were comparable for COPD and CHF patients.

Aged↗

PubMed2005

The relationship between self-efficacy and self-reported physical functioning in chronic obstructive pulmonary disease and chronic heart failure.

In this study, the authors investigated whether self-reported physical functioning of patients with chronic obstructive pulmonary disease (COPD) and chronic systolic heart failure (CHF) was primarily explained by illness-specific differences related to diagnosis or whether more generic factors also contributed to their physical functioning. Consecutive patients with COPD (n = 56; mean age = 67.8, SD = 8.5) and CHF (n = 65; mean age = 60.0, SD = 10.2)from the outpatient clinics of a university hospital and a general hospital completed a self-report questionnaire, including the Rand-36 Health Survey, Cantril's ladder, the Mastery scale, the Perceived Health Competence Scale, and the Self-efficacy scale. COPD patients scored significantly worse in self-reported physical and psychological functioning and perceived health competence than did patients with CHF Regression analysis revealed that both the diagnosis and the illness severity contributed to self-reported physical functioning, although self-efficacy explained the main part of physical functioning. Therefore, important aims in the treatment of patients with COPD and CHF should be not only improving physical functioning but also enhancing self-efficacy.

Adaptation, Psychological↗