Impact of Smoking on the Physiological and Pulmonary Functional Status in Patients with Chronic Obstructive Pulmonary Diseases [COPD] | ||||
| Journal of High Institute of Public Health | ||||
| Article 9, Volume 36, Issue 4, October 2006, Page 1009-1036 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/jhiph.2006.153580 | ||||
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| Author | ||||
| Hanan G. Mohammed* | ||||
| Medical Surgical Nursing Department, Faculty of Nursing, Banha University, Egypt | ||||
| Abstract | ||||
| Smoking tobacco dramatically increases the risk developing many diseases. It is responsible for a substantial majority of cases of COPD. COPD takes years to develop and progress. The symptoms usually progress quickly in patients who continue to smoke and who have higher life time tobacco exposure. A study reported that the physiological effect of smoking would limit ability to improve their functional status. This study aimed at identifying the effect of smoking on the pulmonary function testes [PFTs] and pulmonary functional status [PFS] in patients with Chronic Obstructive Pulmonary Diseases [COPD]. It was carried out at the Chest Diseases Hospital of Abu Seta, Tripoli, Algmaheria Arabia of Libya. It included 40 patients [20 patients who smoke and 20 patients who non-smoke]. Great percentages of them were found suffering from both bronchial asthma and chronic bronchitis. All the studied sample included in the present study were males. The majority of the sample were 40 years. This study excluded patients who were less than 25 years because their years of smoking affected the physical and functional status. Three tools were used in the study. COPD patients’ Assessment Sheet, Part I comprised patients personal characteristics [the patient’s age, sex, marital status, level of education, socioeconomic, occupation, diagnosis, and smoking patterns]. This part involved closed ended questions related to patents’ characteristics. Part II included Pulmonary Functions Tests [PFTs] record. This part aimed at estimating the Pulmonary functions tests, once before inhalation of bronchodilators by Metered Dose Inhaler and once after drug was administered within 15-20 minutes. This was to evaluate the lung functioning changes and improvement in how responsive to bronchodilator for patients who smoke compared with those who non-smoke, e.g., Forced expiratory volume [FEV1] in one second, Forced vital capacity [FVC] and FVC/FEV1, [FEV1%]. The pulmonary Functional Status scale was designed to assess the functional status and psychological behavior according to Weaver and Narsavage.10 It includes 56 items scale and addresses the nine sub-constructions that contribute to functional status, namely: self-care, mobility, household tasks, grocery shopping, meal preparation, daily activities, relationship, as well as dyspnea, and psychological behavior, including, anxiety state, and depression. This instrument was designed to subscale score of the functional status, dyspnea and psychological status. The calibrated Computerized Spirometry was used to measure the forced vital capacity [FVC], Forced expiratory volume in one second [FEV1], FVC/FEV, and [FEV1%]. This study revealed significant effects of bronchodilator on the FEV1 and FVC amongst smokers and non-smokers. But significant better effects were among non-smokers group more than smokers group. This may perhaps be to years of smoking and numbers of cigarette smoking as seen in this study which stated that number of cigarette smoken affects the FEV1 significantly. As regarding the pulmonary functional status, the present study revealed that high significant differences between smokers and non-smokers were found in the area of mobility, daily activity, and dyspnea as well as anxiety. The present study also revealed that mild grocery shopping of functional status was affected by FVC and differed significantly between smokers and non-smokers. Similarly, a statistically significant difference emerged also in FVC for both smokers and non-smokers who were in mild, married, and moderate dyspnea, respectively. Concerning FEV1, according to the functional status in smokers and non-smokers, there was found a significant difference among them in mild daily activity mild single relationship, and highly significant relation in areas of mild grocery shopping, mild married relationship, moderate dyspnea, moderate anxiety, and depression. It also revealed that FCV/FEV1 [FEV1%] in relation to the functional status, a highly significant relation was observed between smokers and non-smokers in moderate self-care, mild mobility, mild daily activity, mild married relation, and single relation as well as moderate and mild depression. The present findings have put in evidence that a well-planned smoking cessation program has been helpful in COPD patients to resume their normal condition as possible. | ||||
| Keywords | ||||
| Impact of Smoking; Physiological; Pulmonary Functional Status; Chronic Obstructive Pulmonary Diseases; COPD | ||||
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