**6. Conclusion**

266 Chronic Obstructive Pulmonary Disease – Current Concepts and Practice

rates of the patients who experienced dyspnea and fatigue were higher in our study too;

Reishtein (2005) found out that means scores for dyspnea and fatigue were moderately high in patients with COPD. In this study, it was found that the mean scores of fatigue and

It was explored that there was not any statistically significant difference between fatigue levels, levels of the daily activities affected by fatigue and dyspnea scores in terms of age and sex. Kapella et al. (2006) reported that fatigue complaint was significantly correlated with age. Skumlien et al. (2006) reported that 82% of the women and 70% of the men had dyspnea complaint and there was not any difference among the sex in terms of dyspnea number and dyspnea scores. Gift and Shepard (1999) reported that men and women did not differ in their level of fatigue. Oh et al. (2004) and Kapella et al. (2006), reported that there were small differences between women and men; however, these difference were not statistically significant. It was observed in our research that although the dyspnea scores and fatigue scores of the women were higher than those of men, it was statistically

High fatigue score and score of the daily activities affected by fatigue were presented by those who had the disease for ≥ 12 years. High fatigue score and score of the daily activities affected by fatigue and dyspnea score were presented by who fourth stage of COPD, who were repeatedly, had hospitalized for ≥ 4 times a year and who identified their own health condition as very bad and frequency of fatigue as always. Several studies show that fatigue is a common symptom in COPD and it has been associated with reduced health status and dyspnea (Breslin et al., 1998; Guyatt et al.,1987). We were found out that dyspnea and fatigue scores were higher in patients which health status is very bad. This result was statically significant. Hospitalization rates in the patients with COPD are high, and increase with age. Baghai-Ravary et al (2009) suggested that increased fatigue was related to dyspnea, exacerbation frequency, health status and time spent outdoors. In this study, we found that the hospitalization rates in the patients with COPD were high and these

Baghai-Ravary et al.(2009) and Wong et al.(2010) explored that they did not find a correlation betweeen severty of COPD and fatigue. Breslin et al.(1998) reported that physical dimensions of fatigue correlated with an increase in the severity of pulmonary impairment and reduction in exercise tolerance. In this study we found that fatigue score was higher in patients with very severe COPD. These data show a relationship between fatigue and

Previous studies have noted significant relationships between dyspnea and fatigue (Baghai-Ravary et al., 2009; Janson-Bjerklie et al.,1986; Kinsman et al.,1983; Peters et al.,2010, Reishtein, 2005; Theander et al., 2009). As in earlier studies, we found correlations between fatigue and dyspnea. It was concluded in our research that there was a positive correlation between dyspnea and fatigue (r=0.636, p<0.01) and as dyspnea scores increased so did mean fatigue scores. This result is consistent with previous research reports. Also, there was a significant negative correlation between the measured FEV1 values of the patients and dyspnea scores (r=-.341 p<0.01) and fatigue scores (r=-.260 p<0.01). McCarley (2003) discovered that there was moderately significant correlation between dyspnea and fatigue

which concurred with literature.

insignificant.

dyspnea of the participant patients were high.

patients'dyspnea and fatigue scores were also high.

pulmonary function in COPD.

According to the results of the present research which was conducted in order to investigate dyspnea, fatigue-experience and the correlation between dyspnea and fatigue; all of the patients experienced dyspnea and almost all of them had fatigue. Mean scores of fatigue and dyspnea of the women were higher than those of men. Dyspnea severity and fatigue was more intensified among those who belonged to ≥ 65 age group, who had the disease for ≥ 12 years, who had fourth stage of COPD, who were repeatedly hospitalized and fatigue scores increased as dyspnea severity increased and there was significant negative correlation between FEV1 values and dyspnea and fatigue scores. As a result, it was recommended that nurses who care COPD patients should assess dyspnea and fatigue-situations and the complaint severity of the patients using scales; should plan and practice the appropriate nursing interventions considering the linear correlation between dyspnea and fatigue; should perform personal care plans for those COPD patients who belonged to ≥ 65 age group, who had longer disease length, who had advanced stage of COPD, who were repeatedly hospitalized due to the fact that the rates of severe dyspnea and fatigue were higher. Dyspnea and fatigue should be evaluated in usual care with a questionnaire that corrects for them in order to tailor treatment to patients' need. Dyspnea and fatigue is an important symptom requiring evaluation and management in patients with COPD.

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**Part 3** 

**Treatment** 


http://www.who.int/nmh/publications/ncd\_report2010/en/

