Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
The Relationship Between Dyspnea Severity, COVID-19 Fear, and Death Anxiety Levels in COPD Patients Admitted to the Emergency Department: Descriptive and Relationship-Seeking Study
Acil Servise Başvuran KOAH Hastalarının Dispne Şiddeti ile COVID-19 Korkusu ve Ölüm Kaygısı Düzeyi Arasındaki İlişki: Tanımlayıcı-İlişki Arayıcı Çalışma
Şeyma GÖRPÜZa , Aygül KISSALb
aTokat Gaziosmanpaşa University Institute of Graduate Studies, Department of Emergency Medicine Nursing, Tokat, Türkiye
bTokat Gaziosmanpaşa University Faculty of Health Science, Department of Nursing, Division of Public Health Nursing, Tokat, Türkiye
Turkiye Klinikleri J Nurs Sci. 2024;16(1):247-56
doi: 10.5336/nurses.2022-94887
Article Language: EN
Full Text
ABSTRACT
 Objective: This study was conducted to evaluate the association between dyspnea severity, COVID-19 fear, and death anxiety levels in individuals diagnosed with chronic obstructive pulmonary disease (COPD). Material and Methods: This descriptive relationshipseeking study was conducted with 144 patients aged 40 years and older who were admitted to a state hospital emergency department with a diagnosis of COPD. The data were collected using a personal information form, the Medical Research Council (MRC) dyspnea scale, COPD assessment Test-CAT, Death Anxiety Scale (DAS), and Coronavirus Fear Scale (FCV-19S). Results: The mean age of the individuals was 66.39 ± 9.72. The fear of death was severe in 52 patients (36.1%) and mild in 48 patients (33.3%). The difference between DAS and FCV-19S was statistically significant according to the severity of COPD, frequency of admission to hospital, presence of other chronic diseases, ability to meet physical needs, diagnosis of COVID-19, and anxiety levels related to COVID-19 transmission (p<0.05). DAS and FCV-19S increased in accordance with the severity of dyspnea. As the level of death anxiety increased from mild to severe, the mean score of the FCV-19S increased accordingly. Conclusion: The majority of COPD patients (69.4%) experience moderate or higher fear of death and their COVID-19 fear levels are at high levels. COPD patients with severe dyspnea, female patients, and those with additional chronic diseases should be evaluated in terms of death anxiety and fear of COVID-19. Additionally, they should be provided with the necessary psychological support.

Keywords: Chronic obstructive pulmonary disease; attitude to death; fear; COVID-19
ÖZET
 Amaç: Bu çalışma KOAH tanısı alan bireylerde dispne şiddeti ile COVID-19 korkusu ve ölüm kaygısı düzeyleri arasındaki ilişkinin değerlendirilmesi amacıyla yapılmıştır. Materyal ve Metod: Tanımlayıcı-ilişki arayıcı nitelikteki bu araştırma bir devlet Hastanesinin acil servisine KOAH tanısı ile başvuran 40 yaş ve üzeri 144 hasta ile yürütülmüştür. Veriler kişisel bilgi formu, Medical Research Council (MRC) Dispne Skalası, KOAH Değerlendirme Testi-CAT, Ölüm Kaygısı Ölçeği ve Koronavirüs Korku Ölçeği ile toplanmıştır. Bulgular: Bireylerin yaş ortalaması 66.39 ± 9.72'dir. Çalışmada 52 hastanın (%36.1) ölüm korkusu düzeyinin şiddetli, 48 hastanın (%33.3) ise hafif düzeyde olduğu tespit edilmiştir. KOAH derecesi, hastaneye başvuru sıklığı, başka kronik bir hastalığın varlığı, fiziksel ihtiyaçlarını karşılayabilme durumu, COVID-19 tanısı alma ve COVID-19 bulaşması ile ilgili kaygı düzeylerine göre ölüm kaygısı ve COVID19 korkusu puanları arasındaki fark istatiksel olarak anlamlı bulunmuştur (p<0.05). Dispne şiddetine göre ölüm kaygısı ve COVID-19 korkusu puanları artış göstermiştir. Ölüm kaygısı düzeyi arttıkça (hafiften ağıra doğru) COVID-19 korkusu ölçeği puan ortalaması artmıştır. Sonuç: KOAH hastalarının çoğunluğu (%69.4) orta düzey ve üzeri ölüm korkusu yaşamaktadır. COVID-19 korku düzeyleri yüksektir. Dispne şiddeti yüksek, kadın ve ek kronik hastalığı olan KOAH'lı hastaların ölüm kaygısı ve COVID-19 korkusu yönünden değerlendirilmesi, bu gruba gerekli ruhsal desteğin sağlanması önerilmektedir.

Anahtar Kelimeler: Kronik obstrüktif akciğer hastalığı; ölüm düşüncesi; korku; COVID-19
REFERENCES:
  1. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease 2022 report. [Link] 
  2. Ruvuna L, Sood A. Epidemiology of chronic obstructive pulmonary disease. Clin Chest Med. 2020;41(3):315-27. [Crossref]  [PubMed] 
  3. Türkiye İstatistik Kurumu [İnternet]. Ölüm ve Ölüm Nedeni İstatistikleri, 2019. Erişim tarihi: 15 Mayıs, 2021 Erişim linki: [Link] 
  4. Bakan G. COVID-19 pandemi sürecinde KOAH olan bireylerin yaşam deneyimleri: nitel bir çalışma [Life experiences of individuals with COPD during the COVID-19 pandemic: a qualitative study]. Genel Sağlık Bilimleri Dergisi. 2021;3(3):189-99. [Crossref] 
  5. Zhao S, Lin Q, Ran J, Musa SS, Yang G, Wang W, et al. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: a data-driven analysis in the early phase of the outbreak. Int J Infect Dis. 2020;92:214-7. [Crossref]  [PubMed]  [PMC] 
  6. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. [PubMed]  [PMC] 
  7. Turan MO, Balbay EG, Aksu K, Uzaslan E. COVID-19 pandemisinde astım, kronik obstrüktif akciğer hastalığı ve eşlik eden komorbiditelerin yönetimi: sistematik derleme [The management of asthma, chronic obstructive pulmonary diseases and other comorbidities in the COVID-19 pandemic: systematic review]. Turkiye Klinikleri Arch Lung. 2022;21(1):29-38. [Crossref] 
  8. Turan O, Arpınar Yigitbas B, Turan PA, Mirici A. Clinical characteristics and outcomes of hospitalized COVID-19 patients with COPD. Expert Rev Respir Med. 2021;15(8):1069-76. [Crossref]  [PubMed]  [PMC] 
  9. Alqahtani JS, Oyelade T, Aldhahir AM, Alghamdi SM, Almehmadi M, Alqahtani AS, et al. Prevalence, severity and mortality associated with copd and smoking in patients with COVID-19: a rapid systematic review and meta-analysis. PLoS One. 2020;15(5):e0233147. [Crossref]  [PubMed]  [PMC] 
  10. Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7(3):228-9. [Crossref]  [PubMed]  [PMC] 
  11. Korkmaz T, Tel H. KOAH'lı hastalarda anksiyete, depresyon ve sosyal destek durumunun belirlenmesi [Determination of the conditions of anxiety, depression and social support among the patients with COPD]. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2010;13(2):79-86. [Link] 
  12. Togluk S, Çuhadar D. The effect of death anxiety on psychosocial adjustment in individual with chronic obstructive pulmonary disease. Indian J Palliat Care. 2021;27(3):358-66. [Crossref]  [PubMed]  [PMC] 
  13. Ateş T, Önal B, Kaptan D, Kurt Y, Öztürk H. COVID-19 tanısı olan hastanın uluslararası hemşirelik uygulaması sınıflandırma sistemine göre hemşirelik bakımı: olgu sunumu [Nursing care of a patient COVID-19 diagnosis according to international classification for nursing practice system: a case report]. Journal of Current Nursing Research. 2021;1(1):32-43. [Link] 
  14. Tel Aydın H, Yıldız FT, Karagözoğlu Ş, Özden D. Hastaların bakış açısıyla kronik obstrüktif akciğer hastalığı ile yaşamak: fenomenolojik çalışma [Living with chronic obstructive pulmonary disease from the perspective of patients: a phenomenological study]. Florence Nightingale Journal of Nursing. 2012;20(3):177-83. [Link] 
  15. Liu Y, Gayle AA, Wilder-Smith A, Rocklöv J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J Travel Med. 2020;27(2):taaa021. [Crossref]  [PubMed]  [PMC] 
  16. Ozoglu Aytac S, Kilic SP, Ovayolu N. Effect of inhaler drug education on fatigue, dyspnea severity, and respiratory function tests in patients with COPD. Patient Educ Couns. 2020;103(4):709-16. [Crossref]  [PubMed] 
  17. Güneş YU, Kara D, Erbağcı A. Dispne yakınması olan hastalarda farklı dispne ölçeklerinin karşılaştırılması [Comparison of the different dyspnea scales in patients with complaints of dyspnea]. DEUHYO ED. 2012;5(2):65-71. [Link] 
  18. Jones PW, Harding G, Berry P, Wiklund I, Chen WH, Kline Leidy N. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34(3):648-54. [Crossref]  [PubMed] 
  19. Yorgancıoğlu A, Polatlı M, Aydemir Ö, Yılmaz Demirci N, Kırkıl G, Naycı Atış S, et al. KOAH değerlendirme testinin Türkçe geçerlilik ve güvenilirliği [Reliability and validity of Turkish version of COPD assessment test]. Tuberk Toraks. 2012;60(4):314-20. [Crossref]  [PubMed] 
  20. Şenol C. Ankara ilinde kurumlarda yaşayan yaşlılarda ölüme ilişkin kaygı ve korkular [Yüksek lisans tezi]. Ankara: Ankara Üniversitesi; 1989. Erişim tarihi: 20 Mayıs 2021 Erişim linki: [Link] 
  21. Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The Fear of COVID-19 Scale: development and initial validation. Int J Ment Health Addict. 2022;20(3):1537-45. [Crossref]  [PubMed]  [PMC] 
  22. Satici B, Gocet-Tekin E, Deniz ME, Satici SA. Adaptation of the Fear of COVID-19 Scale: its association with psychological distress and life satisfaction in Turkey. Int J Ment Health Addict. 2021;19(6):1980-8. [Crossref]  [PubMed]  [PMC] 
  23. Bal Özkaptan B, Kapucu S. Home nursing care with the self-care model improves self-efficacy of patients with chronic obstructive pulmonary disease. Jpn J Nurs Sci. 2016;13(3):365-77. [Crossref]  [PubMed] 
  24. Karakuş G, Öztürk Z, Tamam L. Ölüm ve ölüm kaygısı [Death and death anxiety]. Arşiv Kaynak Tarama Dergisi. 2012;21(1):42-79. [Link] 
  25. Özdemir Ü, Taşcı S. Kronik hastalıklarda psikososyal sorunlar ve bakım [Psychosocial problems and care of chronic diseases]. Erciyes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2013;1(1):57-72. [Link] 
  26. Özdin S, Bayrak Özdin Ş. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: the importance of gender. The International Journal of Social Psychiatry. 2020;66(5):504-11. [Crossref]  [PubMed]  [PMC] 
  27. Özdemir N, Enç N. Kronik obstrüktif akciğer hastalarında COVID-19 korkusunun günlük yaşam aktiviteleri, semptom kontrolü ve ölüm kaygısı düzeyine etkisi: kesitsel bir çalışma [The effect of fear of COVID-19 on activities of daily living, symptom control and death anxiety level in chronic obstructive pulmonary patients: a cross-sectional study]. Turkiye Klinikleri Journal of Nursing Sciences. 2022;14(4):1155-65. [Crossref] 
  28. Bakioğlu F, Korkmaz O, Ercan H. Fear of COVID-19 and positivity: mediating role of intolerance of uncertainty, depression, anxiety, and stress. Int J Ment Health Addict. 2021;19(6):2369-82. [Crossref]  [PubMed]  [PMC] 
  29. Ekiz T, Ilıman E, Dönmez E. Bireylerin sağlık anksiyetesi düzeyleri ile Covid-19 salgını kontrol algısının karşılaştırılması [Comparison of health anxiety level and control perception of COVID-19]. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi. 2020;6(1):139-54. [Link] 
  30. Kurt O, Deveci SE, Oguzoncul AF. Levels of anxiety and depression related to COVID-19 among physicians: an online cross-sectional study from Turkey. Annals of Clinical and Analytical Medicine. 2020;11(Suppl 3): S288-S293. [Crossref] 
  31. Uçar ME, Konal B, Gündoğdu R. Covit- 19 pandemi döneminde algılanan stres ve ölüm kaygısı arasındaki ilişkiler [Relationships between perceived stress and death anxiety during the Covid-19 pandemic period]. Aksaray Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2023;7(1):1-32. [Crossref] 
  32. Gencer N. Pandemi sürecinde bireylerin koronavirüs (Kovid-19) korkusu: Çorum örneği [Coronavirus (COVID-19) fear of individuals during the pandemia: Çorum sample]. Uluslararası Sosyal Bilimler Akademi Dergisi. 2020;(4):1153-73. [Crossref] 
  33. Kandemir F. Bazı demografik değişkenler bağlamında COVID-19 pandemi neslinin dindarlık ve ölüm kaygısı ilişkisi üzerine ampirik bir araştırma [In the context of some demographic variables, COVID-19 pandemic generation's relationship of religion and death anxiety is an ampyric study]. Tokat İlmiyat Dergisi. 2020;8(1):99-129. [Link] 
  34. Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020;288:112954. Erratum in: Psychiatry Res. 2021;299:113803. [Crossref]  [PubMed]  [PMC] 
  35. Bozkurt N, Bozkurt A. COVID-19 pandemi döneminde kronik obstrüktif akciğer hastalığı olan hastaların anksiyete ve depresyon düzeylerindeki değişim: bir izlem çalışması [The change in anxiety and depression levels of chronic obstructive pulmonary disease patients during the COVID-19 pandemic period: a follow-up study]. Türkiye Klinikleri Akciğer Arşivi. 2022; 21(1):1-8. [Crossref] 

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-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

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