Papers by NATHALIE FERNANDES
Relevance of multidimensional dyspnea assessment in context of pulmonary rehabilitation
Rehabilitation and chronic care
Effects of pulmonary rehabilitation on the sensory and affective dimension of dyspnea
Dyspnea, a major predictor of mortality and quality of life (QoL) in COPD, is essentially explore... more Dyspnea, a major predictor of mortality and quality of life (QoL) in COPD, is essentially explored through its impact (e.g. via the mMRC scale). Many studies highlight two other major components: the sensory (SD) and affective (AD) dimension. Therefore, a multidimensional assessment of dyspnea is recommended in pulmonary rehabilitation (PR). However, studies having concomitantly investigated the SD and AD during PR are scarce. Our aim was thus to study 1) the effects of PR on the SD and AD of dyspnea and 2) the possible predictors of SD and AD response to PR. Seventy COPD patients admitted for a 4-week inpatient PR program were included. In addition to usual data, Multidimensional Dyspnea Profile questionnaire data were collected at the entrance (T1) and at the end (T2) of the PR. Stepwise regression analyses were performed to obtain predictive equations of SD and AD response. In baseline, the mean scores were 38 (± 10) for SD and 22 (± 14) for AD. Post-PR, the SD and AD scores improved significantly: -10.5 (effect size; d=0.81) and -9.5 (d=0.66) respectively. Thirty-seven percent of patients did not improve their scores (n=5 for SD, n=11 for AD and n=10 for both). QoL and AD at T1 predicted AD response (r=0.50, adjusted r2=0.21; standard error of the regression = 9.75). Overall, PR improves the SD and AD of dyspnea with a large and a medium effect size respectively. However, the analysis of individual responses shows that one third of patients does not improve in at least one of the two dimensions. Targeted intervention could be considered to enhance and maintain PR benefits for these patients.
HAL (Le Centre pour la Communication Scientifique Directe), 2007
Background: Exposure to hypobaric hypoxemia causes acute mountain sickness (AMS) in 40% of subjec... more Background: Exposure to hypobaric hypoxemia causes acute mountain sickness (AMS) in 40% of subjects acutely exposed to an altitude of 4,000 m. Vascular endothelial growth factor (VEGF) and cytokines appear to play a role in AMS in model systems. The objective of this pilot study was to explore the change in VEGF, the vasodilatory prostacyclin PGI-2, interleukin-6 and thiobarbituric acid reactive substances (TBARS) levels following prolonged exposure to hypobaric hypoxemia on Bolivian Altiplano. The secondary objective was to investigate the relationship between these markers with good versus poor adaptation to high altitude. Methods: The study population consisted of 7 climbers aged 24-64 yr. One cardiac transplant and one kidney transplant recipients participated in this study. Aerobic capacity was assessed on a treadmill using a RAMP protocol with gas exchange analyses. Blood samples were harvested within 48 hr of departure and within 24 hr returning to sea level. Results: Selected biochemisty parameters are presented in the table:
Clinical & Investigative Medicine, 2007
Background: At the admission in rehabilitation program, some patients with chronic respiratory di... more Background: At the admission in rehabilitation program, some patients with chronic respiratory disease were asked by a health professional to to answer a questionnaire about their sexuality. The objectives of the study were 1) to determine if sexual problems occurred in patients with respiratory chronic disease ; 2) to assess if these survey problems were linked to respiratory disease; 3) to explore the motivation to speak about sexuality during rehabilitation program. Methods: 52 consecutive respiratory disease subjects (58.3 ± 9 yr; FEV1 = 65.5 ± 21 % predicted, mean ± SD) answered a sexuality questionnaire survey with rehabilitation team (psychologists, nurses, physiotherapists). This group comprised 26 men and 26 women. Results: 70% of patients estimated that respiratory disease had an impact on their sexuality. A visual analog scale showed that 62% of patients were not satisfied. The severity of obstruction (FEV1) was not correlated to satisfaction (r=.017, P=0.90), or frequenc...
Effects of pulmonary rehabilitation on the sensory and affective dimension of dyspnea
European Respiratory Journal, 2020
Dyspnea, a major predictor of mortality and quality of life (QoL) in COPD, is essentially explore... more Dyspnea, a major predictor of mortality and quality of life (QoL) in COPD, is essentially explored through its impact (e.g. via the mMRC scale). Many studies highlight two other major components: the sensory (SD) and affective (AD) dimension. Therefore, a multidimensional assessment of dyspnea is recommended in pulmonary rehabilitation (PR). However, studies having concomitantly investigated the SD and AD during PR are scarce. Our aim was thus to study 1) the effects of PR on the SD and AD of dyspnea and 2) the possible predictors of SD and AD response to PR. Seventy COPD patients admitted for a 4-week inpatient PR program were included. In addition to usual data, Multidimensional Dyspnea Profile questionnaire data were collected at the entrance (T1) and at the end (T2) of the PR. Stepwise regression analyses were performed to obtain predictive equations of SD and AD response. In baseline, the mean scores were 38 (± 10) for SD and 22 (± 14) for AD. Post-PR, the SD and AD scores impr...
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Papers by NATHALIE FERNANDES