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Jakobsson, Per
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Publications (10 of 16) Show all publications
Tödt, K., Skargren, E., Jakobsson, P., Theander, K. & Unosson, M. (2015). Factors associated with low physical activity in patients with Chronic Obstructive Pulmonary Disease: A cross-sectional study. Scandinavian Journal of Caring Sciences, 29(4), 697-707
Open this publication in new window or tab >>Factors associated with low physical activity in patients with Chronic Obstructive Pulmonary Disease: A cross-sectional study
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2015 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 697-707Article in journal (Refereed) Published
Abstract [en]

Objectives

Low physical activity (PA) in chronic obstructive pulmonary disease (COPD) is associated with poor prognosis. In addition physical activity seems to be low early in the disease. The aim in this study was to describe the level of PA in patients with stable COPD, and to explore factors associated with low PA, with a focus on fatigue, symptom burden and body composition.

Methods

In a cross-sectional study 101 patients (52 women) with COPD  were classified having low, moderate or high PA according to the International Physical Activity Questionnaire – Short. Fatigue, dyspnoea, depression and anxiety, symptom burden, body composition, physical capacity (lung function, exercise capacity, muscle strength), exacerbation rate and systemic inflammation were assessed. A multiple logistic regression was used to identify independent associations with low PA.

Results

Mean age was 68 (+/- 7) years and mean percentage of predicted forced expiratory volume in one second was 50 (+/-16.5). Forty-two patients reported a low PA level, while 34 moderate and 25 reported high levels. Factors independently associated with low PA, presented as odds ratio (95% confidence interval), were severe fatigue 5.87 (1.23 – 28.12), exercise capacity 0.99 (0.99 – 1.0) and the number of pack years 1.04 (1.01 – 1.07). No relationship was found between depression, anxiety, body composition, exacerbation rate or systemic inflammation and PA.

Conclusions

Severe fatigue, worse exercise capacity and a higher amount of smoking were independently associated with low PA. Promoting physical activity is important in all patients with COPD. Our result suggests that patients with severe fatigue might need specific strategies to become more physically active.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-105194 (URN)10.1111/scs.12200 (DOI)000368345900010 ()
Note

The author belong to the Department of Mecical and Health Science and is Ph.D. student at the Department of Social and Welfare Studies.

Vid tiden för disputationen förelåg publikationen endast som manuskript

Funding agencies: Swedish Heart and Lung foundation; Medical Research Council of Southeast Sweden; County Council of Ostergotland

Available from: 2014-03-12 Created: 2014-03-12 Last updated: 2017-12-05Bibliographically approved
Tödt, K., Skargren, E., Kentson, M., Theander, K., Jakobsson, P. & Unosson, M. (2014). Experience of fatigue, and its relationship to physical capacity and disease severity in men and women with COPD. The International Journal of Chronic Obstructive Pulmonary Disease, 9, 17-25
Open this publication in new window or tab >>Experience of fatigue, and its relationship to physical capacity and disease severity in men and women with COPD
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2014 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 9, p. 17-25Article in journal (Refereed) Published
Abstract [en]

Introduction: Several differences have been reported in the clinical characteristics of chronic obstructive pulmonary disease (COPD) between men and women. Differences have been found in the association between respiratory symptoms and lung function, and in the factors associated with dyspnea. This raises the question of whether there are differences between the sexes in the relationship between fatigue, the second most prevalent symptom, and the variables of physical capacity and disease severity. Objectives: To examine the experience of fatigue and its relationship to physical capacity and disease severity in men and women with COPD. Methods: In a cross-sectional study 121 patients with COPD (54 men and 67 women), the experience of fatigue (frequency, duration, and severity) and physical capacity (lung function, 6-minute walk distance [6MWD], grip strength, and timed-stand test) were assessed. Disease severity was graded according to the Body mass index, airway Obstruction, Dyspnoea and Exercise capacity (BODE) index. Two multiple logistic regression models were tested, both of which were performed separately in men and women, to examine the association between the experience of fatigue and variables of physical capacity and the BODE index. Results: Eighty-nine (73.6%) patients experienced fatigue, with similar proportions in men and women. The men with fatigue had worse physical capacity and more severe disease than did the men without fatigue: for men with and without fatigue, respectively, the percent of predicted forced expiratory volume in 1 second (FEV1) (mean [standard deviation]) was 47 (14) vs 64 (17); the 6MWD (mean [standard deviation]) was 398 (138) vs 539 (105) m; and the BODE index (median [quartile 1-3]) was 3 (2-5) vs 1 (0-1) (Pless than0.01). In women, only higher leg fatigue post-6MWD was seen among those experiencing fatigue compared with women without fatigue: for women with and without fatigue, respectively, leg fatigue (median [quartile 1-3]) was 4 (3-5) vs 2 (0-3) (Pless than0.001). The regression models showed that the 6MWD and the BODE index were associated with fatigue in both men and women, but in women, leg fatigue remained an independent associate in both models. Conclusion: Exercise capacity and disease severity were associated with fatigue in both men and women. In women, leg fatigue was strongly associated with fatigue, which warrants further investigation.

Place, publisher, year, edition, pages
Dove Medical Press, 2014
Keywords
chronic obstructive pulmonary disease; disease state; functional capacity; sex differences; symptom experience; leg fatigue
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-103279 (URN)10.2147/COPD.S52506 (DOI)000328463500001 ()
Note

The author belong to the Department of Mecical and Health Science and is Ph.D. student at the Department of Social and Welfare Studies.

Available from: 2014-01-17 Created: 2014-01-16 Last updated: 2017-12-06Bibliographically approved
Eckerblad, J., Tödt, K., Jakobsson, P., Unosson, M., Skargren, E., Kentsson, M. & Theander, K. (2014). Symptom burden in stable COPD patients with moderate or severe airflow limitation. Heart & Lung, 43(4), 351-357
Open this publication in new window or tab >>Symptom burden in stable COPD patients with moderate or severe airflow limitation
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2014 (English)In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 43, no 4, p. 351-357Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:

To describe a multidimensional symptom profile in patients with stable chronic obstructive pulmonary disease (COPD) and determine whether symptom experience differed between patients with moderate or severe airflow limitations.

BACKGROUND:

Patients with severe airflow limitation experience numerous symptoms, but little is known regarding patients with moderate airflow limitation.

METHODS:

A multidimensional symptom profile (Memorial Symptom Assessment Scale) was assessed in 42 outpatients with moderate and 49 with severe airflow limitations.

RESULTS:

The mean number of symptoms in the total sample was 7.9 (±4.3) with no difference between patients with moderate and severe airflow limitations. The most prevalent symptoms with the highest MSAS symptom burden scores were shortness of breath, dry mouth, cough, sleep problems, and lack of energy in both groups.

CONCLUSIONS:

Patients with moderate or severe airflow limitations experience multiple symptoms with high severity and distress. An assessment of their multidimensional symptom profile might contribute to better symptom management.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Chronic obstructive pulmonary disease; Symptom assessment; Symptom experience; Respiratory nursing
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-109384 (URN)10.1016/j.hrtlng.2014.04.004 (DOI)000338972500022 ()24856227 (PubMedID)
Available from: 2014-08-15 Created: 2014-08-15 Last updated: 2017-12-05Bibliographically approved
Eckerblad, J., Hellström, I., Jakobsson, P., Kentsson, M., Skargren, E., Tödt, K., . . . Theander, K. (2012). Symptom Prevalence And Symptom Distress In Patients With COPD. Paper presented at American Thoracic Society International Conference (ATS 2012), 18-23 May 2012, San Francisco, CA, USA.
Open this publication in new window or tab >>Symptom Prevalence And Symptom Distress In Patients With COPD
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2012 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-86868 (URN)
Conference
American Thoracic Society International Conference (ATS 2012), 18-23 May 2012, San Francisco, CA, USA
Available from: 2013-01-07 Created: 2013-01-07 Last updated: 2013-01-17
Theander, K., Jakobsson, P., Jorgensen, N. & Unosson, M. (2009). Effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Clinical Rehabilitation, 23(2), 125-136
Open this publication in new window or tab >>Effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease: a randomized controlled trial
2009 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, no 2, p. 125-136Article in journal (Refereed) Published
Abstract [en]

Objective: To test the effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease.

Design: Randomized controlled trial.

Setting: Pulmonary outpatient department.

Subjects: Thirty patients randomly assigned to a rehabilitation (3 men, 9 women, mean age 66 ( 2) years) or a control group (10 men, 4 women, mean age 64 ( 2) years).

Interventions: The patients in the rehabilitation group participated in a multidisciplinary rehabilitation programme comprising exercise training twice weekly, for a 12-week period, nutritional and self-care advice, and education about disease and energy conservation strategies.

Main measures: Fatigue, functional limitations due to fatigue, functional performance and satisfaction, six-minute walking distance, hand grip strength and health perception were assessed at baseline and after 12 weeks.

Results: At baseline there were no significant differences between the groups, except for gender. The six-minute walking distance was 312.6 (+/- 79.3) m for the rehabilitation group and 3603 (+/- 84.7) m for the control group. After 12 weeks, the rehabilitation group improved their walking distance by 40.6 (+/- 27.2) m (P<0.05). The rehabilitation group improved in performance (from 4.8 (12.0) to 6.0 (+/- 1.5) scores, P<0.01) and satisfaction (from 4.6 (+/- 2.2) to 6.0 (+/- 2.1) scores, P<0.001) with regard to own selected daily activities. No statistically significant differences were seen between the changes within the rehabilitation group and changes within the control group at the 12-week follow-up.

Conclusions: Although the pulmonary rehabilitation programme had an immediate effect, it was not sustained.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16975 (URN)10.1177/0269215508096174 (DOI)
Available from: 2009-03-01 Created: 2009-02-27 Last updated: 2017-12-13
Stratelis, G., Fransson, S. G., Schmekel, B., Jakobsson, P. & Mölstad, S. (2008). High prevalence of emphysema and its association with BMI: A study of smokers with normal spirometry. Scandinavian Journal of Primary Health Care, 26(4), 241-247
Open this publication in new window or tab >>High prevalence of emphysema and its association with BMI: A study of smokers with normal spirometry
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2008 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 26, no 4, p. 241-247Article in journal (Refereed) Published
Abstract [en]

Objectives: To evaluate to what extent emphysema was evident, as identified by High Resolution Computed Tomography (HRCT), in smokers with normal lung function and to relate age, gender, smoking history, and body mass index (BMI) to the HRCT results. A secondary aim was to study to what extent emphysema was present in smokers with lower normal values of lung function defined as FEV1/FVC ratio percentage of predicted value (89-93% of predicted value for males and 90-93% for females) or FEF50 60% of predicted compared with smokers without this definition.

Methods: Fifty-nine smokers, with a mean age of 53 years and with normal lung function, were examined with HRCT.

Results: Emphysema evidenced visually by HRCT was present in 43% of the subjects. Using a 0-5 grade scale (0=normal finding; 5=emphysema in most slices), the degree of emphysema was almost exclusively 3-4. The type of emphysema was distributed as centrilobular emphysema predominant in 43.5%, paraseptal emphysema predominant in 43.5%, and as an equal mixture of these types in 13%. The presence of emphysema did not differ between the group of smokers with lower normal values of lung function and the rest of the smokers. Smokers with emphysema had significantly lower BMI than those devoid of emphysema, 24 and 27 respectively (p0.0011).

Conclusion: There was a high occurrence of visual emphysema in middle-aged smokers with normal lung function. The densitometric quantitative analysis method is inadequate for detecting mild emphysema. High prevalence of emphysema was associated with low BMI.

Keywords
Body mass index, computed tomography, family practice, pulmonary emphysema, smoking, spirometry
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16159 (URN)10.1080/02813430802452732 (DOI)
Available from: 2009-01-08 Created: 2009-01-07 Last updated: 2017-12-14
Theander, K., Jakobsson, P., Torstensson, O. & Unosson, M. (2008). Severity of fatigue is related to functional limitation and health in patients with chronic obstructive pulmonary disease. INTERNATIONAL JOURNAL OF NURSING PRACTICE, 14(6), 455-462
Open this publication in new window or tab >>Severity of fatigue is related to functional limitation and health in patients with chronic obstructive pulmonary disease
2008 (English)In: INTERNATIONAL JOURNAL OF NURSING PRACTICE, ISSN 1322-7114, Vol. 14, no 6, p. 455-462Article in journal (Refereed) Published
Abstract [en]

Fatigue is one of the most prevalent symptoms in patients with chronic obstructive pulmonary disease (COPD). In research as well as in clinical practise, fatigue and its influence on functioning and health has not been in focus. The aim of this study was to compare fatigue, functional limitations owing to fatigue and health between patients with COPD and individuals from the general population to assess the differences between patients experiencing no, moderate and severe fatigue. Patients with COPD (n = 151) and individuals from the general population (n = 95) answered questions about fatigue, the Fatigue Impact Scale and the Medical Outcomes Survey Short Form-36. The patients with COPD reported a higher frequency, longer daily duration and more severity of fatigue compared with individuals from the general population as well as more functional limitations and worse health. The patients who reported severe fatigue had more functional limitations and worse health compared with patients reporting moderate fatigue. These results indicate that fatigue severity should be screened for during the nursing care process with purpose to reduce the symptom burden.

Keywords
chronic obstructive pulmonary disease, fatigue, functioning, health, respiratory nursing
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-16414 (URN)10.1111/j.1440-172X.2008.00720.x (DOI)
Available from: 2009-01-23 Created: 2009-01-23 Last updated: 2009-08-21
Theander, K., Cliffordson, C., Torstensson, O., Jakobsson, P. & Unosson, M. (2007). Fatigue Impact Scale: Its validation in patients with chronic obstructive pulmonary disease. Psychology, Health and Medicine, 12(4), 470-484
Open this publication in new window or tab >>Fatigue Impact Scale: Its validation in patients with chronic obstructive pulmonary disease
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2007 (English)In: Psychology, Health and Medicine, ISSN 1354-8506, Vol. 12, no 4, p. 470-484Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate the reliability and validity of the Fatigue Impact Scale (FIS) among patients with chronic obstructive pulmonary disease (COPD) and shorten the questionnaire. The empirically developed FIS, which comprised three subscales (cognitive, physical and psychosocial), was tested originally on Pipers' theoretical framework of subjective manifestations of fatigue, including behavioural, physical, emotional and cognitive expressions. The data analysed here consisted of responses from 296 patients with COPD who reported fatigue. The dimensionality of the FIS was examined using confirmatory factor analysis. A reduction of 15 items from the original FIS was made based on theory, modification indices and factor loadings. The results indicate that a nested-factor model with one general behavioural factor and three specific factors, physical, emotional and cognitive, shows acceptable fit. A modified version of 25 items, FIS-25 was developed. The original FIS and the FIS-25 were able to discriminate between patients with differing duration of fatigue. Test - retest correlations ranged from .70 to .85 for items and .94 for the total scale. Due to modification, the FIS-25 needs to be validated on a new group of patients with COPD.

Keywords
Fatigue Impact Scale, confirmatory factor analysis, chronic obstructive pulmonary disease
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-14294 (URN)10.1080/13548500601086771 (DOI)
Available from: 2007-02-13 Created: 2007-02-13 Last updated: 2009-08-21Bibliographically approved
Faager, G., Söderlund, K., Sköld, C., Rundgren, S., Tollbäck, A. & Jakobsson, P. (2006). Creatine supplementation and physical training in patients with COPD: A double blind, placebo controlled study. International Journal of Chronic Obstructive Pulmonary Disease, 1, 445-453
Open this publication in new window or tab >>Creatine supplementation and physical training in patients with COPD: A double blind, placebo controlled study
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2006 (English)In: International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, Vol. 1, p. 445-453Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-37760 (URN)38405 (Local ID)38405 (Archive number)38405 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2010-08-23
Jakobsson, P. & Jorfeldt, L. (2006). Oxygen supplementation increases glucose tolerance during euglycaemic hyperinsulinaemic glucose clamp procedure in patients with severe COPD and chronic hypoxaemia. Clinical Physiology and Functional Imaging, 26(5), 271-274
Open this publication in new window or tab >>Oxygen supplementation increases glucose tolerance during euglycaemic hyperinsulinaemic glucose clamp procedure in patients with severe COPD and chronic hypoxaemia
2006 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 26, no 5, p. 271-274Article in journal (Refereed) Published
Abstract [en]

Investigations in chronic obstructive pulmonary disease (COPD) patients have shown impaired glucose tolerance in hypoxic COPD patients, compared with COPD patients with normal arterial blood gases. In healthy subjects, hypoxaemia or stay at altitude, have been shown to alter glucose metabolism. At altitude the effect seems to be dependent on duration of stay. A short stay is associated with insulin resistance, a longer stay gives rise to increased glucose uptake. The euglycaemic hyperinsulinaemic glucose clamp technique is a method to study glucose tolerance and enables determinations of glucose clearance in peripheral tissues. We investigated six COPD patients [forced expiratory volume in 1 s 0.7 ± 0.2 l (mean ± SD)] with chronic hypoxaemia (PaO2 7.9 ± 0.6 kPa at rest, breathing air), with and without oxygen supplementation, using the glucose clamp technique. Net peripheral glucose uptake was 5.5 ± 1.2 and 7.1 ± 1.6 mg (kg*min)-1 (+29%) breathing air and supplemental oxygen, respectively (P = 0.03). The tissue sensitivity to insulin increased 32% (P = 0.03) with oxygen supplementation. The results indicate that normalization of oxygen saturation in COPD patients with chronic hypoxaemia may have an immediate effect on glucose tolerance and tissue sensitivity to insulin in these patients. © 2006 Blackwell Publishing Ltd.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-34789 (URN)10.1111/j.1475-097X.2006.00686.x (DOI)23270 (Local ID)23270 (Archive number)23270 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
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