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Skargren, Elisabeth
Publications (10 of 29) 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
Kammerlind, A.-S. C., Ledin, T., Ödkvist, L. & Skargren, E. (2011). Recovery after acute unilateral vestibular loss and predictors for remaining symptoms. American Journal of Otolaryngology, 32(5), 366-375
Open this publication in new window or tab >>Recovery after acute unilateral vestibular loss and predictors for remaining symptoms
2011 (English)In: American Journal of Otolaryngology, ISSN 0196-0709, E-ISSN 1532-818X, Vol. 32, no 5, p. 366-375Article in journal (Refereed) Published
Abstract [en]

Purpose: The aims of this study were to follow recovery during the first 6 months after acute unilateral vestibular loss (AUVL) and to determine predictors for self-rated remaining symptoms. Materials and methods: Forty-two subjects were included less than 10 days after AUVL. Static and dynamic clinical balance tests, visual analogue scales, University of California Los Angeles Dizziness Questionnaire, Dizziness Beliefs Scale, European Quality of Life questionnaire, Dizziness Handicap Inventory, and Hospital Anxiety and Depression Scale were performed at inclusion and at 7 follow-ups over 6 months. Subjects rated their symptoms on visual analogue scales daily at home. Videonystagmography was performed in the acute stage and after 10 weeks. Results: Decrease of symptoms and improvement of balance function were larger during the first compared with the latter part of the follow-up period. Visual analogue scale ratings for balance problems were higher than those for dizziness. A prediction model was created based on the results of 4 tests in the acute stage: standing on foam with eyes closed, standing on 1 leg with eyes open, visual analogue scale rating of vertigo at rest, and European Quality of Life questionnaire rating of health-related quality of life. The prediction model identified subjects at risk of having remaining symptoms after 6 months with a sensitivity of 86% and a specificity of 79%. Conclusions: Recovery mainly takes place during the first weeks after AUVL. Subjects rate more balance problems than dizziness. Self-rated remaining symptoms after 6 months may be predicted by clinical balance tests and subjective ratings in the acute stage.

Place, publisher, year, edition, pages
WB Saunders, 2011
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-71109 (URN)10.1016/j.amjoto.2010.07.008 (DOI)000294704200002 ()
Available from: 2011-09-30 Created: 2011-09-30 Last updated: 2017-12-08
Karlsson, N., Skargren, E. & Kristenson, M. (2010). Emotional support predicts more sickness absence and poorer self assessed work ability: a two-year prospective cohort study. BMC Public Health, 10(1), 648
Open this publication in new window or tab >>Emotional support predicts more sickness absence and poorer self assessed work ability: a two-year prospective cohort study
2010 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 10, no 1, p. 648-Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: While back pain and stressful work environment are shown to be important causes of sickness absence the effect of psychosocial resources on sickness absence, and on self assessed work ability, is less commonly investigated. The aim of this study was to assess these associations in a two-year follow-up study.

METHODS: 341 working people aged 45 to 64, randomly drawn from the population, responded to a questionnaire at baseline and at a two-year follow-up. Poisson regression was used to analyse the association of psychosocial factors (psychosocial instruments on work environment, emotional support and psychological resources) and previous back pain (low back and/or neck) at baseline with sickness absence (spells and days) at follow-up, controlling for effects of age, sex, BMI, smoking, alcohol, occupation, disease and previous sickness absence. Logistic regression was used to study the associations of psychosocial factors and previous back pain at baseline with self assessed prognosis of poor work ability six months from follow-up. Finally, a multivariate analysis tested the independent effects of previous back pain and 3 psychosocial factors derived in a factor analysis: 1. work environment; 2. emotional support; 3. psychological resources, on work ability and absence days and spells.

RESULTS: 80% of the sickness absence spells within the last 12 months before follow-up were short-term (<= 14 days). In the final model, high emotional support predicted more sickness absence spells (RR 1.36; 1.11-1.67) and days (RR 1.68, 1.22-2.31). Previous back pain (OR 2.56; 1.13-5.81), high emotional support (OR 1.58; 1.02-2.46), and low psychological resources (OR 0.62; 0.44-0.89) were related to poorer self assessed prognosis of work ability at follow up.

CONCLUSIONS: In a general middle aged working population high emotional support was related to more sickness absence and also poorer self assessed prognosis of work ability. Our findings suggest that both sickness absence and self assessed work ability are dependent of life outside work and can be affected by a person's close community.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-61458 (URN)10.1186/1471-2458-10-648 (DOI)000284330000001 ()20977767 (PubMedID)
Note
Original Publication: Nadine Karlsson, Elisabeth Skargren and Margareta Kristenson, Emotional support predicts more sickness absence and poorer self assessed work ability: a two-year prospective cohort study, 2010, BMC Public Health, (10), 1, 648. http://dx.doi.org/10.1186/1471-2458-10-648 Copyright: BioMed Central http://www.biomedcentral.com/ Available from: 2010-11-16 Created: 2010-11-16 Last updated: 2017-12-12
Siebers, A., Öberg, U. & Skargren, E. (2010). The effect of modified constraint –induced movement therapy on spasticity and motor function of the affected arm in patients with chronic stroke.. Physiotherapy Canada, 62(4), 388-366
Open this publication in new window or tab >>The effect of modified constraint –induced movement therapy on spasticity and motor function of the affected arm in patients with chronic stroke.
2010 (English)In: Physiotherapy Canada, ISSN 0300-0508, E-ISSN 1708-8313, ISSN 0300-0508, Vol. 62, no 4, p. 388-366Article in journal (Refereed) Published
Abstract [en]

 

Purpose: The purpose of this study was to explore the effect of modified constraint-induced movement therapy (CIMT) in a real-world clinical setting on spasticity and functional use of the affected arm and hand in patients with spastic chronic hemiplegia.

Method: A prospective consecutive quasi-experimental study design was used. Twenty patients with spastic hemiplegia (aged 22–67 years) were tested before and after 2-week modified CIMT in an outpatient rehabilitation clinic and at 6 months. The Modified Ashworth Scale (MAS), active range of motion (AROM), grip strength, Motor Activity Log (MAL), Sollerman hand function test, and Box and Block Test (BBT) were used as outcome measures.

Results: Reductions (p<0.05–0.001) in spasticity (MAS) were seen both after the 2-week training period and at 6-month follow-up. Improvements were also seen in AROM (median change of elbow extension 5°, dorsiflexion of hand 10°), grip strength (20 Newton), and functional use after the 2-week training period (MAL: 1 point; Sollerman test: 8 points; BBT: 4 blocks). The improvements persisted at 6-month follow-up, except for scores on the Sollerman hand function test, which improved further.

Conclusion: Our study suggests that modified CIMT in an outpatient clinic may reduce spasticity and increase functional use of the affected arm in spastic chronic hemiplegia, with improvements persisting at 6 months.

 

Place, publisher, year, edition, pages
University of Toronto Press, 2010
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-64549 (URN)10.3138/physio.62.4.388 (DOI)
Available from: 2011-01-27 Created: 2011-01-27 Last updated: 2017-12-11
Siebers, A. & Skargren, E. (2006). Improvement and impact of initial motor skill after intensive rehabilitation - CI-therapy in patients with chronic hemiplegia. A follow-up study. Advances in Physiotherapy, 8(4), 146-153
Open this publication in new window or tab >>Improvement and impact of initial motor skill after intensive rehabilitation - CI-therapy in patients with chronic hemiplegia. A follow-up study
2006 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 8, no 4, p. 146-153Article in journal (Refereed) Published
Abstract [en]

Previous studies suggest that constraint-induced movement therapy (CI-therapy) in the chronic phase after hemiplegia improves motor skill and increases the use of the affected arm. The purpose of the study was to evaluate outcome after modified CI-therapy and to study the influence of degree of motor skill. Twenty-six consecutive patients with chronic hemiplegia, who could actively extend the wrist 20° and the finger joints 10° were included. The patients were tested before and after a 2-week training period and 6 months later. Subgroup analyses were based on BL motor assessment, upper extremity. BL motor assessment, Finger-Nose Test (FNT), Motor Activity Log (MAL) and Patient-Specific Functional Scale (PSFS) were the main measures. Highly significant improvements (p<0.001) were found in all instruments (BL motor assessment, 6.5 points, FNT, 6 s, MAL, 1 step and PSFS, 3.3 steps). The result remained at the 6-month follow-up. Significant improvements were seen in all subgroups. The improvements did not differ between the subgroups. The literature states that no further improvements of motor arm function are to be expected in the chronic phase after stroke. This study showed that CI-therapy improved motor skill and use in daily life, and that the improvements remained after 6 months. The initial level of motor skill did not influence degree of improvement.

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-37869 (URN)10.1080/14038190600921221 (DOI)39966 (Local ID)39966 (Archive number)39966 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
Kammerlind, A.-S., Ledin, T., Ödkvist, L. & Skargren, E. (2006). Influence of asymmetry of vestibular caloric response and age on balance and perceived symptoms after acute unilateral vestibular loss. Clinical Rehabilitation, 20(2), 142-148
Open this publication in new window or tab >>Influence of asymmetry of vestibular caloric response and age on balance and perceived symptoms after acute unilateral vestibular loss
2006 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 20, no 2, p. 142-148Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate the influence of asymmetry of vestibular caloric response and age on balance and perceived symptoms after acute unilateral vestibular loss.

Design: Prospective study.

Setting: Ear, nose and throat departments in three hospitals.

Subjects: Fifty-four patients (mean age 52 years) with acute unilateral vestibular loss participating in a randomized controlled training study were included.

Main measures: Electronystagmography testing was performed within one week after onset of symptoms and after 10 weeks. The outcome measures clinical static balance tests (sharpened Romberg's test with eyes closed, standing on foam with eyes closed, and standing on one leg with eyes open and closed) and subjective symptom ratings on a visual analogue scale were done after one week, 10 weeks and six months. The correlation between age and asymmetry of vestibular caloric response, respectively, and the outcome measures were analysed.

Results: Greater caloric asymmetry correlated with poorer performance at the sharpened Romberg's test and standing on one leg with eyes closed at all three follow-ups (rho=-0.31 to -0.54), and with higher symptom ratings at the 10-week and six-month follow-ups (rho=0.30-0.60). Higher age was associated with poorer performance on the sharpened Romberg's test and standing on one leg at all three follow-ups (rho=0.31-0.64), but did not change over time. Higher age was also associated with higher ratings of vertigo at the six-month follow-up, and less reduction of vertigo between the 10-week and six-month follow-ups (rho=0.29-0.48).

Conclusions: A higher degree of asymmetry of vestibular caloric response and high age seem to be associated with poor outcome in balance and perceived symptoms after acute unilateral vestibular loss.

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-33400 (URN)10.1191/0269215506cr886oa (DOI)19416 (Local ID)19416 (Archive number)19416 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
Enthoven, P., Skargren, E., Carstensen, J. & Öberg, B. (2006). Predictive factors for 1-year and 5-year outcome for disability in a working population of patients with low back pain treated in primary care. Pain, 122(1-2), 137-144
Open this publication in new window or tab >>Predictive factors for 1-year and 5-year outcome for disability in a working population of patients with low back pain treated in primary care
2006 (English)In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 122, no 1-2, p. 137-144Article in journal (Refereed) Published
Abstract [en]

Many patients seeking primary care for low back pain continue to report disability several years after their initial visit. The aims of this study were to assess the independent predictive value of a number of potential predictive factors for disability at the 1-year and 5-year follow-ups, and to examine whether prediction models were improved by replacing baseline health-state-related variables with corresponding variables after treatment. A further aim was to describe possible differences between those on sick leave, early retirement or disability pension, and those who were not. Baseline factors were age, gender, self-reported physical-activity-related and work-related factors, expectations of treatment, similar problems previously, duration of episode, more than one localization, sick leave, pain frequency, disability, and well-being. The study sample comprised 148 participants in a previous randomized trial who were eligible for sick-leave benefits. Multiple logistic regression was used to identify predictive factors. At the 5-year follow-up, 37% (n = 19/52) of the patients with disability were on sick leave or were receiving early retirement or disability pension. For those without disability the corresponding figure was 9% (n = 8/92). Being a woman, duration of the current episode, similar problems during the previous 5 years, exercise level before the current episode, pain frequency at baseline, and disability after treatment emerged as predictive factors for disability at the 5-year follow-up. Replacing baseline health-state-related measures with corresponding measures after the treatment period, and adding physical-activity-related and possibly work-related factors might improve the likelihood of predicting future disability.

National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-33458 (URN)10.1016/j.pain.2006.01.022 (DOI)19479 (Local ID)19479 (Archive number)19479 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13Bibliographically approved
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