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  • 1.
    Broström, Anders
    et al.
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Hübbert, Laila
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Jakobsson, Per
    Linköping University, Department of Medicine and Care, Pulmonary Medicine. Linköping University, Faculty of Health Sciences.
    Johansson, Peter
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Fridlund, Bengt
    Department of Nursing, Lund University, Lund, Sweden and School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.
    Dahlström, Ulf
    Linköping University, Department of Medicine and Care, Cardiology. Linköping University, Faculty of Health Sciences.
    Effects of long-term nocturnal oxygen treatment in patients with severe heart failure2005In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 20, no 6, p. 385-396Article in journal (Refereed)
    Abstract [en]

    Sleep-disordered breathing (SDB) is common in patients with heart failure (HF) and leads to disturbed sleep. The objective of this study was to determine the persistent effects of long-term nocturnal oxygen treatment in patients with severe HF regarding (1) objective outcomes, such as sleep, SDB, cardiac function, and functional capacity; (2) subjective outcomes, such as self-assessed sleep difficulties, daytime sleepiness, and health-related quality of life (HRQOL); and (3) the relationship between objective and subjective outcomes. In this open nonrandomized experimental study, 22 patients, median age 71 years, with severe HF were studied before and after 3 months of receiving nocturnal oxygen. The measures used were overnight polysomnography, echocardiography, 6-minute walk test, self-assessed sleep difficulties (Uppsala Sleep Inventory-HF), daytime sleepiness (Epworth Sleepiness Scale), and HRQOL (36-Item Short Form Health Survey and Minnesota Living with Heart Failure Questionnaire). SDB, with a 90% dominance of central sleep apnea, occurred in 41% of the patients with severe HF before intervention. After intervention, functional capacity improved for both the whole group of patients with HF (P < .01) and HF patients with SDB (P < .05). No improvements regarding cardiac function, objective sleep, subjective sleep, or SDB were seen, except for a decrease of > or = 4% desaturations (P < .05). HRQOL did not differ significantly between HF patients with and without SDB before or after intervention with nocturnal oxygen. Long-term nocturnal oxygen treatment improved functional capacity in patients with severe HF, with or without SDB. No improvements were seen regarding sleep, daytime sleepiness, SDB, cardiac function, or HRQOL.

  • 2.
    Eckerblad, Jeanette
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Hellström, Ingrid
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Jakobsson, Per
    Linköping University, Department of Medical and Health Sciences, Pulmonary Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine UHL.
    Kentsson, Magnus
    Landstinget i Jönköpings län.
    Skargren, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Tödt, Kristina
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Theander, Kersti
    Karlstad Universitet.
    Symptom Prevalence And Symptom Distress In Patients With COPD2012Conference paper (Other academic)
  • 3.
    Eckerblad, Jeanette
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Tödt, Kristina
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
    Jakobsson, Per
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Skargren, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Kentsson, M.
    Ryhov Hospital, Jönköping, Sweden.
    Theander, K.
    Karlstad University, Sweden; Värmland County Council, Karlstad, Sweden.
    Symptom burden in stable COPD patients with moderate or severe airflow limitation2014In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 43, no 4, p. 351-357Article in journal (Refereed)
    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.

  • 4. Faager, G
    et al.
    Söderlund, K
    Sköld, CM
    Rundgren, S
    Tollbäck, A
    Jakobsson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Pulmonary Medicine. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Respiratory Medicine UHL.
    Creatine supplementation and physical training in patients with COPD: A double blind, placebo controlled study2006In: International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, Vol. 1, p. 445-453Article in journal (Refereed)
  • 5.
    Jacobsson, Per
    Linköping University, Department of Medicine and Care, Clinical Physiology. Linköping University, Department of Medicine and Care, Pulmonary Medicine. Linköping University, Faculty of Health Sciences.
    Skeletal muscle metabolism in patients with severe chronic obstructive pulmonary disease: A study of carbohydrate and fat metabolism1995Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In chronic obstructive pulmonary disease (COPD) deterioration of skeletal muscle metabolism is reported in both respiratory and non-respiratory muscles. This deterioration may contribute to both the development of respiratory failure and general disability often seen in severe COPD patients. The aim of this study was to obtain more information on carbohydrate and fat metabolism in advanced, stable COPD patients and to investigate the possible association between muscle glycogen and estimates of malnuttition. Furthermore, the effect of long-term oxygen therapy on the metabolic state was studied. Using the needle biopsy technique, muscle specimens were obtained from the quadriceps femoris muscle for analysis of muscle metabolites, glycolytic and oxidative enzyme activities and skeletal muscle fibre composition. Blood fuel metabolites were studied at rest, during exercise and recovery. Lipolysis was studied using a tracer technique and the response of lipolysis to insulin, as well as insulin resistance in peripheral tissues were studied using the euglycaernic, hyperinsulinaernic glucose clamp technique.

    Depletion of glycogen, A TP and creatine phosphate and increased concentrations of creatine and lactate were observed in the quadriceps femoris muscle. Metabolite concentrations correlated to anerial blood gas values- the lower the Pa02 and the higher the PaC02 the greater the deterioration of the metabolic state. Muscle glycogen concentration correlated to estimates of malnuttition. The correlation between glycogen concentration and prealbumin concentration was strong - the lower the glycogen concentration the lower the prealbumin concentration. After 8 months of long-term oxygen therapy (L TOT) the high energy phosphate state had improved. There was a verylow percentage "oxidative" Type I muscle fibres in the quadriceps femoris muscle. Analysis of enzyme activity also showed adaptation in the form of augmented glycolysis and decreased aerobic metabolism. No changes in enzyme activity were observed after 7 months of LTOT. The turnover rate of free fatty acids (FFA) and plasma FFA concentration were increased in the fasting state. There was a significant positive  correlation between turnover rate ofFFA and FFA concentration in arterial plasma. The results also suggest a reduction in the inhibitory effect of inulin on lipolysis. A few hours after a light breakfast FFA, glycerol and 3-hydroxybutyrate concentrations were lower in COPD patients with chronic respiratory failure (CRF) that in COPD patients without CRF at rest, during exercise and recovery, indicating decreased lipolysis in the CRF patients compared to COPD patients without CRF. In patients with severe COPD and muscle glycogen depletion no resistance to insulin in peripheral tissues was observed.

    In conclusion, skeletal muscle depletion exists in patients with severe, stable COPD. Skeletal muscle glycogen concentration is associated with concentrations of serum proteins. Adaptation of muscle metabolism in the form of augmented glycolysis and reduced aerobic metabolism was observed. Lipolysis is increased in the fasting state and the results suggest a reduction in the inhibitory effect of insulin on lipolysis. No resistance to insulin in peripheral tissues was found. LTOT may improve the muscle energy state of hypoxaemic COPD patients.

  • 6.
    Jakobsson, Per
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Pulmonary Medicine. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Respiratory Medicine UHL.
    Jorfeldt, Lennart
    Stockholm.
    Oxygen supplementation increases glucose tolerance during euglycaemic hyperinsulinaemic glucose clamp procedure in patients with severe COPD and chronic hypoxaemia2006In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 26, no 5, p. 271-274Article in journal (Refereed)
    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.

  • 7.
    Stratelis, Georgios
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Primary Health Care in Motala.
    Fransson, Sven Göran
    Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Schmekel, Birgitta
    Linköping University, Department of Medical and Health Sciences, Clinical Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Clinical Physiology.
    Jakobsson, Per
    Linköping University, Department of Medical and Health Sciences, Pulmonary Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Respiratory Medicine UHL.
    Mölstad, Sigvard
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    High prevalence of emphysema and its association with BMI: A study of smokers with normal spirometry2008In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 26, no 4, p. 241-247Article in journal (Refereed)
    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.

  • 8.
    Stratelis, Georgios
    et al.
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, West County Primary Health Care.
    Jakobsson, Per
    Linköping University, Department of Medicine and Health Sciences, Pulmonary Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Respiratory Medicine UHL.
    Mölstad, Sigvard
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Zetterström, Olle
    Linköping University, Department of Clinical and Experimental Medicine, Allergy Centre . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Allergy Centre.
    Early detection of COPD in primary care: screening by invitation of smokers aged 40 to 55 years2004In: British Journal of General Practice, ISSN 0960-1643, E-ISSN 1478-5242, Vol. 54, no 500, p. 201-206Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The incidence of chronic obstructive pulmonary disease (COPD) is increasing in developed countries, as is the mortality rate. The main cause of COPD is smoking, and COPD is usually diagnosed at a late stage. AIM: To evaluate a method to detect COPD at an early stage in smokers in a young age group (40-55 years).

    DESIGN OF STUDY: Prospective descriptive study.

    SETTING: The city of Motala (45,000 inhabitants) and its surrounding rural areas (43,000 inhabitants) in south-east Sweden. Nineteen thousand, seven hundred and fifty subjects were between 40 and 55 years of age. According to Swedish statistics, approximately 27% of this population are smokers.

    METHOD: Smokers aged between 40 and 55 years were invited to have free spirometry testing in primary healthcare centres. Placards were placed in pharmacies and health centres and advertising was carried out locally twice a year.

    RESULTS: A total of 512 smokers responded. The prevalence of COPD was 27% (n = 141). The COPD was classified as mild obstruction in 85% (n = 120), moderate in 13% (n = 18) and severe in 2% (n = 3) according to the European Respiratory Society classification. Knowledge of the disease COPD was acknowledged by 39% of the responders to the questionnaire. Logistic regression analysis showed that age, male sex, number of pack years, dyspnoea and symptoms of chronic bronchitis significantly increased the odds of having COPD. The adjusted odds ratio was significant for having > 30 pack years.

    CONCLUSIONS: This method of inviting relatively young smokers selected a population of smokers with a high incidence of COPD, and may be one way of identifying smokers with COPD in the early stages.

  • 9.
    Stratelis, Georgios
    et al.
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, West County Primary Health Care.
    Mölstad, Sigvard
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Jakobsson, Per
    Linköping University, Department of Medicine and Health Sciences, Pulmonary Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Respiratory Medicine UHL.
    Zetterström, Olle
    Linköping University, Department of Clinical and Experimental Medicine, Allergy Centre . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Allergy Centre.
    The impact of repeated spirometry and smoking cessation advice on smokers with mild COPD2006In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 24, no 3, p. 133-139Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Smoking cessation is the most important therapeutic intervention in patients with chronic obstructive pulmonary diseases (COPD) and the health benefits are immediate and substantial. Major efforts have been made to develop methods with high smoking cessation rates.

    OBJECTIVES: To study whether a combination of spirometry and brief smoking cessation advice to smokers with COPD, annually for three years, increased their smoking cessation rate in comparison with groups of smokers with normal lung function.

    METHOD: Prospective, randomized study in primary care. Smoking cessation rates were compared between smokers with COPD followed-up yearly over a period of three years and smokers with normal lung function followed-up yearly for three years or followed-up only once after three years.

    RESULTS: The point-prevalence abstinence rate and prolonged abstinence rate at 6 and 12 months increased yearly and in smokers with COPD at year 3 was 29%, 28%, and 25%, respectively. The abstinence rates were significantly higher in smokers with COPD than in smokers with normal lung function. Smoking cessation rates among smokers with normal lung function did not increase with increasing number of follow-ups.

    CONCLUSION: Smokers diagnosed with COPD stopped smoking significantly more often than those with normal lung function.

  • 10.
    Theander, Kersti
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Cliffordson, Christina
    Division for Health and Caring Sciences, Karlstad University, Karlstad, Sweden.
    Torstensson, Olof
    Hospital of Oskarshamn, Oskarshamn, Sweden.
    Jakobsson, Per
    Linköping University, Department of Medicine and Health Sciences, Pulmonary Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Respiratory Medicine UHL.
    Unosson, Mitra
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Fatigue Impact Scale: Its validation in patients with chronic obstructive pulmonary disease2007In: Psychology, Health and Medicine, ISSN 1354-8506, Vol. 12, no 4, p. 470-484Article in journal (Refereed)
    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.

  • 11.
    Theander, Kersti
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Jakobsson, Per
    Linköping University, Department of Medicine and Health Sciences, Pulmonary Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Respiratory Medicine UHL.
    Jorgensen, Nils
    Karlstad Hospital.
    Unosson, Mitra
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease: a randomized controlled trial2009In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 23, no 2, p. 125-136Article in journal (Refereed)
    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.

  • 12.
    Theander, Kersti
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Jakobsson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Pulmonary Medicine. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Respiratory Medicine UHL.
    Torstensson, O
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Fatigue and quality of life among patients with COPD2005In: European Respiratory Society Copenhagen 2005 Congress,2005, 2005Conference paper (Other academic)
  • 13.
    Theander, Kersti
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Jakobsson, Per
    Linköping University, Department of Medicine and Health Sciences, Pulmonary Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Respiratory Medicine UHL.
    Torstensson, Olof
    Hospital Oskarshamn.
    Unosson, Mitra
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Severity of fatigue is related to functional limitation and health in patients with chronic obstructive pulmonary disease2008In: INTERNATIONAL JOURNAL OF NURSING PRACTICE, ISSN 1322-7114, Vol. 14, no 6, p. 455-462Article in journal (Refereed)
    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.

  • 14.
    Theander, Kersti
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Jakobsson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Pulmonary Medicine. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Respiratory Medicine UHL.
    Functional impact of fatigue in patients with chronic obstructive pulmonary disease2004In: 12th Biennal Conference of the Workgroup of European Nurses Researchers,2004, 2004Conference paper (Other academic)
  • 15.
    Tödt, Kristina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Skargren, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Jakobsson, Per
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Theander, Kersti
    Karlstad University, Sweden .
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Factors associated with low physical activity in patients with Chronic Obstructive Pulmonary Disease: A cross-sectional study2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 697-707Article in journal (Refereed)
    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.

  • 16.
    Tödt, Kristina
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
    Skargren, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Kentson, Magnus
    Ryhov Hospital, Sweden .
    Theander, Kersti
    Karlstad University, Sweden .
    Jakobsson, Per
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Respiratory Medicine.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Experience of fatigue, and its relationship to physical capacity and disease severity in men and women with COPD2014In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 9, p. 17-25Article in journal (Refereed)
    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.

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