| 1. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Functional status and well being in chronic obstructive pulmonary disease with regard to clinical parameters and smoking: a descriptive and comparative study.
- 1996
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Ingår i: Thorax. - 0040-6376. ; 51:8, s. 825-30
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Self-assessment questionnaires which measure the functional and affective consequences of chronic obstructive pulmonary disease (COPD) give valuable information about the effects of the disease and may serve as important tools with which to evaluate treatment. METHODS: A cross sectional comparative study was performed between patients with COPD (n = 68), stratified according to pulmonary function, and a healthy control group (n = 89). A battery of well established clinical and quality of life measures (the Sickness Impact Profile (SIP), Mood Adjective Check List (MACL), and Hospital Anxiety and Depression scale (HAD)) was used to examine in which functional and affective aspects the patient group differed from the control group and how these measures related to pulmonary function and smoking habits. RESULTS: Compared with the controls, COPD affected functional status in most areas, not just those requiring physical activity. Forty six patients with forced expiratory volume in one second (FEV1) below 50% predicted showed particularly high levels of dysfunction in ambulation, eating, home management, and recreation/ pastimes (SIP). Despite this, their level of psychosocial functioning and mood status was little different from that of the healthy controls. Among the patients, a subgroup reported substantial psychological distress, but mood status was only weakly, or not at all, related to pulmonary function. Smoking habits did not affect functional status or well being. CONCLUSIONS: Quality of life is not significantly affected in patients with mild to moderate loss of pulmonary function, possibly due to coping and/or pulmonary reserve capacity. This suggests that generic self-assessment questionnaires are of limited value for detecting the early consequences of COPD. However, in later stages of the disease they are sensitive enough to discriminate between patients with different levels of pulmonary dysfunction. The low correlations between the indices of pulmonary function and the indices of affective status suggest that well being depends, to a large extent, on factors outside the clinical domain.
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| 2. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Health-related quality of life in COPD: why both disease-specific and generic measures should be used.
- 2001
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Ingår i: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology. - 0903-1936. ; 18:1, s. 69-76
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Tidskriftsartikel (refereegranskat)abstract
- Although research has consistently demonstrated that chronic obstructive pulmonary disease (COPD) impairs health-related quality of life (HRQL), little agreement has been evidenced regarding the factors identified as contributing to impaired HRQL. The aim was to study such factors using well established generic and specific HRQL instruments. The patients (n=68) were stratified by forced expiratory volume in one second (FEV1) to represent a wide range of disease severity. Pulmonary function, blood gases and 6-min walking distance test (6MWD) were assessed. HRQL instruments included: St George's Respiratory Questionnaire (SGRQ), Sickness Impact Profile (SIP), Hospital Anxiety and Depression Scale and Mood Adjective Check List. The strength of the impact of COPD on HRQL was represented along a continuum ranging from lung function, functional status (physical and psychosocial) to wellbeing. Although correlations between FEV1 versus SGRQ total and SIP overall scores (r=-0.42 and -0.32) were stronger than previously reported, multiple regression analyses showed that lung function contributed little to the variance when dyspnoea-related limitation, depression scores and 6MWD were included in the models. These three factors were important to varying degrees along the whole range of HRQL. Physiological, functional and psychosocial consequences of chronic obstructive pulmonary disease are only poorly to moderately related to each other. The present study concludes that a comprehensive assessment of the effects of chronic obstructive pulmonary disease requires a battery of instruments that not only tap the disease-specific effects, but also the overall burden of the disease on everyday functioning and emotional wellbeing.
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| 3. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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KOL och livskvalitet
- 2006
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Ingår i: In: KOL Kroniskt obstruktiv lungsjukdom. Larsson K, ed.. ; Kapitel 3.4, s. 145-151
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Tidskriftsartikel (refereegranskat)
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| 4. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Long-term effects of a pulmonary rehabilitation programme in outpatients with chronic obstructive pulmonary disease: a randomized controlled study.
- 1999
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Ingår i: Scandinavian journal of rehabilitation medicine. - 0036-5505. ; 31:4, s. 207-13
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Tidskriftsartikel (refereegranskat)abstract
- Fifty patients with severe chronic obstructive pulmonary disease (FEV1 < 50% pred.) were randomized to a rehabilitation group and a control group. The rehabilitation group took part in an individualized multidisciplinary, outpatient 12-month rehabilitation programme. Exercise training was intensive during the first 6 weeks and was then gradually replaced by an individual home-training programme and booster sessions. Controls received the usual outpatient care. Positive effects were found in terms of maximum symptom-limited exercise tolerance and walking distance (13.5 and 12.1% increase, respectively) in the rehabilitation group compared with the controls. Quality of life measurements showed minor beneficial effects on the Sickness Impact Profile, indicating a higher level of activity. No effect was seen on the St George's Respiratory Questionnaire or the Mood Adjective Check List. Patients expressed their enthusiasm for the rehabilitation programme in a study-specific questionnaire.
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| 5. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Reliability and validity of a Swedish version of the St George's Respiratory Questionnaire.
- 1998
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Ingår i: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology. - 0903-1936. ; 11:1, s. 61-6
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Tidskriftsartikel (refereegranskat)abstract
- The St George's Respiratory Questionnaire (SGRQ) was designed to measure quality of life (QoL) in obstructive pulmonary disease. Its reliability, validity and sensitivity have been demonstrated. The aim was to develop a Swedish version of the SGRQ and to confirm its scaling and clinical properties. The SGRQ was adapted for Swedish conditions following a translation-backtranslation procedure. The psychometric and clinical evaluation included 68 patients with chronic obstructive pulmonary disease (COPD). Supplementary QoL, clinical and physiological data were collected. A follow-up study was performed 1 yr later. Correlation analysis used a multitrait-multimethod model. Internal consistency reliability and discriminant validity were documented by performing a multitrait analysis. The results confirmed expected levels of associations. Correlation coefficients between the SGRQ total score and the Sickness Impact Profile Total score (a generic health measure), forced expiratory volume in one second (FEV1) and 6 min walking distance were 0.69, -0.42 and -0.61 respectively. The pattern of correlations in the Swedish data set was very similar to that of the original. The stability of the SGRQ scores was confirmed at follow-up after 1 yr. The reliability was satisfactory, with Cronbach's alpha coefficients >0.80 for the SGRQ and its subdimensions. In conclusion, the Swedish version of the St George's Respiratory Questionnaire is reliable, valid and compares well with the corresponding tests of the original version.
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| 6. |
- Engström, Carl-Peter, 1945
(författare)
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Studies on health-related quality of life in patients with chronic obstructive pulmonary disease
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims. To describe health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD), to develop a Swedish version of the St George's Respiratory Questionnaire (SGRQ), to study factors related to HRQL in COPD and to study long-term effects of rehabilitation on exercise tolerance and HRQL.Methods. Two sets of data were collected to meet the research questions.A. Sixty-eight patients with COPD were consecutively recruited and stratified according to FEV1 to represent different levels of the disease. Spirometry and walking test were performed. A control group was recruited from the general population. HRQL was assessed with the Sickness Impact Profile (SIP), the Hospital Anxiety and Depression scale (HAD), the Mood Adjective Check List (MACL) and (patients only) the SGRQ. B. Patients with COPD were consecutively recruited to a randomized controlled study of a multidisciplinary rehabilitation programme (n=26). Controls (n=24) were treated conventionally. Exercise tolerance and HRQL were measured.Results. Major findings were presented in four articles:A1. Compared with controls, patients with COPD scored worse on all the SIP categories except alertness behaviour and communication. The worst dysfunction reported on the SIP were: ambulation, sleep/rest, eating, home management and recreation/pastimes. These differences were noted mainly in patients with an FEV1 < 50% predicted. Physical functioning was most severely affected followed by psychosocial functioning and then emotional well-being. A 2. An established disease-specific questionnaire, the SGRQ, was adapted to Swedish according to a standardized translation and psychometric analysis procedure. Validity was confirmed as the correlation pattern was almost identical to that reported for the original version. Reliability was satisfactory with Cronbach's alpha coefficient > 0.80 for all three SGRQ sections, although overlap of content was seen in two.A 3. The SIP and SGRQ scores showed substantial associations to walking distance and affective measures but modest to pulmonary function. Stepwise multiple regression demonstrated three factors of overriding importance for the full range of generic and specific HRQL measures: dyspnoea-related restriction, exercise tolerance (walking distance), and level of depressed mood (HAD).B. After 12 months the rehabilitation group showed an improved exercise capacity (walking distance and maximal exercise capacity). In contrast, no statistically significant improvement in HRQL was seen. Conclusions. Five major conclusions were drawn: 1) All aspects of HRQL are affected by COPD when pulmonary function (FEV1) is reduced by 50% or more; 2) Physical functioning is most severely affected; 3) Dyspnoea-related restriction, exercise tolerance (walking distance) and level of depressed mood (HAD) are consistent determinants of the full range of HRQL measures; 4) Impacts of COPD can be detected also in Swedish patients by the validated version of the SGRQ; 5) A rehabilitation programme for COPD patients has positive long-term effects on exercise tolerance.
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| 7. |
- Grönberg, Anne Marie, 1951, et al.
(författare)
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Dietary problems in patients with severe chronic obstructive pulmonary disease
- 2005
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Ingår i: J Hum Nutr Diet. ; 18:6, s. 445-52
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Low body weight and low fat-free mass-index (FFMI) are common in patients with severe chronic obstructive pulmonary disease (COPD). Several factors seem to contribute. The aims of the present observational study were to investigate dietary problems in patients with severe COPD and to compare dietary problems to nutritional status, energy intake and smoking habits. METHODS: Nutritional status was assessed in 73 stable outpatients using body mass index and FFMI by single-frequency bioelectrical impedance. Lung function, smoking habits, energy intake and dietary problems were also assessed. RESULTS: The most frequently reported dietary problems were 'anorexia', 'dyspeptic symptoms other than diarrhoea', 'slimming', 'fear of gaining weight', 'dyspnoea', 'diarrhoea', 'depression, anxiety, solitude'. Smoking habits and gender had impact on the kind of dietary problems reported. Reporting two dietary problems correlated to low FFMI, whereas reporting one or more dietary problems correlated to decreased energy intake. CONCLUSION: Dietary problems are common in the group studied and related to smoking habits and gender. Dietary problems affect energy intake and FFMI negatively. It is important to recognize dietary problems and to offer intervention of the dietary problems as a part of the dietary intervention.
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| 8. |
- Niklasson, Anna, 1977, et al.
(författare)
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Prevalence of gastrointestinal symptoms in patients with chronic obstructive pulmonary disease.
- 2008
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Ingår i: European journal of gastroenterology & hepatology. - 0954-691X. ; 20:4, s. 335-41
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Symptoms of gastro-oesophageal reflux disease (GERD) have previously been shown to be of importance in patients with asthma. Limited data, however, exist on the prevalence of GERD in patients with chronic obstructive pulmonary disease (COPD), and information about the occurrence of the total burden of gastrointestinal (GI) symptoms in these patients is lacking. METHODS: A total of 113 patients with COPD completed four self-administered questionnaires: the Gastrointestinal Symptom-Rating Scale (GSRS), ROME II modular questionnaires (criteria for irritable bowel syndrome), the Psychological General Well-Being index (PGWB), and the Hospital Anxiety and Depression scale. Eighty-two patients with chronic renal failure (CRF) and 2000 healthy individuals from the general Swedish population served as controls. RESULTS: The total GSRS score in patients with COPD was 2.12 (1.92-2.28) which was significantly higher than the score from the general population of 1.96 (1.81-2.12). No significant difference between COPD and CRF patients was, however, observed, in any of the GSRS dimensions. Patients in the COPD group had lower total PGWB scores compared both with CRF patients 90 (78-104) vs. 98 (83-113) (P<0.05) and with the general population 103 (102-104) (P<0.001). A negative correlation between the GSRS and PGWB scores (r=-0.49; P<0.001) was observed in patients with COPD. Sixteen (14%) of the patients with COPD fulfilled the Rome II criteria for irritable bowel syndrome. CONCLUSION: The prevalence of GI symptoms is higher in patients with COPD than in healthy individuals, but not higher than in CRF patients. The GI symptoms are associated with impairments in psychological well-being, and they require diagnostic workups to explore different treatment options in these patients.
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| 9. |
- Persson, Lars-Olof, 1951, et al.
(författare)
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Life values in patients with COPD: relations with pulmonary functioning and health related quality of life.
- 2005
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Ingår i: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. - 0962-9343. ; 14:2, s. 349-59
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Tidskriftsartikel (refereegranskat)abstract
- Theories of coping and response shift have suggested that emotional adaptation is related to value changes, e.g. a deemphasized importance of lost life values and an enlargement of the scope of values. Perceived attainment and importance of 82 life values were examined in 65 patients with chronic obstructive pulmonary disease (COPD) and related to clinical and Health-Related Quality of Life (HRQL) measures. The life values covered 10 dimensions--harmony, positive relations, involvement, mobility, communication, knowledge, responsibility, comfort, religion and health. Forty-six of the patients were followed up after 1 year. The patients with COPD were compared with a healthy control group, a group of neurologically impaired and a non-disabled group representing the general population. Significant congruence was found between importance and attainment ratings in all groups (correlations from 0.44 to 0.53), suggesting that both impaired and healthy persons tend to perceive that they have what they find important in life. Congruence was significantly related to mood (correlations from 0.28 to 0.40), but not to functional status or clinical data. Compared to the healthy responders, the patients with COPD had significantly lower attainment ratings in health, mobility, involvement, but no differences were found for importance ratings. No evidence was found that they had replaced unattainable values with new available values, and no changes over time of perceived values were found. This suggests that patients with COPD do not seem to adapt by means of changing their value orientation.
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| 10. |
- Slinde, Frode, 1973, et al.
(författare)
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Body composition by bioelectrical impedance predicts mortality in chronic obstructive pulmonary disease patients
- 2005
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Ingår i: Respir Med. ; 99:8, s. 1004-9
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Tidskriftsartikel (refereegranskat)abstract
- Pulmonary rehabilitation is recommended in international treatment guidelines for chronic obstructive pulmonary disease (COPD). No one has however studied the effect on long-term mortality. The aim of the current study was to study the mortality in a sample of patients with severe COPD included in a 1-year multidisciplinary rehabilitation program. Body composition was assessed at baseline using bioelectrical impedance. Mortality was studied in 86 patients using the Cox proportional hazards model. Forty-seven (55%) of the patients died during the mean follow-up time which was almost 6 years. Risk of mortality increased with increasing age, increasing number of hospital days the year before inclusion and men had higher mortality risk than women. The mortality risk decreased with increasing % reference body weight, increasing fat-free mass index (FFMI), increasing FEV(1) and increasing 6-min walking distance. Gender, age and FFMI continued to be statistical significant predictors of mortality when controlling for the other baseline variables in a multivariate analysis. To conclude, body composition, measured by bioelectrical impedance and presented as FFMI, is an independent predictor of mortality in COPD patients.
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