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- Kentson, Magnus, et al.
(författare)
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Factors associated with experience of fatigue, and functional limitations due to fatigue in patients with stable COPD
- 2016
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Ingår i: Therapeutic Advances in Respiratory Disease. - : Sage Publications. - 1753-4658 .- 1753-4666. ; 10:5, s. 410-424
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to determine the influence of selected physiological, psychological and situational factors on experience of fatigue, and functional limitations due to fatigue in patients with stable chronic obstructive pulmonary disease (COPD). Methods: In total 101 patients with COPD and 34 control patients were assessed for experience of fatigue, functional limitation due to fatigue (Fatigue Impact Scale), physiological [lung function, 6-minute walk distance (6MWD), body mass index (BMI), dyspnoea, interleukin (IL)-6, IL-8, high sensitivity C-reactive protein (hs-CRP), surfactant protein D], psychological (anxiety, depression, insomnia), situational variables (age, sex, smoking, living alone, education), and quality of life. Results: Fatigue was more common in patients with COPD than in control patients (72% versus 56%, p < 0.001). Patients with COPD and fatigue had lower lung function, shorter 6MWD, more dyspnoea, anxiety and depressive symptoms, and worse health status compared with patients without fatigue (all p < 0.01). No differences were found for markers of systemic inflammation. In logistic regression, experience of fatigue was associated with depression [odds ratio (OR) 1.69, 95% confidence interval (CI) 1.28-2.25) and insomnia (OR 1.75, 95% CI 1.19-2.54). In linear regression models, depression, surfactant protein D and dyspnoea explained 35% (R-2) of the variation in physical impact of fatigue. Current smoking and depression explained 33% (R-2) of the cognitive impact of fatigue. Depression and surfactant protein D explained 48% (R-2) of the psychosocial impact of fatigue. Conclusions: Experiences of fatigue and functional limitation due to fatigue seem to be related mainly to psychological but also to physiological influencing factors, with depressive symptoms, insomnia problems and dyspnoea as the most prominent factors. Systemic inflammation was not associated with perception of fatigue but surfactant protein D was connected to some dimensions of the impact of fatigue
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| 3. |
- Stake-Nilsson, Kerstin, et al.
(författare)
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A Study of Self-Care Practice in Routine Radiotherapy Care: Identifying Differences Between Practitioners and Non-Practitioners in Sociodemographic, Clinical, Functional, and Quality-of-Life-Related Characteristics
- 2022
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Ingår i: Integrative Cancer Therapies. - : Sage Publications. - 1534-7354 .- 1552-695X. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objective of this study was to describe self-care practice during radiotherapy for cancer and to identify potential differences between practitioners and non-practitioners of self-care regarding sociodemographic, clinical, functional, and quality-of-life-related characteristics.Methods: In this descriptive study, 439 patients (87% response rate) undergoing radiotherapy responded to a study questionnaire regarding self-care, sociodemographic, clinical (eg, experienced symptoms), functional, and quality-of-life-related characteristics.Results: Of the 439 patients, 189 (43%) practiced at least one self-care strategy, while 250 (57%) did not. In total, the patients described 332 self-care practices, resulting in 14 different categories of self-care strategies. The 5 most common indicators of practicing self-care were fatigue, general wellbeing, psychological symptoms, nausea, vomiting and improving physical condition. The 5 most common self-care strategies were physical activity, increased recovery, healthy eating, distraction, and skincare. Patients who were married, were older than 69, patients with less education than university education, patients undergoing a combination of internal and external radiotherapy, patients experiencing fewer than 8 symptoms, and better quality of life, practiced self-care to a lower extent than did other patients. Functional capacity did not differ between self-care practitioners and non-practitioners.Conclusion and Implications for Practice: Of the patients undergoing radiotherapy, slightly less than half practiced self-care during an ordinary week of radiotherapy. Because older and less-educated patients were less likely to practice self-care, cancer care practitioners should consider paying particular attention to helping such patients with their self-care practice.
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| 4. |
- Tödt, Kristina, 1966-, et al.
(författare)
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Factors related with fatigue in patients undergoing radiotherapy
- 2019
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Ingår i: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 27:Supp1, s. S109-
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionFatigue is a common and debilitating symptom during cancer-related radiotherapy. The purpose of this study was to investigate fatigue in patients undergoing radiotherapy for cancer and to investigate factors in relation to fatigue, for example physical activity and quality of life (QoL).MethodsOf 507 available patients, 458 patients (52% women, mean age 65 years, breast (38%), prostate (32%), or other cancer types) answered a questionnaire once, after receiving mean 33 (+/-17) Gy fractioned radiotherapy.ResultsOf the patients, 321 (72%) reported presence of fatigue (median 4, interquartile range 4, rated 0; never to 10; all the time). Factors related to greater likelihood to experience fatigue were <45 years age (p<0.01), living alone (p<0.01), radiotherapy to thorax/mediastinum/lung (p=0.02), accumulated radiotherapy dose of >44 Gy (p<0.01), concomitant chemotherapy (p=0.04), any other disease beside cancer (p<0.01), and ≥ six symptoms, other than fatigue (Memorial Symptom Assessment Scale, p<0.01). Patients experiencing fatigue compared to non-fatigue patients experienced worse QoL (Functional Assessment of Cancer Therapy-General score, Support Care Cancer (2019) 27 (Suppl 1):S1– S302 S109 p<0.01), were less likely to adhere to physical activity recommendations (39% versus 67%, p<0.01), and more seldom perceived a healthy balance between rest and activity (33% versus 75%, p<0.01).ConclusionsThree quarters of patients during radiotherapy experienced fatigue and subgroups of patients were more likely to experience fatigue. Patients experiencing fatigue practiced less physical activity and experienced worse QoL than other patients. Cancer care professionals may considering paying attention to the subgroups of patients presenting greater likelihood to experience fatigue, to reduce symptom distress, and improve physical activity level and QoL
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| 5. |
- Tödt, Kristina, 1966-
(författare)
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Fatigue in long-term illness : Influencing factors and functional performance in chronic obstructive pulmonary disease and in cancer
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Syfte: Avhandlingen studerade sambandet mellan fatigue (trötthet) och valda inverkande faktorer, funktionsförmåga (fysisk och daglig aktivitet och arbetsförmåga) samt med hälsorelaterad livskvalitet (HRQL) vid kroniskt obstruktiv lungsjukdom (KOL) och vid cancer. Metod: Patienter med KOL (n=121, delarbete I-II) och patienter med cancer under pågående strålbehandling (n=457, delarbete III) studerades i tvärsnittsstudier. Canceröverlevare följdes longitudinellt upp sju år efter strålbehandling (n=215, jämfört med 172 matchade icke-cancerreferenter, delarbete IV). Data samlades in genom frågeformulär och kliniska bedömningar. Beskrivande och inferentiell statistik användes.Resultat: Fatigue förekom hos 74% av patienterna med KOL, 72% hos patienterna under cancerbehandling, 58% hos långtids-canceröverlevarna samt 41% av referenterna. Svårare sjukdom och sämre ansträngningsförmåga vid KOL, och samsjuklighet och nedstämdhet vid cancer under strålbehandling var associerat med större sannolikheten för fatigue. Fatigue under tidigare strålbehandling, och nuvarande nedstämdhet, smärta och antal symptom var associerat med fatigue vid uppföljningen. Svår fatigue hade samband med låg fysisk aktivitet vid KOL och fatigue vid strålbehandling med mindre fysisk och daglig aktivitet och sämre HRQL. Under strålbehandling rapporterade patienter med fatigue 60% sjukfrånvaro gentemot 40% utan. Fatigue hade minskat vid uppföljning men var värre än hos referenterna. Fysisk och daglig aktivitet hade förbättrats och var inte sämre än referenternas. Självskattad arbetsförmåga och arbetsprocent var dock lägre. Fatigue och tilltron till sin arbetsförmåga var associerat med självskattad arbetsförmåga hos canceröverlevare som arbetade. Konklusion: Att uppmärksamma fatigue kan underlätta för hälso och sjukvårdspersonal att identifiera och ge stöd till patienter med nedsatt funktionsförmåga samt till canceröverlevare med risk för långvarig fatigue och påverkad arbetsförmåga.
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| 6. |
- Tödt, Kristina, 1966-
(författare)
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The relationship between physical function and experience of fatigue in patients with chronic obstructive pulmonary disease
- 2014
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundChronic Obstructive Pulmonary Disease (COPD) is increasing throughout the world and most rapidly among women. COPD is characterized by a progressive loss of physical functions. The reason for this is multi-factorial and include not only lung related deficiencies but also several systemic consequences and symptoms of which several are potential restrictors of physical function. The relationship between physical function and symptoms are not clear, especially not among women with COPD.AimThe overall aim of this thesis was to illuminate the relationship between two dimensions of physical function (physical activity and physical capacity) and experience of fatigue. The specific aims were to explore factors associated with low physical activity and to examine experience of fatigue and its relationship to physical capacity and disease severity in men and women with COPD.MethodsA cross-sectional study was conducted including 121 patients (67 women) with stable COPD and mean age of 67 (+/-7) years. Physical activity was measured with the International Physical Activity Questionnaire short form. Physical capacity included assessment of lung function (dynamic spirometry), exercise capacity (the 6-minute walk distance [perceived dyspnoea and leg fatigue in connection to the test]) and muscle strength (the Timed Stands Test and grip strength). Fatigue was assessed with structured questions covering the frequency, duration and severity of fatigue the previous month and patients were categorized as those with no fatigue, moderate fatigue or severe fatigue. Data about other symptoms (dyspnoea, anxiety and depression), symptom burden (Memorial Symptom Assessment Scale), fat and fat free mass (bio-impedance analysis) and smoking history was collected.ResultsForty-two percent of the patients reported a low physical activity level. A majority of the patients reported experience of fatigue the previous month, 52% moderate fatigue and 25% severe fatigue. Low physical activity was associated with severe fatigue, worse exercise capacity and a higher amount of smoking. There were no differences in experience of fatigue between men and women. Men with fatigue had worse physical capacity and disease severity compared to men without fatigue. Women with fatigue had comparable physical capacity and disease severity to women without fatigue except for a higher perceived leg fatigue after the exercise capacity test. Multiple logistic regression analysis showed that exercise capacity and disease severity were associated with fatigue in both men and women but in women, leg fatigue was also strongly associated with the presence of fatigue.ConclusionsSevere fatigue, worse exercise capacity and a higher amount of smoking were independently associated with low PA. This result suggests that patients with severe fatigue might need specific strategies to become more physically active. Presence of fatigue was associated with exercise capacity and disease severity in both men and women. In addition, in women leg fatigue was strongly associated with fatigue. Muscle endurance training might be extra important in the rehabilitation of women with COPD experiencing fatigue. However the association between fatigue and exercised induced leg fatigue among the women warrant further investigation.
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| 7. |
- Tödt, Kristina, 1966-, et al.
(författare)
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What does self-care practice look like among patients undergoing radiotherapy in routine radiotherapy care?
- 2023
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Ingår i: Palliative & Supportive Care. - : Springer. - 1478-9515 .- 1478-9523. ; 31:S1, s. S162-
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionSupporting cancer survivors in practicing evidence-based self-care has a central place in the rehabilitation plan to reduce side-efects of cancer treatment. However, knowledge is needed on the implementation of self-care practice among patients in routine radiotherapy care. Are there diferences in characteristics between self-care practitioners and non-practicing patients?MethodsA study questionnaire including self-care and symptoms was delivered to 507 eligible patients undergoing radiotherapy at radiotherapy clinics in Sweden. The questions about self-care practice were responded by n=439 (51% women, 49% men) with breast (38%), prostate (33%), or other cancer (29%) types.ResultsOf the responding patients, 43% (n=189) practiced some form of self-care. The 332 self-reported descriptions of self-care were categorized into 14 self-care strategies of which six were practiced by more than 10 patients: physical activity (n=113), increased recovery (n=69), healthy eating (n=66), distraction (n=24), skincare (n=20), and self-medication (n=12). The most common indicators for self-care practice were fatigue (experienced by 72 %), general wellbeing (poor general wellbeing experienced by10%), psychological symptoms (worrying experienced by 44% and feeling sad by 42%), nausea (experienced by 34%), vomiting (experienced by 12%), and improving physical condition. Of the patients reporting experience of the above symptoms, 42%, 46%, 48%, 41%, 53%, and 47% practiced selfcare. Older age, relative risk (RR) 2.62, 95% confdence interval (CI) 1.6-4.28 and lower education i.e., elementary and secondary school, RR 1.75,CI 1.00-3.03 and RR 1.46, CI 1.16-1.85 were independently related with increased likelihood of being non-practitioners.ConclusionsRoughly 40% of patients undergoing radiotherapy in a routine care setting practiced self-care. The most common indicator was fatigue, and the most common self-care strategy was physical activity. Half of symptomatic patients are non-practitioners who might beneft from evidenced based self-care. Among them, older and those with lower education might need more support in selfcare than others.
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