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- Strandkvist, Viktor, et al.
(författare)
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Hand muscle strength in COPD : A population based study
- 2013
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Ingår i: European Respiratory Journal. - 0903-1936 .- 1399-3003. ; 42:Suppl 57
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Tidskriftsartikel (refereegranskat)abstract
- Background: Skeletal muscle dysfunction is a known systemic- or extra pulmonary effect in COPD. The relationship between the severity of the disease according to GOLD’s spirometric criteria and muscle dysfunction is however not clearly explored.Aim: To investigate hand grip strength (HGS) in subjects with COPD compared to subjects without airflow obstruction.Method: Lung function and HGS was measured according to validated methods in the years of 2009-2010 within the Obstructive Lung Disease in Northern Sweden (OLIN) COPD-study. HGS, was measured with a hand-held dynamometer (Jamar®) in kilogram-strength (kgf), which has been shown to correlate strongly with both upper- and lower extremity strength. The sample included 441 subjects with COPD according to GOLD criteria (FEV1/FVC<0.70) and 571 non-COPD subjects in the same ages.Results: Among men, HGS was lower in GOLD III-IV, mean=31.4 kgf, compared to GOLD II, mean=37.2 kgf (p=0.009), GOLD I, mean=36.9 kgf (p=0.024), and subjects without COPD, mean=37.6 kgf (p=0.024). Among women no such correlation was found. In the whole sample, HGS, did not differ significantly between subjects with and without COPD, or COPD stages according to GOLD. No correlation was found between percent predicted FEV1 but a strong and positive relationship was found between the crude value of FEV1 and HGS (pearson's r=0.67).Conclusion: Among men, GOLD III-IV was associated with a lower HGS, however not among women.
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| 7. |
- Stridsman, Caroline, et al.
(författare)
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Fatigue in chronic obstructive pulmonary disease : a qualitative study of people's experiences
- 2014
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 28:1, s. 130-138
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundFatigue is reported to be one of the most common symptoms among people with chronic obstructive pulmonary disease COPD. However, there is hardly any qualitative research describing how fatigue affects people living with this illness. AimTo describe people's experience of fatigue in daily life when living with moderate to very severe COPD. MethodsA purposive sample of 20 people with COPD stages II-IV was recruited from the Obstructive Lung Disease in Northern Sweden COPD study. Data were collected through semi-structured interviews with participants regarding their experience of fatigue. The interviews were subjected to qualitative content analysis. ResultsOne theme was identified: Reconcile with the dimensions of fatigue, and four categories were identified: To understand the reasons of fatigue, To preserve fatigue unexpressed, When fatigue takes control and How to manage fatigue. Fatigue seems to be an always-present feeling, involving the whole body, raising feelings of hopelessness and controlling one's life. It seems to be accepted as a natural consequence of COPD and may therefore remain unexpressed. Further, when experienced with dyspnoea, fatigue becomes even heavier and more difficult to manage. To gain control of fatigue, people plan daily life and continue with physical activities. ConclusionFatigue affects the daily lives of people with COPD. Perceived with dyspnoea, fatigue was described as overwhelming. Most importantly, fatigue seems to be unexpressed to healthcare professionals and relatives.
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| 8. |
- Stridsman, Caroline, et al.
(författare)
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Fatigue in COPD and the impact of heart disease comorbidity : a population-based study
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Fatigue is a common symptom among people with COPD. However, there are few studies describing fatigue in COPD and the impact of comorbidity, none of them population based.Aim: To describe fatigue in COPD by disease severity according to GOLD, and the impact of self-reported heart disease.Methods: The Functional Assessment of Chronic Illness Therapy (FACIT)- Fatigue scale was used to assess fatigue; lower scores represent worse fatigue (0-52). Data were collected in 2007 from the Obstructive Lung Disease in Northern Sweden (OLIN) COPD cohort; 564 subjects with COPD, with a distribution of disease severity representative for the general population, and 786 non-COPD subjects.Results: Median FACIT-F score was 44.0 in COPD subjects, significantly lower compared to 46.0 in non-COPD (p=0.006). Score decreased by disease severity: 46.0, 43.7, and 37.5 in GOLD stage I, II, and III-IV (I vs II p=0.020, II vs III-IV p=0.035). There was no significant difference between stage I and non-COPD. In subjects without heart disease, there were lower scores in stage II, 45.0 and III-IV, 38.5 compared to non-COPD, 47.0 (p=0.005 and p=0.205). In subjects with heart disease, only stage III-IV had significantly lower scores than non-COPD, 30.5 vs 42.0 (p=0.030). Subjects with heart disease reported lower scores than those without heart disease at all severities of COPD (non-COPD: 42.0 vs 47.0, p<0.001, stage I: 40.5 vs 48.0, p<0.001, stage II: 40.0 vs 45.0, p=0.008 and stage III-IV: 30.5 vs 38.5, p=0.051).Conclusion: Fatigue increases with GOLD-defined disease severity, but the score is not significantly different from non-COPD until stage II. Heart disease increases fatigue in both COPD and non-COPD.
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| 9. |
- Stridsman, Caroline, et al.
(författare)
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Fatigue in COPD and the Impact of Respiratory Symptoms and Heart Disease : A Population-based Study
- 2013
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Ingår i: COPD. - London : Informa Healthcare. - 1541-2555 .- 1541-2563. ; 10:2, s. 125-132
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fatigue is reported in COPD and in heart disease; however, there are hardly any population based data on the relationship between these conditions. Aim: To describe fatigue in relation to COPD by disease severity and to evaluate the impact of respiratory symptoms and heart disease. Methods: Data were collected in 2007 from the OLIN COPD study; 564 subjects with COPD (FEV1/FVC < 0.70) and a distribution of disease severity representative for the general population, and 786 subjects without COPD. The Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue scale was used to assess fatigue (0-52); lower scores represent worse fatigue. Results: Median FACIT-F score was 44.0 in COPD defined by merely spirometric criteria and 42.0 in COPD also reporting respiratory symptoms, significantly lower compared to 46.0 in non-COPD (p = 0.006 and p < 0.001), and decreased by disease severity. The score was lower in COPD stage >= II and in COPD with respiratory symptoms already from stage I when compared to non-COPD. Subjects with heart disease reported lower scores than those without heart disease in COPD by all stages and in non-COPD. COPD with respiratory symptoms stage >= II remained a significant risk factor for clinically significant fatigue also when adjusted for gender, age, heart disease and smoking habits (stage II OR 1.65, CI 1.17-2.31 and stage III-IV OR 2.66, CI 1.11-6.36). Conclusion: Fatigue is common in COPD, and is affected by respiratory symptoms and concomitant heart disease. In COPD with respiratory symptoms stage >= II, there is an increased risk for clinically significant fatigue.
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| 10. |
- Stridsman, Caroline
(författare)
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Living with chronic obstructive pulmonary disease with focus on fatigue, health and well-being
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to describe and evaluate experiences of living with chronic obstructive pulmonary disease (COPD), with focus on fatigue, health and well-being. A mixed method study design was used to reach the overall aim. All studies were based on data from the Obstructive Lung Disease in Northern Sweden (OLIN) COPD study. Papers I (n=1350) and III (n=1089) included participants (aged 35-88 years) with and without a spirometric classification of COPD. Bivariate, multiple logistic regression (I, III), and correlation (III) analyses were performed. Papers II (n=20) and IV (n=10) included participants (aged 59-77 years) with moderate to very severe COPD. Semi-structured interviews were conducted, and data were analysed through qualitative content analysis. The result showed that fatigue was worse among people with COPD compared to people without COPD. Fatigue increased with disease severity, and was already worse in COPD grade I among people with respiratory symptoms compared with the non-COPD group. COPD grade II with respiratory symptoms (OR 1.65) and grade III-IV with respiratory symptoms (OR 2.66) were significant risk factors for clinically significant fatigue when adjusted for sex, age, heart disease, and smoking habits (Paper I). Fatigue was described to mainly be COPD related; it was accepted as a natural consequence of COPD, but it was unexpressed. Fatigue affected and controlled the daily life of these people, and with dyspnea, fatigue was described to be overwhelming. Planning physical activity was the most important strategy to manage fatigue (Paper II). Fatigue had a great impact on both physical and mental dimensions of the health status, irrespective of having COPD or not. Among people with clinically significant fatigue, those with COPD had significantly lower physical health scores. Fairly strong correlations existed between FACIT-Fatigue and physical as well as mental health dimensions in SF-36. Increased fatigue and decreased physical and mental dimensions of health, each predicted mortality, but only among people with COPD (Paper III). Identified aspects for increased well-being for people living with COPD were adjusting to lifelong limitations, handling variations in illness, relying on self-capacity and accessibility to a trustful care. People had to adapt to limitations and live forward by finding a balance between breathing and viability (Paper IV). In conclusion, increased fatigue can be experienced in COPD already at grade I when respiratory symptoms are present, and COPD grade ≥II is a risk factor for clinically significant fatigue. Fatigue is common but seems to be unspoken, and an increased awareness of the symptom is necessary for an early identification. It is therefore important for health care professionals to take fatigue into consideration, to objectively assess and ask patients about it. This is important, since fatigue clearly worsens the health status among people living with COPD, and furthermore is associated with mortality in COPD. To enhance health and well-being, an increased viability may facilitate self-capacity and increase the strength for illness and fatigue management among people living with COPD
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| 11. |
- Stridsman, Caroline, et al.
(författare)
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The experience of fatigue in subjects with chronic obstructive pulmonary disease
- 2010
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Besides respiratory symptoms, fatigue is reported as one of the most common among people with moderate to severe chronic obstructive pulmonary disease, COPD. Fatigue can be described as anything from tiredness to exhaustion and the most typical is that fatigue does not disappears after rest or sleep. The experience of how fatigue affects the daily life in patients with COPD is hardly described.
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