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Siltanen H, Aine T, Huhtala H, Kaunonen M, Paavilainen E. The information needs of people with COPD-The holistic approach with special reference to gender and time since diagnosis. Nurs Open 2021; 8:2498-2508. [PMID: 33755324 PMCID: PMC8363367 DOI: 10.1002/nop2.773] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/07/2020] [Accepted: 12/18/2020] [Indexed: 12/12/2022] Open
Abstract
AIMS The aim of this study was to determine what kinds of unmet information needs people with COPD have and whether there are differences in information needs between genders or based on the time since COPD diagnosis. DESIGN A descriptive cross-sectional study. METHODS Data on people with COPD (N = 169) were collected from a two-part questionnaire distributed via website. On the first part, information needs concerning the medical aspects of self-management were measured by the Lung Information Needs Questionnaire (LINQ). On the second part, which was developed specifically for this study, a more holistic view of self-management counselling was sought. Statistical methods were used to analyse the data. RESULTS The respondents had wide-ranging information needs in many areas of COPD self-management. The most often reported areas of unmet information needs included exacerbations, diet, fatigue, stress and anxiety, palliative care and sexual life. The information needs varied by gender and time since COPD diagnosis.
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Affiliation(s)
- Hannele Siltanen
- Department of Health SciencesFaculty of Social SciencesTampere UniversityTampereFinland
| | - Tiina Aine
- Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland
| | - Heini Huhtala
- Department of Health SciencesFaculty of Social SciencesTampere UniversityTampereFinland
| | - Marja Kaunonen
- Department of Health SciencesFaculty of Social SciencesTampere UniversityTampereFinland
- Pirkanmaa Hospital DistrictTampereFinland
| | - Eija Paavilainen
- Department of Health SciencesFaculty of Social SciencesTampere UniversityTampereFinland
- Etelä‐Pohjanmaa Hospital DistrictSeinäjokiFinland
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Alpaydin AÖ, Aktan R, Keleş E, Özalevli S. Factors affecting the severity of fatigue in male patients with chronic obstructive pulmonary disease. Rev Clin Esp 2021; 221:86-92. [PMID: 38108662 DOI: 10.1016/j.rce.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/20/2020] [Accepted: 06/17/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Fatigue, the second most common symptom after dyspnea in patients with chronic obstructive pulmonary disease, impairs functional capacity and quality of life. This study aims to predict the factors that affect fatigue severity and investigate the effects of fatigue in patients with chronic obstructive pulmonary disease. METHODS Data were collected to assess demographic and clinical characteristics, cigarette consumption, fatigue severity (Fatigue Severity Scale), dyspnea severity (Medical Research Council Dyspnea Scale), level of physical activity (International Physical Activity Questionnaire-Short Form), and health-related quality of life (36-Item Short Form Health Survey). RESULTS A total of 64 male chronic obstructive pulmonary disease patients were evaluated (mean age 61.1±4.7 years, mean Fatigue Severity Scale score 39.8±14.4). The result of the linear regression model was significant and explained 84% of the variance in fatigue severity (Adjusted R-squared=0.84, F=29.48, df=60, p<.001). It showed that the Medical Research Council Dyspnea Scale score (β=.40), cigarette consumption (β=.35), and physical activity level (β=-.37) were significantly correlated with the severity of fatigue (p<.001 for all) and that they independently contributed to the prediction of severity of fatigue. CONCLUSION Dyspnea, cigarette consumption, and physical activity level affect fatigue severity. Additionally, physical activity level, pulmonary function, and health-related quality of life were also associated with fatigue. These findings support the assertion that it is important to measure fatigue and the factors that affect its severity.
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Affiliation(s)
- A Ö Alpaydin
- Departamento de Enfermedades Torácicas, Facultad de Medicina, Universidad Dokuz Eylul, Esmirna, Turquía
| | - R Aktan
- Departamento de Fisioterapia, Escuela vocacional de Servicios de Salud, Universidad de Economía de Esmirna, Esmirna, Turquía; Instituto de Ciencias de la Salud, Universidad Dokuz Eylul, Esmirna, Turquía
| | - E Keleş
- Departamento de Fisioterapia y Rehabilitación, Facultad de Ciencias de la Salud, Universidad Izmir Kâtip Celebi, Esmirna, Turquía
| | - S Özalevli
- Departamento de Rehabilitación Pulmonar, Universidad Dokuz Eylul, Esmirna, Turquía.
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Factors affecting the severity of fatigue in male patients with chronic obstructive pulmonary disease. Rev Clin Esp 2020; 221:86-92. [PMID: 33998493 DOI: 10.1016/j.rceng.2020.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/17/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Fatigue, the second most common symptom after dyspnea in patients with chronic obstructive pulmonary disease, impairs functional capacity and quality of life. This study aims to predict the factors that affect fatigue severity and investigate the effects of fatigue in patients with chronic obstructive pulmonary disease. METHODS Data were collected to assess demographic and clinical characteristics, cigarette consumption, fatigue severity (Fatigue Severity Scale), dyspnea severity (Medical Research Council Dyspnea Scale), level of physical activity (International Physical Activity Questionnaire Short-Form), and health-related quality of life (36-Item Short Form Health Survey). RESULTS A total of 64 male COPD patients were evaluated (mean age 61.1 ± 4.7 years, mean FSS score 39.8 ± 14.4). The result of the linear regression model was significant and explained 84% of the variance in fatigue severity (Adjusted R-squared = 0.84, F = 29.48, df = 60, p < .001). It showed that the MRC score (β = .40), cigarette consumption (β = .35), and physical activity level (β = -.37) were significantly correlated with the severity of fatigue (p < .001 for all) and that they independently contributed to the prediction of severity of fatigue. CONCLUSION Dyspnea, cigarette consumption, and physical activity level affect fatigue severity. Additionally, physical activity level, pulmonary function, and HRQOL were also associated with fatigue. These findings support the assertion that it is important to measure fatigue and the factors that affect its severity.
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Comparing health status between patients with COPD in primary, secondary and tertiary care. NPJ Prim Care Respir Med 2020; 30:39. [PMID: 32901030 PMCID: PMC7478961 DOI: 10.1038/s41533-020-00196-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/07/2020] [Indexed: 11/15/2022] Open
Abstract
In this study, we compare health status between COPD patients treated in three different care levels in the Netherlands and assess determinants that influence their health status. We applied the Nijmegen Clinical Screening Instrument to measure eight health status subdomains in primary (n = 289), secondary (n = 184) and tertiary care (n = 433) COPD patient cohorts. Proportions of patients with severe problems in ≥3 subdomains are 47% in primary, 71% in secondary and 94% in tertiary care. Corrected for patient characteristics, differences between the care levels are statistically significant for nearly all health status subdomains. The pooled cohort data show female sex, age, FEV1 % predicted and BMI to be determinants of one or more subdomains. We conclude that the proportion of COPD patients with severe health status problems is substantial, not just in tertiary care but also in primary and secondary care. Use of detailed health status information may support patient-tailored COPD care.
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Strandkvist V, Andersson M, Backman H, Larsson A, Stridsman C, Lindberg A. Hand grip strength is associated with fatigue among men with COPD: epidemiological data from northern Sweden. Physiother Theory Pract 2018; 36:408-416. [DOI: 10.1080/09593985.2018.1486490] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Viktor Strandkvist
- Department of Health Science, Division of Health and Rehabilitation, Luleå University of Technology, Luleå, Sweden
- Department of Public Health and Clinical Medicine, The OLIN Unit, Division of Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Mikael Andersson
- Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden
| | - Helena Backman
- Department of Public Health and Clinical Medicine, The OLIN Unit, Division of Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Agneta Larsson
- Department of Health Science, Division of Health and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Caroline Stridsman
- Department of Health Science, Division of Nursing, Luleå University of Technology, Luleå, Sweden
| | - Anne Lindberg
- Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden
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Medina-Mirapeix F, Bernabeu-Mora R, Giménez-Giménez LM, Montilla-Herrador J, García-Vidal JA, Benítez-Martínez J. Patterns and predictors of exhaustion episodes in patients with stable COPD: A longitudinal study. Int J Clin Pract 2018; 72:e13068. [PMID: 29436160 DOI: 10.1111/ijcp.13068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 01/18/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Exhaustion is the perception of low energy. Little is known about how exhaustion persists, remits or reappears over time in patients with chronic obstructive pulmonary disease (COPD) or how to predict these events. We determined the likelihood of transitions between states of exhaustion and no exhaustion among patients with stable COPD followed up for 2 years. We investigated combinations of potential factors for their abilities to predict new-onset exhaustion episodes. METHODS We prospectively included 137 patients with stable COPD (mean age, 66.9 years ± 8.3). Exhaustion states were measured at baseline and 1 and 2 years later. Exhaustion was defined as an answer of "most of the time" or "a moderate amount of time" to 1 of 2 questions: "How often have you found it hard to get going?" and "How often does everything seem to require effort?" We evaluated demographic, non-respiratory and respiratory variables as potential predictors. The likelihoods of new episodes and recovery were calculated. Predictors were evaluated with generalised estimating equations. RESULTS At baseline, 27 patients (19.7%) displayed exhaustion. Of the 110 patients without exhaustion at baseline, 17 (15.5%) displayed exhaustion at least once during the follow-up period. During the study period, a total of 204 annual transitions displaying no exhaustion at the beginning were identified. Of them, 10.3% transitioned to exhaustion in the next year. The likelihood of recovery after exhaustion was 50%. Independent predictors of new-onset exhaustion episodes within the following year were: the COPD assessment test score (odds ratio [OR] = 1.10; 95% confidence interval [CI] 1.01-1.21), depression (OR = 6.89; 95% CI: 1.00-47.41) and female gender (OR = 6.88; 95% CI: 1.83-25.73). CONCLUSIONS Patients in stable COPD with high CAT scores and depression were most likely to experience new-onset exhaustion episodes Thus, exhaustion might be predicted by a combination of psychological factors and respiratory health status. Nevertheless, exhaustion is dynamic in COPD; half of patients recover from exhaustion.
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Affiliation(s)
| | - Roberto Bernabeu-Mora
- Department of Physical Therapy, University of Murcia, Murcia, Spain
- Department of Pneumology, Hospital General Universitario JM Morales Meseguer, Murcia, Spain
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Kentson M, Tödt K, Skargren E, Jakobsson P, Ernerudh J, Unosson M, Theander K. Factors associated with experience of fatigue, and functional limitations due to fatigue in patients with stable COPD. Ther Adv Respir Dis 2016; 10:410-24. [PMID: 27591046 PMCID: PMC5933621 DOI: 10.1177/1753465816661930] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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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Affiliation(s)
- Magnus Kentson
- Department of Medicine, Division of Pulmonology, Ryhov County Hospital, Jönköping, Sweden, S-551 85 Jönköping, Sweden and Department of Medical and Health Sciences, Linköping University, S-581 83 Linköping, Sweden
| | - Kristina Tödt
- Department of Respiratory Medicine, Linköping University, Linköping, Sweden and Department of Respiratory Medicine & Allergology, Skane University Hospital, Lund, Sweden
| | - Elisabeth Skargren
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Per Jakobsson
- Department of Medicine, Division of Pulmonology, Ryhov County Hospital, Jönköping, Sweden
| | - Jan Ernerudh
- Department of Clinical Immunology and Transfusion Medicine, Clinical Immunology, Linköping, Sweden
| | - Mitra Unosson
- Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden
| | - Kersti Theander
- Faculty of Health, Science and Technology, Department of Health Sciences, Nursing, Karlstad University and Primary Care Research Unit, County Council of Värmland, Karlstad, Sweden
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Eckerblad J, Tödt K, Jakobsson P, Unosson M, Skargren E, Kentsson M, Theander K. Symptom burden in stable COPD patients with moderate or severe airflow limitation. Heart Lung 2014; 43:351-7. [PMID: 24856227 DOI: 10.1016/j.hrtlng.2014.04.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 04/02/2014] [Accepted: 04/03/2014] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- J Eckerblad
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linkoping University, 581 85 Linkoping, Sweden.
| | - K Tödt
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linkoping University, 581 85 Linkoping, Sweden; Department of Pulmonary Medicine, University Hospital, 581 85 Linkoping, Sweden
| | - P Jakobsson
- Department of Pulmonary Medicine, University Hospital, 581 85 Linkoping, Sweden
| | - M Unosson
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linkoping University, 581 85 Linkoping, Sweden
| | - E Skargren
- Department of Medicine and Health Sciences, Faculty of Health Sciences, Linkoping University, 581 85 Linkoping Sweden
| | - M Kentsson
- Department of Pulmonary Medicine, Ryhov Hospital, Jonkoping S-551 85, Sweden
| | - K Theander
- Faculty of Health, Science and Technology, Department of Health Sciences, Nursing, Karlstad University, 656 37 Karlstad, Sweden; Primary Care Research Unit, Varmland County Council, Karlstad, Sweden
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Tödt K, Skargren E, Kentson M, Theander K, Jakobsson P, Unosson M. Experience of fatigue, and its relationship to physical capacity and disease severity in men and women with COPD. Int J Chron Obstruct Pulmon Dis 2013; 9:17-25. [PMID: 24368883 PMCID: PMC3869832 DOI: 10.2147/copd.s52506] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
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) (P<0.01). 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) (P<0.001). 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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Affiliation(s)
- Kristina Tödt
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden ; Department of Pulmonary Medicine, University Hospital, Linköping, Sweden
| | - Elisabeth Skargren
- Department of Medicine and Health, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Magnus Kentson
- Department of Pulmonary Medicine, Ryhov Hospital, Jönköping, Sweden
| | - Kersti Theander
- Department of Nursing, Faculty of Social and Life Sciences, Karlstad University, Karlstad, Sweden ; Primary Care Research Unit, County Council of Värmland, Sweden
| | - Per Jakobsson
- Department of Pulmonary Medicine, University Hospital, Linköping, Sweden
| | - Mitra Unosson
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden
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Stridsman C, Müllerova H, Skär L, Lindberg A. Fatigue in COPD and the Impact of Respiratory Symptoms and Heart Disease—A Population-based Study. COPD 2013; 10:125-32. [DOI: 10.3109/15412555.2012.728642] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Stridsman C, Lindberg A, Skär L. Fatigue in chronic obstructive pulmonary disease: a qualitative study of people's experiences. Scand J Caring Sci 2013; 28:130-8. [DOI: 10.1111/scs.12033] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 01/24/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Caroline Stridsman
- Department of Health Science; Division of Nursing; Luleå University of Technology; Luleå Sweden
- The OLIN studies; Sunderby Hospital; Luleå Sweden
| | - Anne Lindberg
- The OLIN studies; Sunderby Hospital; Luleå Sweden
- Department of Public Health and Clinical Medicine; Division of Medicine; Umeå University; Umeå Sweden
| | - Lisa Skär
- Department of Health Science; Division of Nursing; Luleå University of Technology; Luleå Sweden
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