Embedded Assumptions in Qualitative Studies of Fatigue

Abstract

Qualitative researchers have long recognized that fatigue is a common concern among those with chronic illness; however, the insights derived from this body of inquiry have not been synthesized into a coherent body of clinical knowledge that could provide direction for nursing practice. Using a synthesis approach of meta-study, the authors identify four predominant assumptions embedded in qualitative studies that have influenced the way researchers have interpreted and made sense of their findings about fatigue in chronic illness over the past two decades. They argue that these assumptions may have inhibited the development of more dynamic, comprehensive understandings of fatigue. They conclude that addressing some of the methodological issues within this body of research might lead to a more accurate portrayal of the complexity, fluidity, and contextual nature of the fatigue experienced in chronic illness.

The experience of fatigue as a distressing symptom of heart failure

“…Fatigue as a distressing symptom of HF has been illustrated through the experiences of our participants as an embodied understanding of their HF disease 5,26,27 and of their mortality. Knowing fatigue, the embodiment of the symptom experience, and how the patient's world has changed all come together to create an understanding by the patient with HF of the spatial, temporal, and interpersonal limitations imposed on those who experience fatigue as a symptom of HF, leading to a significant reduction of the world in which they had previously lived.…”

“…A metastudy of qualitative research exploring fatigue across conditions (n ¼ 35 primary studies) recommended that fatigue be studied with attention to the personal and sociocultural context in which it occurs. 27 International research has begun to highlight elements of the fatigue life experience, but given that the meaning of fatigue is related to the context of the experience, cultural and system nuances can influence the perceived impact on life, quality of life, and adaptation strategies. An understanding of fatigue in an American context is needed to help inform partnership development with patients, so that providers can work within a patient-centered framework.…”

Problems of Adults with a Mitochondrial Disease – The Patients’ Perspective: Focus on Loss

“…However, the results resemble those from studies in people with other loss-related neurodegenerative and severe chronic diseases (Issaksson and Ahlstr€ om 2008;Ahlstr€ om 2007;Issaksson et al 2007;Pool et al 2004;Pool and Stap 2004;Paterson et al 2003;Lindgren 1996;Eakes et al 1993) [Abma TA, Nierse CJ, Horemans AMC, Vos I, de Jonge R, van Engelen B, 2007, Over kwaliteit en gezondheid. Een dialoog over onderzoek tussen mensen met een spierziekte en onderzoekers (About quality and health.…”

Reflective practice in nursing care: Embedded assumptions in qualitative studies

“…The data were sampled and analysed in every meta‐study phase. The studies were idiomatically translated into another 18,19 by the team members and then discussed to determine similarities and differences in interpretations and to arrive at a consensus on the interpretations 17 …”