Fatigue associated with congestive heart failure: use of Levine's Conservation Model

Abstract

This study aimed to refine and extend the findings of an original study which focused on the description of fatigue associated with congestive heart failure. A descriptive approach based on Levine's Conservation Model provided both quantitative and qualitative data. Qualitative data addressed personal integrity and quantitative data measured energy conservation, structural and social integrity. Patients described fatigue as being tired and exhausted and containing both physical and emotional components. Fatigue occurred as a result of stress, physical activity and disease. Patient-identified interventions included rest, distraction, medicine, and physical and spiritual activities. Age, pH and oxygen saturation were significantly related to fatigue. The findings are examined using the concept of adaptation as defined by Levine. Implications for nursing are discussed within the framework of the Conservation Model with emphasis on a holistic approach to patient care.

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

“…Schaefer & Schober (1993) reported that fatigue in CHF was associated with overwhelming tiredness, which interfered with functional ability. The patients' own descriptions of the fatigue experience have been summarized by Schaefer (1990):…”

“…Fatigue in patients with CHF has been found to be associated with other physical symptoms, such as breathlessness, chest pain and palpitations (Friedman & King, 1995;Tiesinga et al, 1998;Schaefer, 1990;Mayou et al, 1991), sleep diffi culties (Friedman & King, 1995;Thiesinga et al, 1998), nausea, loss of appetite and headache (Schaefer, 1990). Fatigue has also been reported to be associated with LVEF (Schaefer, 1990) and oxygen saturation (Schafer & Shober, 1993) but no other relationships between physical signs and experience of fatigue have been found in the literature.…”

“…Fatigue has also been reported to be associated with LVEF (Schaefer, 1990) and oxygen saturation (Schafer & Shober, 1993) but no other relationships between physical signs and experience of fatigue have been found in the literature.…”

“…(Plach et al, 2006). Older persons seem to accept fatigue and perceive it as less bothersome because they accept it as an inevitable effect of the aging process (Schaefer, 1990;Friedman, 1997). The response to fatigue differed between men and women.…”

The Experience of Fatigue among Elderly Women with Chronic Heart Failure

“…In a study using open-ended questions about what fatigue meant to elderly patients with CHF, the most commonly-mentioned factors were feebleness, listlessness, and the desire for rest [10]. Patients with CHF have reported feelings about being fatigued which include annoyance, frustration, disappointment, fear, and anger, but also 'taking it in one's stride' [11]. Nordgren et al [12] found a constant presence of weakness and fatigue among middle-aged patients with CHF, including perceptions of the body as unfamiliar and objectified.…”