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

Abstract

Although fatigue is a prevalent and distressing symptom in patients with chronic heart failure (CHF), it is an underestimated problem in the care of patients, and consequently, insuffi ciently investigated. The primary aim of this thesis was, therefore, to advance the knowledge from the patients' perspective by describing characteristics of the fatigue experience and its consequences in daily life in patients with CHF. A secondary aim was to investigate the relationships between fatigue and selected physiological and psychological factors associated with fatigue. Both quantitative and qualitative methods have been used and three samples of patients have been interviewed on different occasions. In two of the quantitative studies 93 patients, and in another study 112 patients, consecutively included, were interviewed at the hospital. Fifteen patients were included in the qualitative study. These 15 participants were enrolled when they visited an outpatient clinic and most of them were interviewed in their homes. These interviews were supplemented with the content of an Internet discussion with persons living with CHF.The results of the studies indicated that fatigue embraces the individual's body, emotions and cognitive abilities, forcing the person to physical restrictions that, in turn, perpetuate emotional discomfort. However, the physical sensation of fatigue followed by functional limitations seemed to be the most prevalent and distressing experience in patients with CHF. The patients described fatigue as lacking strength, which was associated in connection with physical efforts and lacking energy, viewed as an annoying sensation after both mental and physical strain. Another dimension of fatigue was described as being sleepy, often with a rapid and unforeseen onset. Consequences of fatigue, such as refraining from daily chores, denying oneself opportunities for rejoice and social isolation, further exaggerated the experience of fatigue. Restorative activities that engaged, absorbed or distracted the patients counteracted these negative consequences. Depressed mood was related to those fatigue dimensions that compromised functional ability and motivation to start any activities, whereas anxiety was associated with cognitive impairment. Feelings of uncertainty were related to physical tiredness, possibly infl icted by limitations in performing activities. Symptom distress that was caused by a number of reported symptoms other than fatigue had a diminutive infl uence on fatigue and separate symptoms that were associated with fatigue were, with the exception of breathlessness, not the fi rst and most pressing symptom reported by the patients. Anemic patients reported more fatigue compared with non-anemic patients and functional status, according to the New York Heart Association (NYHA) functional classifi cation criteria, was associated with those fatigue dimensions that encompassed physical tiredness and reduced functioning.The fi ndings provide new insights on the characteristics of fatigue and its con...

The Experience of Fatigue among Elderly Women with Chronic Heart Failure

“…Decreased motivation and interest in surroundings, an attribute of fatigue presented by Trendall [15], was not relevant for the women with CHF in our study, where the experience of fatigue seemed to be mostly of a physical character. This is in accordance with earlier findings among patients with CHF [5][6][7]. The role of age in this matter should not be disregarded.…”

Study of Fatigue and Associated Factors in Patients with Chronic Heart Failure

“…In the findings of the present study, dysfunction of daily life activities was observed, also in the study by Faulk, there was a significant relationship between fatigue and patient's reduced function (45). Fatigue is considered as a limiting factor for physical activity (19), while excessive fatigue leads to reduced skeletal muscle function (46), which occurs due to increased catabolic muscle myopathy, therefore reduced activity and fatigue accompany skeletal muscle inappropriate function (19,24,46).…”

“…In another comparative study, it was also clear that there is a significant relationship between fatigue factor, anxiety and depression (19). Different studies reported fatigue symptoms with depression signs in patients with heart failure (39,45) and coronary artery (52). Also in the study of Guallar-Castillon et al (53), 48.8% of heart failure patients had depression; the authors of this research believed that depression may prepare patients for other psychological factors and progresses the disease.…”

Fatigue in Patients with Chronic Heart Failure — A Burden Associated with Emotional and Symptom Distress

“…Fatigue is recognised as a prevalent and severe health problem in patients with chronic heart failure (CHF) [1,2]. Fatigue presents a number of serious threats to an individual's well-being, affecting both body and mind.…”