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

Institute of Health and Care Sciences, The Sahlgrenska Academy at Göteborg University, Box 457, S-405 30 Göteborg, Sweden.
European Journal of Cardiovascular Nursing (Impact Factor: 1.88). 07/2007; 6(2):99-104. DOI: 10.1016/j.ejcnurse.2006.05.004
Source: PubMed


Fatigue is a common symptom in patients with chronic heart failure (CHF) and has a major impact on their daily life activities. The purpose of this study was to examine the prevalence and severity of fatigue, conceptualized as a multiple dimensional symptom, and to determine the influence of sense of coherence and uncertainty on the fatigue experience in patients with CHF.
Ninety-three consecutive patients, hospitalized with a diagnosis of CHF, completed the Multidimensional Fatigue Inventory Scale (MFI-20), Cardiovascular Population Scale (CPS), and Sense of Coherence Scale (SOC) and were classified according to the New York Heart Association (NYHA) functional classification criteria. Associations between selected variables were explored with multiple regression analysis.
The patients reported high prevalence and severity in the physical dimensions of fatigue. Uncertainty was associated positively with tiredness and reduced functional status. High age predicted reduced motivation and the ability to concentrate were affected by low SOC.
Fatigue is a prevalent and distressing experience in patients with CHF, where a variety of factors influence different dimensions of the fatigue experience. Recognising this, symptom management must be directed towards comprehensive assessment and a broad approach in interventions aimed at alleviating fatigue.

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    • "Fatigue is highly prevalent among CHF patients, and progression of CHF is on par with an increase in symptoms of fatigue.1,3,4,11 However, the evolution of fatigue over time is not the same for all patients with CHF. "
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    ABSTRACT: To identify distinct trajectories of fatigue over a 12-month period and to examine their impact on mortality in chronic heart failure (CHF). Consecutive CHF patients (n = 310) were assessed at baseline and at 2- and 12-month follow-up for symptoms of exertion and general fatigue. Latent growth mixture modelling was used to examine the course of fatigue over time. The endpoint was mortality following the 12-month assessment of fatigue. Over the initial 12-month follow-up, six distinct trajectories for exertion fatigue and four distinct trajectories for general fatigue were identified. Beyond the 12-month follow-up (mean follow-up period, 693 days), 50 patients (17%) had died. After controlling for standard risk factors and disease severity, both severe exertion fatigue [hazards ratio (HR) = 2.59, 95% confidence interval (CI): 1.09-6.16, P = 0.03] and severe general fatigue (HR = 3.20, 95% CI: 1.62-6.31, P = 0.001) trajectories predicted an increased mortality rate (29 vs. 19% and 28 vs. 14%, respectively). The low exertion fatigue trajectory was associated with a decreased mortality risk (3 vs. 19%, HR = 0.12, 95% CI: 0.02-0.93, P = 0.04). Fatigue trajectories varied across CHF patients and had a differential effect on mortality. Persistent severe fatigue was a predictor of poor prognosis. These results may help identify distinct groups of CHF patients with potentially differential risks of adverse health outcomes.
    European Journal of Heart Failure 08/2010; 12(8):841-8. DOI:10.1093/eurjhf/hfq075 · 6.53 Impact Factor
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    • "It is a common and complex symptom with wide-ranging implications for the fatigued patients lives (Ream & Richardson 1996) and is reported to be distributed continuously in the general population (Loge et al. 1998). Fatigue is associated with diseases such as MI (Brink et al. 2005; Appels et al. 1995; Pedersen & Middel 2001), chronic heart failure (Ekman & Ehrenberg 2002; Falk et al. 2007), multiple sclerosis (Flensner et al. 2003), chronic fatigue syndrome (Larun & Malterud 2007), and depression (Pedersen et al. 2007, Lee et al. 2000). It is also a common side effect of various cancer treatments (Smets et al. 1998; Stone et al. 2001; Ahlberg et al. 2005; Browall et al. 2008). "
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    ABSTRACT: ABSTRACT The aims of this thesis are to (1) explore the factors related to seeking care (Paper I), (2) describe the association between fatigue and selected symptoms (Paper II), (3) validate a method to detect the symptoms,(Paper III) and (4) evaluate home,care with respect to health-related quality of life (HRQL), medical safety, and cost-effectiveness in patients with worsening,chronic heart failure (CHF) (Paper IV). All studies utilise data on patients with worsened,CHF who sought care at the emer-
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