| Description |
Although fatigue is a common and troublesome symptom of chronic heart failure (CHF), studies on CHF symptoms have not focused on fatigue. The purpose of this research was to describe fatigue and the relationships among intensity of fatigue, demographic and clinical variables, and functional status in older adults with CHF. The approach to measuring fatigue was based on the fatigue literature in cancer patients, which proposed that fatigue is a self-perceived state and should be measured by self-report. Instruments with established reliability and validity were used to measure fatigue in this descriptive and correlational study: (a) Profile of Mood States (POMS-F), (b) visual analogue scale (VAS-F), (c) functional status (Heart Failure Functional Status Inventory (HFFSI), (d) trait-negative affectivity (Positive and Negative Affect Schedule [PANAS]), (e) symptoms (a symptom checklist), and (f) overall life satisfaction (Satisfaction With Life Scale [SWLS]). Older adults (at least 65 years) with stable CHF and documented systolic dysfunction were enrolled (N = 53). Those with recent changes in their medical regimen, other fatigue-inducing illnesses, and isolated diastolic dysfunction were excluded. The prevalence of fatigue was 96% when measured by the POMS-F and 100% when measured by the VAS-F. The mean POMS-F was 11.5 (SD = 3.8), and the mean VAS-F was 51.8 (SD = 19.3). No significant differences were found in fatigue based on gender. Fatigue (POMS-F) was associated positively and significantly with the New York Heart Association classification, trait-negative affectivity, marital status, perceived health, and symptom severity. In addition, fatigue was associated negatively and significantly with life satisfaction. No relationship was found between fatigue and self-reported activity level. A hierarchical multiple regression model, using six independent variables, explained 50% of the variance of fatigue. Trait-negative affectivity and being married were significant predictors of fatigue. Future studies are needed to describe the patterns of fatigue, determine other correlates of fatigue, and explain how marital status influences fatigue. This study provides background research needed to develop and test interventions aimed at reducing CHF-related fatigue. The findings that fatigue was not related to self-reported activities challenge common assumptions about proxy measures and approaches to clinical assessment. |
