Heart & Lung: The Journal of Acute and Critical Care
Volume 37, Issue 4 , Pages 245-256, July 2008

Relationships between fatigue and early postoperative recovery outcomes over time in elderly patients undergoing coronary artery bypass graft surgery

  • Susan Barnason, PhD, RN, CCRN, CEN, CS

      Affiliations

    • University of Nebraska Medical Center, Lincoln, Nebraska
    • College of Nursing-Lincoln Division, Lincoln, Nebraska
    • Corresponding Author InformationCorresponding author: Sue Barnason, PhD, RN, University of Nebraska Medical Center, College of Nursing-Lincoln Division, 1230 “O” Street, STE 131, PO Box 880220, Lincoln, NE 68588–0220
  • ,
  • Lani Zimmerman, PhD, RN

      Affiliations

    • University of Nebraska Medical Center, Lincoln, Nebraska
    • College of Nursing-Lincoln Division, Lincoln, Nebraska
  • ,
  • Janet Nieveen, PhD, RN

      Affiliations

    • University of Nebraska Medical Center, Lincoln, Nebraska
    • College of Nursing-Lincoln Division, Lincoln, Nebraska
  • ,
  • Paula Schulz, MSN, RN

      Affiliations

    • College of Nursing-Lincoln Division, Lincoln, Nebraska
  • ,
  • Connie Miller, PhD, RN

      Affiliations

    • College of Nursing-Omaha Division, Omaha, Nebraska.
  • ,
  • Melody Hertzog, PhD

      Affiliations

    • College of Nursing-Lincoln Division, Lincoln, Nebraska
  • ,
  • Doris Rasmussen, MSN, RN

      Affiliations

    • College of Nursing-Lincoln Division, Lincoln, Nebraska

Background

Despite successful coronary artery bypass graft (CABG) surgery, some patients continue to experience fatigue after their surgery.

Objective

The purpose of this secondary analysis study was to examine the relationships of fatigue and early recovery outcomes (psychosocial and physiologic functioning, and physical activity) over time (6 weeks and 3 months) among older adult subjects, age 65 years and older, after CABG surgery. Comparison groups were those subjects who had fatigue at 3 weeks after surgery and nonfatigued subjects.

Design

A prospective, comparative design was used for this secondary analysis study.

Sample

Subjects in this study were drawn from the control group of subjects enrolled in the larger parent study. Subjects (N = 119) were dichotomized into fatigue (n = 66) and nonfatigued (n = 53) groups on the basis of their 3-week self-reports of postoperative fatigue.

Results

At 6 weeks after surgery, fatigued subjects had significantly (P < .05) more impaired psychosocial functioning (role-emotional [t = 1.9], social [t = 2.6], and mental [t = 1.9] functioning) on the basis of the Medical Outcome Study Short Form 36. They had significantly (P < .005) higher mean hospital anxiety (t = −3.6) and depression (t = −2.9) subscale scores, respectively. Anxiety (t = −2.3, P < .05) remained significantly (P < .05) impaired at 3 months. At 6 weeks, role physical functioning, measured by the Medical Outcome Study Short Form 36, was significantly impaired (t = 2.4, P < .01). There were no significant differences in physical activity variables as measured by an RT3 accelerometer (Stayhealthy, Inc., Monrovia, CA) and self-report diary.

Conclusions

Persistent fatigue can hamper early recovery after CABG surgery. Tailored interventions are needed to address fatigue management and improve patient outcomes.

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 This study was funded by National Institutes of Health/National Institute of Nursing Research R01 NR007759.

PII: S0147-9563(07)00166-5

doi:10.1016/j.hrtlng.2007.09.003

Heart & Lung: The Journal of Acute and Critical Care
Volume 37, Issue 4 , Pages 245-256, July 2008