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Fatigue in older adults with stable heart failure

  • Sharon A. Stephen
    Correspondence
    Reprint requests: Sharon A. Stephen, RN, GNP, PhD, Gerontological Nurse Practitioner, Legacy Health System, Legacy Good Samaritan Clinics Geriatric Medicine, 1200 NW 23rd Avenue, Portland, OR 97210.
    Affiliations
    Oregon Health and Science University School of Nursing, Portland, Oregon.
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      Purpose

      The purpose of this study was to describe fatigue and the relationships among fatigue intensity, self-reported functional status, and quality of life in older adults with stable heart failure.

      Methods

      A descriptive, correlational design was used to collect quantitative data with reliable and valid instruments. Fifty-three eligible volunteers completed a questionnaire during an interview. Those with recent changes in their medical regimen, other fatigue-inducing illnesses, and isolated diastolic dysfunction were excluded.

      Results

      Fatigue intensity (Profile of Mood States fatigue subscale) was associated with lower quality of life, perceived health, and satisfaction with life. Fatigue was common, and no relationship was found between fatigue intensity and self-reported functional status. Marital status was the only independent predictor of fatigue.

      Conclusions

      In stable heart failure, fatigue is a persistent symptom. Clinicians need to ask patients about fatigue and assess the impact on quality of life. Self-reported functional status cannot serve as a proxy measure for fatigue.
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      References

        • Ekman I.
        • Fagerberg B.
        • Skoog I.
        The clinical implications of cognitive impairment in elderly patients with chronic heart failure.
        J Cardiovasc Nurs. 2001; 16: 47-55
        • American Heart Association
        Heart Disease and Stroke Statistics: 2006 Update.
        American Heart Association, Dallas, TX2006
        • Mayou R.
        • Blackwood R.
        • Bryant B.
        • Garnham J.
        Cardiac failure: symptoms and functional status.
        J Psychosom Res. 1991; 35: 399-407
        • Baker D.W.
        • Brown J.
        • Chan K.S.
        • Dracup K.A.
        • Keeler E.B.
        A telephone survey to measure communication, education, self-management, and health status for patients with heart failure: the Improving Chronic Illness Care Evaluation (ICICE).
        J Card Fail. 2005; 11: 36-42
        • Friedman M.M.
        • King K.B.
        Correlates of fatigue in older women with heart failure.
        Heart Lung. 1995; 24: 512-518
        • Oka R.K.
        • Stotts N.A.
        • Dae M.W.
        • Haskell W.L.
        • Gortner S.R.
        Daily physical activity levels in congestive heart failure.
        Am J Cardiol. 1993; 71: 921-925
        • Schaefer K.M.
        • Potylycki M.J.S.
        Fatigue associated with congestive heart failure: use of Levine’s Conservation Model.
        J Adv Nurs. 1993; 18: 260-268
        • Ekman I.
        • Ehrenberg A.
        Fatigued elderly patients with chronic heart failure: do patient reports and nurse recordings correspond?.
        Int J Nurs Terminol Classif. 2002; 13: 127-136
        • Friedman M.M.
        Gender differences in the health related quality of life of older adults with heart failure.
        Heart Lung. 2003; 32: 320-327
        • Zambroski C.H.
        • Moser D.K.
        • Bhat G.
        • Ziegler C.
        Impact of symptom prevalence and symptom burden on quality of life in patients with heart failure.
        Eur J Cardiovasc Nurs. 2005; 4: 198-206
        • Ekman I.
        • Ehrenberg A.
        Fatigue in chronic heart failure—does gender make a difference?.
        Eur J Cardiovasc Nurs. 2002; 1: 77-82
        • Schaefer K.M.
        A description of fatigue associated with congestive heart failure: use of Levine’s Conservation Model.
        in: Parker M. Nursing Theory in Practice. National League for Nursing, New York1990: 217-237
        • Painter L.M.
        Living with stage III heart failure: Dissertation Abstracts International. Doctoral dissertation.
        The Catholic University of America, Washington, D.C.2004
        • Winningham M.L.
        • Nail L.M.
        • Burke M.B.
        • et al.
        Fatigue and the cancer experience: the state of the knowledge.
        Oncol Nurs Forum. 1994; 21: 23-36
        • Swain M.G.
        Fatigue in chronic disease.
        Clin Sci. 2000; 99: 1-8
        • Nail L.M.
        Fatigue in patients with cancer.
        Oncol Nurs Forum. 2002; 29: 537-546
        • Aaronson L.S.
        • Teel C.S.
        • Cassmeyer V.
        • et al.
        Defining and measuring fatigue.
        Image J Nurs Sch. 1999; 31: 45-50
        • Meek P.M.
        • Nail L.M.
        • Barsevick A.
        • et al.
        Psychometric testing of fatigue instruments for use with cancer patients.
        Nurs Res. 2000; 49: 181-190
        • Dodd M.
        • Janson S.
        • Facione N.
        • et al.
        Advancing the science of symptom management.
        J Adv Nurs. 2001; 33: 668-676
        • University of California San Francisco School of Nursing Symptom Management Faculty Group
        A model for symptom management.
        Image J Nurs Sch. 1994; 26: 272-276
        • Gift A.G.
        • Pugh L.C.
        Dyspnea and fatigue.
        Nurs Clin North Am. 1993; 28: 373-384
        • Pennebaker J.W.
        Psychological factors influencing the reporting of physical symptoms.
        in: Stone A.A. The Science of Self-Report. Lawrence Erlbaum Associates, Publishers, Mahwah, NJ2000: 299-315
        • Prohaska T.R.
        • Keller M.L.
        • Leventhal E.A.
        • Leventhal H.
        Impact of symptoms and aging attribution on emotions and coping.
        Health Psychol. 1987; 6: 495-514
        • Pfeiffer E.
        A Short Portable Mental Status Questionnaire for the assessment of organic brain deficit in elderly patients.
        J Am Geriatr Soc. 1975; 23: 33-41
        • McNair D.M.
        • Lorr M.
        • Droppleman L.F.
        EdiITS manual for the Profile of Mood States.
        EdITS/Educational and Industrial Testing Service, San Diego, CA1992
        • Hawthorne M.H.
        • Hixon M.E.
        Functional status, mood disturbance and quality of life in patients with heart failure.
        Prog Cardiovasc Nurs. 1994; 9: 22-32
        • Gift A.G.
        Visual analogue scales: measurement of subjective phenomena.
        Nurs Res. 1989; 38: 286-288
        • Nail L.M.
        Symptom Checklist.
        1991 (Available from L. M. Nail, Oregon Health & Science University, Portland, OR)
        • Andrea H.
        • Kant I.J.
        • Beurskens A.J.
        • Metsemakers J.F.
        • Van Schayck C.P.
        Associations between fatigue attributions and fatigue, health, and psychosocial work characteristics: a study among employees visiting a physician with fatigue.
        Occup Environ Med. 2003; 60: i99-i104
        • Dracup K.
        • Walden J.A.
        • Stevenson L.W.
        • Brecht M.L.
        Quality of life in patients with advanced heart failure.
        J Heart Lung Transplant. 1992; 11: 273-279
        • Dunbar S.B.
        • Jenkins L.S.
        • Hawthorne M.
        • Porter L.S.
        Mood disturbance in patients with recurrent ventricular dysrhythmia before insertion of implantable cardioverter defibrillator.
        Heart Lung. 1996; 25: 253-261
        • Rector T.S.
        • Cohn J.N.
        • Pimobendan Multicenter Research Group
        Assessment of patient outcome with the Minnesota Living with Heart Failure questionnaire: reliability and validity during a randomized, double-blind, placebo-controlled trial of pimobendan.
        Am Heart J. 1992; 124: 1017-1025
        • Diener E.
        • Emmons R.A.
        • Larsen R.J.
        • Griffin S.
        The Satisfaction with Life Scale.
        J Pers Assess. 1985; 49: 71-75
        • Watson D.
        • Clark L.A.
        • Tellegen A.
        Development and validation of brief measures of positive and negative affect: the PANAS scales.
        J Pers Soc Psychol. 1988; 54: 1063-1070
      1. Statistical Package for the Social Sciences [computer program].
        SPSS Inc., Chicago, IL1997
        • Chryssanthopoulos S.N.
        • Dritsas A.
        • Cokkinos D.V.
        Activity questionnaires; a useful tool in accessing heart failure patients.
        Int J Cardiol. 2005; 105: 294-299
        • Stephen S.
        • Nail L.M.
        Age-related differences in perceived fatigue in persons receiving treatment for cancer.
        1997 (Paper presented at: Western Institute of Nursing, Portland, OR)
        • Barsevick A.M.
        • Whitmer K.
        • Nail L.M.
        • Beck S.L.
        • Dudley W.N.
        Symptom cluster research: conceptual, design, measurement, and analysis issues.
        J Pain Symptom Manage. 2006; 31: 85-95
        • Friedman M.M.
        Older adults’ symptoms and their duration before hospitalization for heart failure.
        Heart Lung. 1997; 26: 169-176
        • Chen M.K.
        The epidemiology of self-perceived fatigue among adults.
        Prev Med. 1986; 15: 74-81
        • Luttik M.L.
        • Jaarsma T.
        • Veeger N.
        • van Veldhuisen D.J.
        Marital status, quality of life, and clinical outcome in patients with heart failure.
        Heart Lung. 2006; 35: 3-8
        • Yu D.S.
        • Lee D.T.
        • Woo J.
        • Thompson D.R.
        Correlates of psychological distress in elderly patients with congestive heart failure.
        J Psychosom Res. 2004; 57: 573-581
        • Konstam V.
        • Salem D.
        • Pouleur H.
        • et al.
        Predicting mortality and hospitalization in 5,025 patients with heart failure utilizing baseline quality of life.
        Congest Heart Fail. 1998; 4: 31-37