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Fatigue in patients with chronic obstructive pulmonary disease
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
2004 (English)In: Journal of Advanced Nursing, Vol. 45, no 2, 172-177 p.Article in journal (Refereed) Published
Abstract [en]

Background. Fatigue is a frequently occurring symptom in patients with chronic obstructive pulmonary disease (COPD). Despite this, relatively few studies have objectively assessed patients' perceptions of fatigue and the impact of perceived fatigue on their everyday lives.

Objective. The purpose of this study was to describe the prevalence, duration and severity of fatigue among patients with COPD and the impact of perceived fatigue on cognitive, physical and psychosocial functioning in comparison with controls.

Method. The Fatigue Impact Scale, including physical, psychosocial and cognitive dimension and structured questions about the frequency, duration, and severity of fatigue was mailed to 44 outpatients with COPD and 88 randomly selected age- and sex-matched controls. In total 36 patients and 37 controls completed the questionnaire.

Results. Almost half of the patients (47·2%), reported fatigue every day during the preceding month compared with 13·5% of the control group (P < 0·001). The duration of fatigue was more than 6 hours in 52·7% of the patients and 44·4% reported that fatigue was either the worst or one of the worst symptoms they had, compared with 18·9% (P < 0·001) and 10·8% (P < 0·01) in the control group. The patients reported a significantly greater impact of fatigue on cognitive, physical and psychosocial functioning compared with the control group (P < 0·001).

Conclusion. These findings indicate that fatigue is a highly prevalent symptom, which impacts on patients' functional condition and needs to be professionally assessed and managed.

Place, publisher, year, edition, pages
2004. Vol. 45, no 2, 172-177 p.
Keyword [en]
chronic obstructive pulmonary disease, fatigue, Fatigue Impact Scale, nursing
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-14291DOI: 10.1046/j.1365-2648.2003.02878.xOAI: oai:DiVA.org:liu-14291DiVA: diva2:23113
Available from: 2007-02-13 Created: 2007-02-13
In thesis
1. Fatigue, functional status, health and pulmonary rehabilitation in patients with chronic obstructive pulmonary disease
Open this publication in new window or tab >>Fatigue, functional status, health and pulmonary rehabilitation in patients with chronic obstructive pulmonary disease
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to describe fatigue, functional limitations due to fatigue and health in patients with chronic obstructive pulmonary disease (COPD), as well as to compare patients with individuals from the general population and to test if pulmonary rehabilitation can reduce fatigue and functional limitations, and thus improve health. A further aim was to test the Fatigue Impact Scale (FIS) among patients with COPD.

Two studies (I, II) had a descriptive comparative design with data from 36 and 151 patients with COPD respectively, and 37 and 95 individuals respectively, randomly selected from the general population. One study (III) was a randomised pre-test post-test study with 12 patients with COPD randomised to 12 weeks’ pulmonary rehabilitation and 14 patients in a control group. In a further study (IV), the FIS was tested for validity and reliability among 296 patients with COPD who reported fatigue.

Assessments: Structured questions frequency, duration and severity of fatigue, functional limitations due to fatigue with FIS, six minutes’ walking distance, hand grip strength, functional performance and satisfaction with Canadian Occupational Performance Measure and health with St George’s Hospital Respiratory Questionnaire and Short Form-36.

Almost half of the patients with COPD had a problem with fatigue every day and experienced fatigue as a severe symptom. More than 44% reported that fatigue was one of the worst symptoms. The experience of fatigue was related to the patients’ functional performance and health perceptions. Patients with COPD experienced a higher frequency, longer daily duration and greater severity of fatigue than individuals from the general population. After a 12 week pulmonary rehabilitation programme, there were no statistically significant differences between the patients randomised to the rehabilitation group and those in the control group. The patients in the rehabilitation group improved walking distances, performance and satisfaction with regard to their own selected activities compared with baseline.

Confirmatory factor analysis on the three-factor model proposed for FIS showed that the fit of the model was not acceptable. Further validation of the FIS resulted in a removal of 15 items (FIS-25) and support for Pipers´ theoretical framework of subjective manifestations of fatigue including physical, emotional and cognitive dimensions and a general behavioural factor. The internal consistency, sensitivity and stability correlations of FIS-25 were satisfactory.

In conclusion, fatigue is a major concern among patients with COPD, impacting on functioning and health. Interventions with 12 weeks’ pulmonary rehabilitation might not be effective enough to reduce fatigue and the functional limitations due to fatigue. More research is needed to solve the symptom burden of fatigue and its impact on functioning and health in patients with COPD.

Place, publisher, year, edition, pages
Institutionen för medicin och vård, 2007. 60 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 980
Keyword
chronic obstructive pulmonary disease, fatigue, functional status, health, pulmonary rehabilitation, Fatigue impact scale, confirmatory factor analysis
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-8268 (URN)978-91-85715-95-4 (ISBN)
Public defence
2007-02-16, Berzeliussalen, Hälsouniversitetet, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2007-02-13 Created: 2007-02-13 Last updated: 2009-05-15

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Theander, KerstiUnosson, Mitra

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