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I've lost the person I used to be-Experiences of the consequences of fatigue following myocardial infarction
Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på avancerad nivå.ORCID-id: 0000-0003-0339-2671
Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för vårdvetenskap på grundnivå. Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå.ORCID-id: 0000-0001-8291-7223
Högskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för specialistsjuksköterskeutbildning.ORCID-id: 0000-0001-7804-0342
2013 (engelsk)Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 8, s. 20836-Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Fatigue has been found to be the most frequent and bothersome symptom after myocardial infarction (MI), influencing health-related quality of life negatively. Moreover, fatigue after MI has been described as incomprehensible due to its unpredictable occurrence and lack of relationship to physical effort. The aim of this study is therefore to explore persons' experiences of consequences of fatigue and their strategies for dealing with it 2 months after MI. In total, 18 informants, aged 42-75 years, participated in the study. Interviews were conducted and analysed using constructivist grounded theory methodology. Grounded in the data, the main consequence of fatigue, as illustrated in the core category, was: I've lost the person I used to be. It indicates a sense of reduced ability to manage daily life due to experiences of fatigue. The core category was developed from the four categories: involuntary thoughts, certainties replaced with question marks, driving with the handbrake on and just being is enough. Furthermore, attempts to relieve fatigue were limited. These findings indicate that patients with symptoms of fatigue should be supported in developing relief strategies, for example, rest and sleep hygiene as well as physical activity. In conclusion, the results show that fatigue can be understood in light of the concepts "comprehensibility" and "manageability." They also indicate that, working from a person-centered perspective, health-care professionals can support patients experiencing post-MI fatigue by giving them opportunities to straighten out the question marks and by inviting them to discuss involuntary thoughts and feelings of being restricted in their daily life functioning.

sted, utgiver, år, opplag, sider
2013. Vol. 8, s. 20836-
Emneord [en]
Fatigue, grounded theory, myocardial infarction, symptom experience, person-centered care, sense of coherence, chronic heart-failure, quality-of-life, coherence, sense
HSV kategori
Forskningsprogram
VÅRD- OCH HÄLSOVETENSKAP, Vårdvetenskap
Identifikatorer
URN: urn:nbn:se:hv:diva-5570DOI: 10.3402/qhw.v8i0.20836ISI: 000320441000001Scopus ID: 2-s2.0-84880267563OAI: oai:DiVA.org:hv-5570DiVA, id: diva2:642581
Tilgjengelig fra: 2013-08-22 Laget: 2013-08-13 Sist oppdatert: 2019-03-12bibliografisk kontrollert
Inngår i avhandling
1. Fatigue och återhämtning efter hjärtinfarkt
Åpne denne publikasjonen i ny fane eller vindu >>Fatigue och återhämtning efter hjärtinfarkt
2015 (svensk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Fast and efficient acute medical treatment of myocardial infarction (MI) has developed during recent years and has resulted in a reduced number of days spent in hospital and increased survival. To optimize persons’ recovery, secondary preventive strategies are important. Fatigue has been reported to be the most bothersome symptom in 50% of persons treated for MI and was described as incomprehensible due to its unpredictable occurrence and unknown cause. Today, in cardiac rehabilitation programs there are typically few or no recommendations at all concerning strategies for dealing with fatigue after MI. The main focus was to explore how self-reported fatigue after MI could be measured in a psychometrically valid manner and to describe the symptom of fatigue in relation to other concurrent symptoms, how the heart attack was handled and its consequences in everyday life two months after MI. With a view to creating opportunities to identify and measure fatigue post-MI, the first specific aim was to validate the usefulness of the questionnaire Multidimensional Fatigue Inventory-20 (MFI-20). A psychometric method called Rasch analysis was used. The results showed that the MFI-20 can be used to obtain a global score reflecting an underlying unidimensional trait of fatigue; and transformation of the summarized raw scale scores into interval scale scores was possible. Also, four of the five original dimensions separately fitted the Rasch model and could be used to identify general fatigue, physical fatigue, mental fatigue and reduced activity. One of the specific aims was to examine persons’ experiences of fatigue consequences and strategies used to manage fatigue two months after the heart attack. Interviews were conducted (n= 18) and analyzed using constructivist grounded theory methodology. Grounded in the data, the main consequence of fatigue, as illustrated in the core category was I’ve lost the person I used to be. It indicates a sense of reduced ability to manage daily life due to experiences of fatigue. The core category was developed from the four categories: involuntary thoughts, certainties replaced with question marks, driving with the handbrake on and just being is enough. Another specific aim was to explore fatigue levels two months after myocardial infarction (MI) and examine associations with other concurrent symptoms, sleep quality and the coping strategies used to handle the MI. The results showed that a global fatigue score two months post-MI was associated with concurrent symptoms, such as breathlessness and stress, and coping strategies, such as change of values, intrusion, and isolation. In comparisons of present fatigue dimension levels (general fatigue, physical fatigue, reduced activity and mental fatigue) two months post-MI and baseline measurements (first week in hospital), the results showed that levels of fatigue dimensions had decreased. In comparisons with levels of fatigue four months post-MI in a reference group, we found lower levels of fatigue two months post-MI. In the final study, the aim was to validate a single-item measure of stress symptoms and to explore its association with fatigue in a sample of persons treated for MI. The results confirmed the convergent validity of the single-item measure of stress symptoms. In analyses of relations between stress and fatigue, it was found that the single-item stress measure was strongly associated with both the global fatigue score and all four fatigue dimension scores (general, physical and mental fatigue as well as reduced activity). In conclusion, fatigue two months post-MI had significant consequences because it restricted informants’ potential to function in daily life as they had done previously. The present thesis showed that post-MI fatigue could be identified both globally and multidimensionality. The results could serve as the basis for a future recovery intervention aimed at preventing and relieving post-MI fatigue and based on managing daily life in relation to personal experiences. By facilitating identification of fatigued persons using quantitative measurements and personal narratives about the consequences of fatigue, such an intervention would enable health-care professionals to tailor fatigue relief support during the recovery period. Elaboration of this intervention is a question for further research.

sted, utgiver, år, opplag, sider
Göteborg: Institutionen för vårdvetenskap och hälsa vid Sahlgrenska akademin, Göteborgs universitet, 2015. s. 57
Emneord
Coping strategies, fatigue, grounded theory, myocardial infarction, nursing, person-centeredness, psychometric evaluation, Rasch analysis, stress, symptom assessment, symptom experience, symptom research, The Multidimensional Fatigue Inventory-20 (MFI-20)
HSV kategori
Forskningsprogram
VÅRD- OCH HÄLSOVETENSKAP, Vårdvetenskap
Identifikatorer
urn:nbn:se:hv:diva-7636 (URN)9789162893248 (ISBN)978-91-628-9325-5 (ISBN)
Veileder
Tilgjengelig fra: 2015-06-01 Laget: 2015-06-01 Sist oppdatert: 2015-06-01bibliografisk kontrollert

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