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Fatigue is a prevalent and disabling symptom associated with many acute and chronic conditions. It has been identified as a symptom of acute myocardial infarction and chronic heart failure, but it has not been explored in patients with stable coronary heart disease (CHD). Objectives: The purpose of this partially mixed sequential dominant status study was to: 1) describe fatigue in patients with stable CHD, 2) determine if specific demographic (sex, age, education, income), physiologic (hypertension, hyperlipidemia) or psychological variables (depressive symptoms) were correlated with fatigue, and 3) determine if fatigue was associated with health-related quality of life. The theory of unpleasant symptoms was used as a conceptual framework to guide the study design and aims. Methods: Patients (N =102) attending two cardiology clinics were enrolled and completed the Fatigue Symptom Inventory, Patient Health Questionnaire-9, and the Medical Outcomes Study Short Form-36 to measure fatigue, depressive symptoms, and health-related quality of life. Thirteen patients whose interference from fatigue was low, moderate, or high participated in qualitative interviews. Results: Forty percent of the sample reported fatigue more than 3 days of the week lasting more than one-half of the day. Lower interference from fatigue was reported on standardized measures compared to qualitative interviews. Women reported a higher fatigue intensity (t = 2.27; p = 0.003) and more interference from fatigue (t = 2.74; p = 0.007) compared to men. In regression analyses, depressive symptoms were the sole predictor of fatigue intensity and interference. Discussion: Stable CHD patients reported clinically relevant levels of fatigue. Patients with stable CHD may discount fatigue as they adapt to their symptoms. Relying solely on standardized measures may provide an incomplete picture of fatigue burden in patients with stable CHD.


Cardiovascular Diseases | Nursing