Strengths and Limitations
Although previous research has focused on determining if fatigue
predicts CHD in healthy individuals and the prevalence
of fatigue before and after AMI, this is the first study that specifically
describes fatigue in a stable CHD population. This
study is innovative in that the design included the use of mixed
methods, which combined validated quantitative measures
with in-depth qualitative interviews. The qualitative interviews
complemented findings from the quantitative instruments and
added rich descriptive details to the findings. Sampling an urban
and rural population resulted in ethnic and geographic diversity,
thus increasing the generalizability of findings. There
were limitations to this study including the use of a convenience
sample and the potential inclusion of patients with
undiagnosed heart failure. Differences in reports of fatigue intensity
between standardized instruments and interviews in
the low fatigue group may indicate that the FSI-interference
Scale is not as sensitive in individuals with lower interference
from fatigue.
Conclusion
Fatiguewas common in patients with stable CHD.Women experienced
a greater burden from fatigue compared with men,
and this was primarily because of the contribution of depressive
symptoms. The use of mixed methods was beneficial to
the study of fatigue in stable CHD and provided additional insight,
especially in participants who reported low interference
from fatigue. This study provides an important contribution to
understanding fatigue as a possible symptom of stable CHD;
however, these descriptive findings preclude determining if
fatigue is an indicator of new onset or progressive CHD. Future
research is needed to establish the mechanisms of fatigue
in this population. In addition, longitudinal studies are essential
to understand causal relationships between depression
and fatigue. Further study is also needed to examine the effectiveness
of interventions on reducing fatigue to improve
HRQoL in patients with stable CHD.
Strengths and Limitations
Although previous research has focused on determining if fatigue
predicts CHD in healthy individuals and the prevalence
of fatigue before and after AMI, this is the first study that specifically
describes fatigue in a stable CHD population. This
study is innovative in that the design included the use of mixed
methods, which combined validated quantitative measures
with in-depth qualitative interviews. The qualitative interviews
complemented findings from the quantitative instruments and
added rich descriptive details to the findings. Sampling an urban
and rural population resulted in ethnic and geographic diversity,
thus increasing the generalizability of findings. There
were limitations to this study including the use of a convenience
sample and the potential inclusion of patients with
undiagnosed heart failure. Differences in reports of fatigue intensity
between standardized instruments and interviews in
the low fatigue group may indicate that the FSI-interference
Scale is not as sensitive in individuals with lower interference
from fatigue.
Conclusion
Fatiguewas common in patients with stable CHD.Women experienced
a greater burden from fatigue compared with men,
and this was primarily because of the contribution of depressive
symptoms. The use of mixed methods was beneficial to
the study of fatigue in stable CHD and provided additional insight,
especially in participants who reported low interference
from fatigue. This study provides an important contribution to
understanding fatigue as a possible symptom of stable CHD;
however, these descriptive findings preclude determining if
fatigue is an indicator of new onset or progressive CHD. Future
research is needed to establish the mechanisms of fatigue
in this population. In addition, longitudinal studies are essential
to understand causal relationships between depression
and fatigue. Further study is also needed to examine the effectiveness
of interventions on reducing fatigue to improve
HRQoL in patients with stable CHD.
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