The purpose of this partially mixed sequential dominant status study was to (a) describe fatigue in patients with
stable CHD; (b) determine if specific demographic (gender, age, education, income), physiological (hypertension,
hyperlipidemia), or psychological (depressive symptoms) variables were correlated with fatigue; and (c) determine if fatigue
was associated with health-related quality of life. The theory of unpleasant symptoms was used as a conceptual framework.
Methods: Patients (N = 102) attending two cardiology clinics completed the Fatigue Symptom Inventory, Patient Health
Questionnaire-9, and 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 with qualitative interviews. Compared with men,
women reported a higher fatigue intensity (p = .003) and more interference from fatigue (p = .007). In regression analyses,
depressive symptoms were the sole predictor of fatigue intensity and interference.
Discussion: Patients with stable CHD 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.
Key Words: coronary heart disease & fatigue & mixed methods
The purpose of this partially mixed sequential dominant status study was to (a) describe fatigue in patients with
stable CHD; (b) determine if specific demographic (gender, age, education, income), physiological (hypertension,
hyperlipidemia), or psychological (depressive symptoms) variables were correlated with fatigue; and (c) determine if fatigue
was associated with health-related quality of life. The theory of unpleasant symptoms was used as a conceptual framework.
Methods: Patients (N = 102) attending two cardiology clinics completed the Fatigue Symptom Inventory, Patient Health
Questionnaire-9, and 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 with qualitative interviews. Compared with men,
women reported a higher fatigue intensity (p = .003) and more interference from fatigue (p = .007). In regression analyses,
depressive symptoms were the sole predictor of fatigue intensity and interference.
Discussion: Patients with stable CHD 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.
Key Words: coronary heart disease & fatigue & mixed methods
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