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Beta-Blocker Therapy and Symptom of Fatigue following Myocardial Infarction

Monday, 7 July 2008
Naglaa M. El Mokadem, PhD, RN , Nursing Program, Sultan Qaboos University, Al Khoud, Oman

Learning Objective 1: understand the symptoms of fatigue during the first six weeks after Myocardial Infarction

Learning Objective 2: understand the relationship between levels of fatigue and the beta-blocker therapy after Myocardial Infarction

Background and Significant: Beta-blocker therapy after Myocardial Infarction (MI) reduces mortality and reverses cardiovascular remodeling. Despite the substantial benefits of beta-blockers after MI there are concerns about their association with symptom of fatigue. Fatigue has been reported as a problem in day-to-day recovery of patients with MI interfering with the enjoyment of life. However, the extent to which beta-blockers contributes to the severity and the change in the pattern of fatigue during the first six weeks after MI is unknown.

Objectives: To examine the change in fatigue over time during the first six weeks of recovery after myocardial infarction (MI). Also, to determine to what extent do the dose of beta-blocker therapy contribute to the change in fatigue during the first six weeks after MI.

Design: A prospective, descriptive repeated measures design was used.

Sample: A convenience sample of 60 individual (mean age 54 years) with first time MI participated in the study.

Methods: Investigator interviewed the subjects face-to-face three times: third day of admission and two and six weeks after discharge.

Findings: Levels of fatigue significantly decreased over time. The main effect of time on fatigue was significant, F (1.7, 83.3) = 21.3, p < 0.00. Fatigue was moderately correlated with dose of beta-blockers therapy at time three, with subjects taking higher doses of beta-blocker therapy experiencing a higher level of fatigue.

Conclusion: Findings of the study showed that fatigue was significantly declined during the early recovery period. Fatigue was moderately correlated with beta-blocker therapy.

Implications: Developing practice guidelines and home-going discharge protocols should include specific approaches that take into account contextual factors. Treating at-risk patients with early interventions may be useful.

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