Predictors of Fatigue in Patients with Stable Coronary Disease

Friday, 3 August 2012: 9:10 AM

Michelle M. Fennessy, PhD, APRN, BC1
Holli A. DeVon, PhD, RN1
Catherine Ryan, PhD, RN2
Julie Johnson Zerwic, PhD, RN2
(1)Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA
(2)College of Nursing, University of Illinois at Chicago, Chicago, IL

Learning Objective 1: The learner will identify symptom patterns of fatigue in patients with stable coronary disease.

Learning Objective 2: The learner will identify predictors of fatigue after adjusting for gender, depressed mood, age, and prior history of heart failure.

Purpose: Fatigue is a pervasive problem in cardiovascular populations; however, there is limited research examining symptom patterns and predictors of fatigue in patients with stable coronary disease (CAD).  The purpose of this study was to evaluate whether fatigue was predicted by gender, depressive symptoms, age, and prior history of heart failure.  Leventhal’s self-regulation model was used as the conceptual basis for this study.

Methods: In this prospective design, a convenience sample of patients (n=180) with stable CAD were recruited after treatment.  Data collection occurred during hospitalization at baseline (post procedure) and 30-days after discharge using mailed surveys.  At 30-days, 52.8% of surveys were returned (men n=74, women n=21).  Measurements included the Profile of Mood States (POMS) for fatigue (POMS-F) and depressed mood (POMS-D).  Patient mood responses reflected the 7-day period prior to each of the measured time points. 

Results: Regression models were constructed to evaluate predictors of fatigue for patients at baseline (n=180, f=12.65, df=4; r2=.224, p<.01) and 30-days (n=95, f=10.02, df=4, r2=.308, p<.01).  At baseline, gender (beta=.257, p<.01) and depressed mood (beta=.425, p<.01) were predictors of fatigue, with higher fatigue scores in women (M=14.8, SD=6.3) compared to men (M=12.1, SD=6.4).  By 30-days, gender was no longer significant (beta=.055, p=.547; POMS-F scores women: M=5.8, SD=5.7; men: M=5.1, SD=3.8); however, depressed mood remained a predictor of fatigue (beta=.286, p=.005). Age and prior history of heart failure were not significant predictors at either time point. POMS-F normative scores are M=8.7, SD=6.1 for women and M=7.3, SD=5.7 for men.

Conclusion: Women demonstrated higher fatigue scores within the week prior to treatment. Men and women differ in their levels of fatigue prior to treatment for stable CAD.  Our results complement research from patients with acute myocardial infarction, which demonstrated gender differences in the presence of fatigue prior to acute events.  Future research should focus on the severity and etiology of fatigue in this population.