Learning Objective #1: Examine the changes in fatigue, depression, and sleep disturbance in patients with myocardial infarction during the first six weeks of recovery

Learning Objective #2: Determine the extent to which selected physiological, psychological, and situational variables influence those recovery symptoms

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Objectives: To examine the relationships between fatigue, depression, and sleep disturbance during the first six weeks of recovery after Myocardial Infarction (MI). Also, the changes in fatigue, depression, and sleep disturbance over time and weather or not physiological variables of left ventricular function, cardiac functional status, and beta-blockers therapy; psychological variables of patients' perception of the severity of coronary artery diseases, and anxiety level; and situational variables of age, gender, and marital status contribute to changes in these symptoms was determined. Design: A prospective, descriptive repeated measures design was used Sample: A convenience sample of 51 individual (mean age 54 years) with first time MI Methods: Investigator interviewed the subjects face-to-face in coronary care unit three times: third day of admission and at two and six weeks after discharge Findings: Moderate to strong relationships were found between fatigue, depression, and sleep disturbance at all measurement points. Levels of fatigue and sleep disturbance significantly decreased over time, these decrease did not hold when controlling for the physiological, psychological, and situational covariates, suggesting that these symptoms are influenced by these covariates. There were no statistically significant changes in depression over time, although the reduction in depression scores was clinically significant Conclusion: Findings of the study showed that fatigue, depression, and sleep disturbance are correlated in MI patients during the first six weeks of recovery. Recovery symptoms of fatigue and depression were significantly declined during the early recovery period. Implications: Managing a constellation of symptoms may be fruitful approach. 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. Studying symptoms in a textual fashion is important. The study findings support the Theory of Unpleasant Symptoms as a useful theory.