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Fatigue is a common and debilitating symptom linked to a number of acute and chronic conditions such as chronic heart failure and acute myocardial infarction. Fatigue has not been analyzed in regards to patients with stable coronary heart disease (CHD), despite the fact that it might factor into new onsets or progression of CHD. Therefore, Eckhardt et al. (2014) decided that it was important to establish the severity of fatigue and its characteristics in a stable CHD population. There were three main purposes of the study conducted by these researchers, one of which was to describe fatigue in stable CHD patients. Moreover, Eckhardt et al. (2014) intended to determine whether certain demographic, physiological, or psychological variables were in correlation with fatigue. Finally, they aimed at identifying whether fatigue was related to health-related quality of life.
Five people are cited as the authors of the research: Ann L. Eckhardt, Holli A. DeVon, Mariann R. Piano, Catherine J. Ryan, and Julie J. Zerwic. All of them have the credentials of PhD and RN. Ann L. Eckhardt is affiliated with School of Nursing at Illinois Wesleyan University in Bloomington where she holds the position of Assistant Professor. The other four researchers are affiliated with Department of Biobehavioral Health Science, College of Nursing at University of Illinois in Chicago. Holli A. DeVon is Associate Professor, Mariann R. Piano is Professor and Department Head, Catherine J. Ryan is Clinical Assistant Professor, and Julie J. Zerwic is Professor and Executive Associate Dean there.
When it comes to the operational definition of fatigue, it was described by the researchers as the subjective feeling of extreme and constant exhaustion, weariness, and energy deprivation. Conceptually, fatigue was compared to pain on the grounds of its multidimensionality, exposure to physical and psychosocial factors, and presence of common characteristics with some mood and anxiety disorders. Moreover, it was noted that in CHD patients, fatigue is a prevalent symptom associated with weakness, reduced physical activity, and poor life quality.
The study utilized a partially mixed sequential dominant status research design. According to Eckhardt et al. (2014), in their work, the main design of the study was quantitative, followed by a qualitative element. This mixed-method structure was chosen to ensure complementarity, which aims at achieving convergence of quantitative and qualitative results and providing descriptive depth with the help of qualitative interviews. First occurred the collection of the cross-sectional quantitative data, after which participants were selected from this sample for the qualitative element. Qualitative and quantitative data were integrated at the stages of data analysis and discussion.
Statistical analysis of data occurred with quantitative components; the Statistical Package for the Social Sciences was used for it. Eckhardt et al. (2014) report that a nominal alpha level of <.05 was selected for the outcomes to be statistically significant. For the analysis of demographic data and fatigue distinguished by gender, Chi-squared independence tests and independent samples t tests were utilized. The identification of factors connected to fatigue was conducted with the employment of Pearson’s correlation and Spearman’s rank correlation coefficient. Predictors of fatigue were determined with the use of multiple regression.
One hundred and two patients with stable CHD were the participants of this study. Eckhardt et al. (2014) recruited them during routine medical appointments from two cardiology clinics. One clinic mainly served urban minority patients (n = 51), and the other mainly served Caucasian patients from a small rural town (n = 51). Eligibility was decided on by the examination of medical records. Inclusion criteria involved a stable CHD diagnosis, the ability to speak and read English, and independent living. Exclusion criteria involved heart failure with reduced ejection fraction, coronary artery bypass grafting or myocardial infarction in the previous 2 months, and incurable disease with prediction to live for less than 6 months. In addition to that, patients with symptoms related to worsened or exacerbated cardiac disease, unstable angina, and hemodialysis were excluded from participation. Such exclusion criteria were due to the elimination of patients with a recent acute episode, new or worsening CHD symptoms, and co-occurring conditions known to be related to significant fatigue. The institutional review boards of both unspecified sites approved the study, and all participants gave their written informed consent.
In terms of variables, the independent ones were various demographic (gender, age, race, employment), physiological (myocardial infarction, hypertension, diabetes), and psychological (depressive symptoms) factors. The dependent variable was the correlation of fatigue interference and intensity with the independent variables. Eckhardt et al. (2014) used the term ‘variables’ in regards to the independent ones; however, there was no mention of variables being independent or dependent. One specific relationship that was being investigated by the authors of the study was this between fatigue and depressive symptoms. Eckhardt et al. (2014) found that the occurrence of depressive symptoms was the only predictor of interference and intensity of fatigue among the potential fatigue contributors. This was a non-experimental study because it took place in real-life settings, and the researchers controlled neither the environment nor the variables. Finally, there were no interventions, which means that no changes were made in a study in order to study the outcomes.
This study is relevant to the actual practice of nursing due to it providing data about fatigue in stable CHD patients, which has not been done before. Therefore, specialists are able to learn more about this phenomenon and start developing strategies to facilitate the lives of people with stable CHD struggling with the condition. Eckhardt et al. (2014) provided all basic information in their study’s abstract, and divided it into sections for it to be easier perceived. The abstract speaks about background, objectives, methods, results, and discussion, and lists key words. From my perspective, the study must have taken several months to be completed. I came to that conclusion having taken into account the participant sample and the fact that the data gathered from questionnaires, inventories, and interviews had to be analyzed and systematized. If I could ask the authors a question about their research, I would ask them what they believe the best solution on the basis of the study’s outcomes could be.
In conclusion, Eckhardt et al. (2014) conducted their study to explore fatigue in people with stable CHD. The researchers recruited one hundred and two participants from two unspecified cardiology clinics and employed a partially mixed sequential dominant status design. This work is an important contribution to the understanding of the phenomenon of fatigue in stable CHD patients. Further research is needed to explore the effectiveness of various interventions to facilitate the lives of people struggling with the problem and increase their health-related quality of life.
Reference
Eckhardt, A. L., DeVon, H. A., Piano, M. R., Ryan, C. J., & Zerwic, J. J. (2014). Fatigue in the presence of coronary heart disease. Nursing Research, 63(2), 83-93. Web.
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