Fatigue and its related factors in patients with chronic heart failure

Aims and objectives. To understand fatigue in chronic heart failure patients and its related factors. Background. Fatigue is a common symptom in patients with chronic heart failure, but little is known about this phenomenon. Design. Correlational study. Methods. This correlational study sampled 107 chronic heart failure patients from a medical centre in northern Taiwan. Data were collected on objective outcomes (ejection fraction, EF; New York Heart Association classification, NYHA; beta-blocker use and haemoglobin, Hb) and subjective outcomes (depression and fatigue). Since the main outcome variable, fatigue, is multidimensional, it was measured by two scales: Lee's Fatigue Visual Analog Scale and a researcher-developed scale, the Tang Fatigue Rating Scale. Results. Subjects experienced a medium level of fatigue. Fatigue was significantly higher (p < 0·05) in females (226·6 SD 49·1) than males (203·0 SD 52·2) and in patients who took beta-blockers than those who did not (p < 0·01). Depression, EF and NYHA as a set explained 73% of the variance in subjects' fatigue. Subjects with greater depression, lower EF and worse NYHA experienced significantly higher fatigue (F = 76·50, p < 0·001). Conclusions. Fatigue for this sample of chronic heart failure patients was significantly predicted by depression, EF and NYHA. Additional research is needed to explore patterns of fatigue and its related factors over time. Relevance to clinical practice. In nursing care, psychological factors are as important as physiological factors to patients' well-being. Health care providers should therefore pay more attention to the psychological status of patients with chronic heart failure, thus helping them control their fatigue and improve their well-being.