The Experience of Fatigue among Elderly Women with Chronic Heart Failure

Abstract

Background: Fatigue is a common and distressing symptom in chronic heart failure (CHF). Most of the current methods for evaluating patients' symptoms fail to consider the meaning or importance that these symptoms have for the patient. Aim: To illuminate the lived experience of fatigue among elderly women with CHF. Method: Narrative interviews were conducted with 10 women with CHF, aged 73-89 years. Interviews were analysed with qualitative content analysis. Results: The findings are presented in two themes and five subthemes. The first theme, 'living with the loss of physical energy', was based on three subthemes describing the experience of fatigue: 'experiencing a substantial presence of feebleness and unfamiliar bodily sensations', 'experiencing unpredictable variations in physical ability', and 'needing help from others in daily life'. The second theme, 'striving for independence while being aware of deteriorating health', describes how the women managed their life situation; it was based on two subthemes: 'acknowledging one's remaining abilities', and 'being forced to adjust and struggle for independence'. Conclusions: Fatigue was experienced as loss of physical energy, leading to discrepancies between intention and capacity. The will to reduce dependency on others involved a daily struggle against fatigue.

The experience of living with chronic heart failure: a narrative review of qualitative studies

“…Some studies had a specific focus in the context of the experience of CHF, including: adherence to self care/self-management [24-28]; quality of life and spirituality [29,30]; specific types of care or care settings such as palliative care [31], nurse led clinic [22], nursing home [32] and hospital care [33]; gender differences or gender specific [32,34-40]; cultural diversity or specific ethnicity [23,24,41]; health seeking behaviour [39]; and fatigue [36,42]. …”

“…The use of diuretics to address excess body fluid, for example, produced urgency and frequency of urination leading to sleep deprivation and preventing people from leaving home and/or socialising [24,43]. Fatigue, often accompanied by weakness and unpredictable variations in physical ability, sometimes caused by medication, had similar implications for social isolation by reducing patients' abilities to participate in recreation and leisure [35,36,42,44]. Travelling, for example, proved too strenuous for many people with CHF and resulted in patients feeling like prisoners in their own homes [42].…”

To adjust and endure: a qualitative study of symptom burden in older people with multimorbidity

“…Lack of energy or fatigue have been shown to be highly prevalent symptoms among people with chronic diseases ; symptoms with an impact on both cognitive, physical and psychosocial functioning in the everyday lives of older people with heart failure and COPD Unosson 2004, Aldred et al 2005). Older people experiencing fatigue could also be at risk of suffering from depression (Hägglund et al 2008). …”

Psychometric Evaluation of the Patient-Reported Outcomes Measurement Information System Fatigue-Short Form Across Diverse Populations

“…At such levels, fatigue can be overwhelming, debilitating, and lead to a sustained sense of exhaustion (DeWalt, Rothrock, Yount, & Stone, 2007; Junghaenel, et al, 2011). In fact, the experience of fatigue has been described by patients as “living with a loss of physical energy” that engulfs the whole body (Hägglund, Boman, & Lundman, 2008); out of balance with one’s physical and mental state that “drains life” from the body and fatigues the brain (Hodge, Itty, Cadogan, Martinez, & Pham, 2016); and having substantial negative consequences for daily life (Hägglund et al, 2008; Mengshoel, 2010). …”