Predictors of fatigue in patients with heart failure

Aims and objectives: The purpose of this study was to examine the level of fatigue perceived by patients with heart failure and to explore the potential factors influencing fatigue. Design: A cross-sectional, correlational design was used. Methods: A convenience sample of 105 patients was recruited between July and September 2003 in northern Taiwan. The patients were interviewed, and their perceived fatigue was assessed with the modified Piper Fatigue Scale. The factors influencing fatigue were determined using a stepwise linear regression model. Results: The majority of patients with heart failure experienced mild-to-moderate fatigue. Patients with higher levels of fatigue had worse physical functioning and more severe symptomatic and psychological distress. Symptomatic distress, psychological distress (depression and anxiety), New York Heart Association class, activities of daily living (ADL) and appraisal support by health care providers could explain 57·4% of the total variance of fatigue. Symptomatic distress was the strongest predictor of fatigue. Conclusion: Higher levels of fatigue were found in patients with heart failure who had symptomatic or psychological distress. Additional research focusing on developing effective methods to reduce fatigue in patients with heart failure is recommended. Relevance to clinical practice: Nurses should help patients with heart failure to monitor their symptoms and report them to health care providers. Early management of symptoms and support by health care providers may reduce patients' fatigue, help maintain their physical functioning and improve their quality of life.