Fatigue in patients with chronic heart failure—a burden associated with emotional and symptom distress
Abstract
BACKGROUND: The relationship between experience of fatigue and emotional and symptom distress in chronic heart failure (CHF) needs to be thoroughly explored, because fatigue has major impact on daily activities in life. AIMS: The purpose was to examine the association between fatigue, as a multidimensional experience and anxiety, depression and symptom distress, and to explore the relationships between individual symptoms and the dimensions of fatigue in patients with CHF. METHODS: A consecutive sample of 112 patients with exacerbation of symptoms of CHF answered the Multidimensional Fatigue Inventory (MFI-20), the Hospital Depression and Anxiety (HAD) Scale and the Symptom Distress Scale (SDS). RESULTS: Anxiety was associated with mental fatigue, whereas depression was associated with reduction of activity, low motivation and decreased functioning. Physical fatigue was affected by symptom distress, with women reporting more distress than men. With exception of breathlessness, poor agreement was found between fatigue and the most intensive reported symptoms. CONCLUSIONS: The relationship between emotional distress and the experience of fatigue in patients with CHF may have a devastating affect on the patient's ability to cope and manage daily activities, including self-care and adherence to recommended treatment.
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Even mild symptoms of CHF can directly worsen patients' ability to manage daily activities including self-care and adherence to recommended treatment.
“Even mild symptoms of CHF can directly worsen patients' ability to manage daily activities including self‐care and adherence to recommended treatment. 14”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [14]
The Discussion (page unavailable) reports that less intense symptoms were associated with fatigue and links fatigue and depressed mood to difficulty with daily activities. It also suggests that patients with depressed mood and fatigue may be at risk of not adhering to treatment or managing symptoms properly. It does not establish that mild CHF symptoms directly cause impaired self-care or treatment adherence. (LLM, conf=0.84)
Experimental — accuracy not yet measuredDespite not being validated in CHF, the 20-item Multidimensional Fatigue Inventory has been frequently utilized in CHF studies.
“Despite not being validated in CHF, the 20‐item Multidimensional Fatigue Inventory has been frequently utilized in CHF studies. 14 , 47”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [14]
Section 2.3 (page not supplied) identifies the MFI-20 as a 20-item instrument, uses it in this CHF study, and mentions two other CHF studies. It does not establish that use was frequent or state that the instrument had not been validated in CHF; it reports internal-consistency results, which do not settle that validation claim. (LLM, conf=0.84)
Experimental — accuracy not yet measuredWith CHF predominantly affecting the elderly, fatigue is often dismissed as a consequence of ageing and deconditioning and is therefore poorly recognized or explored.
“With CHF predominantly affecting the elderly, fatigue is often dismissed as a consequence of ageing and deconditioning and is therefore poorly recognized or explored. 14”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [14]
The Discussion says symptom assessment and documentation are poor and symptoms are often managed without analysis, supporting the claim that fatigue may be insufficiently explored. The Results describe a study sample with a mean age of 77, but the paper does not say fatigue is dismissed as ageing or deconditioning, or establish that this is why it is poorly recognized. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSignificant dyspnoea appears to worsen physical fatigue, suggesting better symptom management could improve exercise intolerance and consequently mood.
“Significant dyspnoea also appears to worsen physical fatigue suggesting better symptom management could improve exercise intolerance and consequently mood. 14”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [14]
The Results (§3.3; page unavailable) associate breathing difficulties with fatigue, and the Discussion (§4; page unavailable) suggests that relieving manageable symptoms may indirectly reduce fatigue. The study does not establish that dyspnoea causes physical fatigue or that symptom management improves exercise intolerance and, consequently, mood. (LLM, conf=0.84)
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References 34 · Cited by 99
Research works printed but not linked: 1
- Tishelman C. Making sense of sickness experience: cancer patients' perspective on their sickness and care in an urban Sweden: aspects of relevance for nursing. Karolinska Institutet, Stockholm, Sweden; 1993 [Doctorial thesis].
- Authors
- Falk, K., Patel, H., Swedberg, K., & Ekman, I.
- Affiliations
- University of Gothenburg (SE)
- Swedish Institute for Health Sciences (SE)
- Corresponding author
- Falk, Kristin
- Venue
- European Journal of Cardiovascular Nursing
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-06
- Volume
- 8
- Issue
- 2
- Pages
- 91-96
- ISSN
- 1474-5151 (ISSN-L)
- 1873-1953
- OpenAlex
- W2119840618
- Cited by
- 99
- References
- 34
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 3 · 2023: 6 · 2022: 7 · 2021: 6 · 2020: 7 · 2019: 7 · 2018: 6 · 2017: 2 · 2016: 10 · 2015: 4 · 2014: 5 · 2013: 7 · 2012: 4
- FWCI
- 3.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Cardiovascular Nursing (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- chronic heart failure, fatigue, anxiety, depression, symptom distress, mental fatigue, physical fatigue, dyspnea, sex differences, symptom burden, self-care adherence
- MeSH terms
- Adaptation, Psychological, Adult, Affective Symptoms, Aged, Aged, 80 and over, Anxiety, Chronic Disease, Depression, Fatigue, Female, Heart Failure, Humans, Male, Middle Aged, Self Care, Cost of Illness
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