Barnason Susan, Zimmerman Lani, Nieveen Janet, Schulz Paula, Miller Connie, Hertzog Melody, Rasmussen Doris
University of Nebraska Medical Center, College of Nursing-Lincoln Division, 1230 O Street, STE 131, PO Box 880220, Lincoln, NE 68588-0220, USA.
Heart Lung. 2008 Jul-Aug;37(4):245-56. doi: 10.1016/j.hrtlng.2007.09.003.
Despite successful coronary artery bypass graft (CABG) surgery, some patients continue to experience fatigue after their surgery.
The purpose of this secondary analysis study was to examine the relationships of fatigue and early recovery outcomes (psychosocial and physiologic functioning, and physical activity) over time (6 weeks and 3 months) among older adult subjects, age 65 years and older, after CABG surgery. Comparison groups were those subjects who had fatigue at 3 weeks after surgery and nonfatigued subjects.
A prospective, comparative design was used for this secondary analysis study.
Subjects in this study were drawn from the control group of subjects enrolled in the larger parent study. Subjects (N = 119) were dichotomized into fatigue (n = 66) and nonfatigued (n = 53) groups on the basis of their 3-week self-reports of postoperative fatigue.
At 6 weeks after surgery, fatigued subjects had significantly (P < .05) more impaired psychosocial functioning (role-emotional [t = 1.9], social [t = 2.6], and mental [t = 1.9] functioning) on the basis of the Medical Outcome Study Short Form 36. They had significantly (P < .005) higher mean hospital anxiety (t = -3.6) and depression (t = -2.9) subscale scores, respectively. Anxiety (t = -2.3, P < .05) remained significantly (P < .05) impaired at 3 months. At 6 weeks, role physical functioning, measured by the Medical Outcome Study Short Form 36, was significantly impaired (t = 2.4, P < .01). There were no significant differences in physical activity variables as measured by an RT3 accelerometer (Stayhealthy, Inc., Monrovia, CA) and self-report diary.
Persistent fatigue can hamper early recovery after CABG surgery. Tailored interventions are needed to address fatigue management and improve patient outcomes.
尽管冠状动脉旁路移植术（CABG）手术成功，但一些患者术后仍持续感到疲劳。
这项二次分析研究的目的是，在65岁及以上的老年成人患者接受CABG手术后，研究疲劳与早期恢复结果（心理社会和生理功能以及身体活动）在6周和3个月时间内的关系。比较组为术后3周感到疲劳的患者和未感到疲劳的患者。
本二次分析研究采用前瞻性比较设计。
本研究中的受试者来自规模更大的母研究的对照组。根据受试者术后3周的疲劳自我报告，将119名受试者分为疲劳组（n = 66）和非疲劳组（n = 53）。
术后6周，根据医学结局研究简表36，疲劳患者的心理社会功能（角色情感[t = 1.9]、社交[t = 2.6]和心理[t = 1.9]功能）明显受损（P <.05）。他们的医院焦虑（t = -3.6）和抑郁（t = -2.9）分量表平均得分分别显著更高（P <.005）。3个月时，焦虑（t = -2.3，P <.05）仍显著受损（P <.05）。术后6周，通过医学结局研究简表36测量的角色身体功能明显受损（t = 2.4，P <.01）。通过RT3加速度计（加利福尼亚州蒙罗维亚的Stayhealthy公司）和自我报告日记测量的身体活动变量没有显著差异。
持续性疲劳会妨碍CABG手术后的早期恢复。需要采取针对性干预措施来管理疲劳并改善患者预后。
