Whitehead Lisa C, Unahi Kirstin, Burrell Beverley, Crowe Marie T
School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
Southern District Health Board, Dunedin, New Zealand.
J Pain Symptom Manage. 2016 Jul;52(1):131-143.e1. doi: 10.1016/j.jpainsymman.2016.02.013. Epub 2016 May 24.
Fatigue is a common and debilitating symptom associated with many long-term conditions and is reported to cause significant levels of distress for those individuals. There is a substantial body of literature related to the nature of fatigue; however, this has not been drawn together and compared across conditions.
The aim of this review was to synthesize data on the nature of fatigue across long-term conditions.
The review was designed as a qualitative meta-synthesis and followed the Joanna Briggs Institute guidelines for synthesizing qualitative research. The following databases were searched for the period January 1980 to January 2016, Ovid (Medline, Embase, CINAHL, and PsycINFO) and manual searching from the reference lists from articles identified by electronic search. Fifty-seven studies were included in the review, and findings related to the nature of fatigue were extracted and findings meta-synthesized.
The perceived nature of fatigue across long-term conditions was encompassed in one synthesis; the fatigue experience is without precedent, with four categories: a different fatigue to any experienced before, the intensity of fatigue is overwhelming, the trajectory of fatigue, and impact on sleep and sleep disturbance. Just over half of the participants in the included studies were diagnosed with cancer. Patterns in the experience of fatigue by condition were found for cancer-related fatigue and post-stroke fatigue where data were able to be synthesized.
Although similarities in the nature of the fatigue experienced were found across conditions, differences were also evident and could be mapped for cancer-related fatigue and post-stroke fatigue. Further qualitative research on the experience of fatigue across a wide range of chronic conditions would further contribute to understanding similarities and differences across conditions and inform both research and practice in relation to assessment and management.
疲劳是一种常见且使人衰弱的症状，与许多长期疾病相关，据报道会给患者带来极大的痛苦。关于疲劳的本质已有大量文献；然而，尚未对这些文献进行汇总并在不同疾病间进行比较。
本综述旨在综合关于长期疾病中疲劳本质的数据。
本综述设计为定性元分析，并遵循乔安娜·布里格斯研究所关于定性研究综合分析的指南。检索了以下数据库1980年1月至2016年1月期间的文献，Ovid（医学索引、荷兰医学文摘、护理学与健康领域数据库、心理学文摘）以及通过电子检索确定的文章参考文献列表的手工检索。本综述纳入了57项研究，并提取了与疲劳本质相关的研究结果并进行元分析。
在一项综合分析中涵盖了长期疾病中疲劳的感知本质；疲劳体验无前例可循，分为四类：与以往任何经历都不同的疲劳、压倒性的疲劳强度、疲劳的发展轨迹以及对睡眠和睡眠障碍的影响。纳入研究中略多于一半的参与者被诊断患有癌症。在能够进行数据综合分析的癌症相关疲劳和中风后疲劳中，发现了不同疾病疲劳体验的模式。
尽管在不同疾病中发现了疲劳本质的相似性，但差异也很明显，且可以针对癌症相关疲劳和中风后疲劳进行梳理。对广泛慢性疾病中疲劳体验的进一步定性研究将有助于进一步理解不同疾病间的异同，并为评估和管理的研究与实践提供参考。
