Jaime-Lara Rosario B, Koons Brittany C, Matura Lea Ann, Hodgson Nancy A, Riegel Barbara
National Institute of Nursing Research, NIH, Bethesda, Maryland, USA.
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Pain Symptom Manage. 2020 Jun;59(6):1320-1343. doi: 10.1016/j.jpainsymman.2019.12.358. Epub 2019 Dec 20.
Fatigue is a symptom reported by patients with a variety of chronic conditions. However, it is unclear whether fatigue is similar across conditions. Better understanding its nature could provide important clues regarding the mechanisms underlying fatigue and aid in developing more effective therapeutic interventions to decrease fatigue and improve quality of life.
To better understand the nature of fatigue, we performed a qualitative metasynthesis exploring patients' experiences of fatigue across five chronic noninfectious conditions: heart failure, multiple sclerosis, rheumatoid arthritis, chronic kidney disease, and chronic obstructive pulmonary disease.
We identified 34 qualitative studies written in the last 10 years describing fatigue in patients with one of the aforementioned conditions using three databases (Embase, PubMed, and CINAHL). Studies with patient quotes describing fatigue were synthesized, integrated, and interpreted.
Across conditions, patients consistently described fatigue as persistent overwhelming tiredness, severe lack of energy, and physical weakness that worsened over time. Four common themes emerged: running out of batteries, a bad life, associated symptoms (e.g., sleep disturbance, impaired cognition, and depression), and feeling misunderstood by others, with a fear of not being believed or being perceived negatively.
In adults with heart failure, multiple sclerosis, rheumatoid arthritis, chronic kidney disease, and chronic obstructive pulmonary disease, we found that fatigue was characterized by severe energy depletion, which had negative impacts on patients' lives and caused associated symptoms that exacerbated fatigue. Yet, fatigue is commonly misunderstood and inadequately acknowledged.
疲劳是多种慢性病患者报告的一种症状。然而，目前尚不清楚不同疾病中的疲劳是否相似。更好地了解其本质可以为疲劳背后的机制提供重要线索，并有助于开发更有效的治疗干预措施来减轻疲劳并改善生活质量。
为了更好地了解疲劳的本质，我们进行了一项定性元综合分析，探讨了五种慢性非传染性疾病患者的疲劳体验：心力衰竭、多发性硬化症、类风湿性关节炎、慢性肾脏病和慢性阻塞性肺疾病。
我们使用三个数据库（Embase、PubMed和CINAHL），检索了过去10年中撰写的34项定性研究，这些研究描述了上述疾病之一患者的疲劳情况。对有患者描述疲劳的引述的研究进行了综合、整合和解读。
在所有疾病中，患者一致将疲劳描述为持续的压倒性疲倦、严重缺乏能量以及随着时间推移而加重的身体虚弱。出现了四个共同主题：精力耗尽、糟糕的生活、相关症状（如睡眠障碍、认知障碍和抑郁）以及感觉被他人误解，担心不被相信或被负面看待。
在患有心力衰竭、多发性硬化症、类风湿性关节炎、慢性肾脏病和慢性阻塞性肺疾病的成年人中，我们发现疲劳的特征是严重的能量消耗，这对患者的生活产生负面影响，并导致加剧疲劳的相关症状。然而，疲劳通常被误解且未得到充分认识。
