Ternrud Linda, Hlebowicz Joanna, Sandberg Camilla, Johansson Bengt, Sparv David
Department of Cardiology, Department of Clinical Science, Skåne University Hospital, Lund University, Lund, Sweden.
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Cardiol Young. 2022 Sep;32(9):1432-1439. doi: 10.1017/S1047951121004297. Epub 2021 Oct 29.
The aim of this cross-sectional study was to examine the prevalence of the multidimensional phenomenon of fatigue in adults with congenital heart disease.
Adults with congenital heart disease are a growing population, and patient-reported outcomes can provide valuable information about the patient's experience of living with CHD. Fatigue is a multidimensional phenomenon that can be described as an overwhelming feeling of exhaustion with a reduced capacity of mental and physical work. Fatigue can be observed clinically in adults with congenital heart disease, but the actual prevalence is unknown.
Fatigue was assessed by the Multidimensional Fatigue Inventory which enables the respondent to report the presence of fatigue according to five dimensions: "general fatigue," "physical fatigue," "mental fatigue," "reduced motivation," and "reduced activity." The questionnaire was sent to 463 patients in Lund and Umeå. Four groups with complex CHD and two groups with moderately complex CHD were included. The reliability (internal consistency) of the Multidimensional Fatigue Inventory was tested for all dimensions and groups of diagnosis.
The response rate was 56.6% (n= 262). In patients with complex CHD, 40.0-59.4% reported severe to very severe general fatigue, and patients with a single ventricle reported the highest prevalence (59.4%). Among patients with complex CHD, 29.2-40.0% reported severe to very severe mental fatigue. The Multidimensional Fatigue Inventory had a high reliability measured with Cronbach's alpha.
The study findings show a relatively high prevalence of fatigue in adults with congenital heart disease, and general fatigue was the most prevalent. Further studies are needed regarding fatigue and its causes and consequences in adults with congenital heart disease.
The Multidimensional Fatigue Inventory proved to be an instrument with high reliability and low internal loss, which suggests that the instrument may be suitable to use as a patient-reported outcome in the care of adults with congenital heart disease, preferably at repeated occasions.
本横断面研究旨在调查先天性心脏病成人患者疲劳这一多维度现象的患病率。
先天性心脏病成人患者数量不断增加，患者报告的结果可为了解患者患先天性心脏病的生活体验提供有价值的信息。疲劳是一种多维度现象，可被描述为一种压倒性的疲惫感，伴有精神和体力工作能力下降。先天性心脏病成人患者临床上可观察到疲劳，但实际患病率未知。
采用多维疲劳量表评估疲劳情况，该量表能让受访者根据五个维度报告疲劳的存在：“总体疲劳”“身体疲劳”“精神疲劳”“动力下降”和“活动减少”。问卷被发送给隆德和于默奥的463名患者。纳入了四组复杂先天性心脏病患者和两组中度复杂先天性心脏病患者。对多维疲劳量表在所有维度和诊断组的信度（内部一致性）进行了测试。
回复率为56.6%（n = 262）。在复杂先天性心脏病患者中，40.0 - 59.4%报告有严重至极严重的总体疲劳，单心室患者报告的患病率最高（59.4%）。在复杂先天性心脏病患者中，29.2 - 40.0%报告有严重至极严重的精神疲劳。多维疲劳量表用克朗巴哈系数测量具有较高的信度。
研究结果表明先天性心脏病成人患者疲劳患病率相对较高，总体疲劳最为普遍。需要对先天性心脏病成人患者的疲劳及其原因和后果进行进一步研究。
多维疲劳量表被证明是一种信度高且内部损耗低的工具，这表明该工具可能适合作为先天性心脏病成人患者护理中患者报告的结果，最好在多次随访时使用。
