College of Healthcare and Management, Asia Eastern University of Science and Technology, New Taipei City, Taiwan.
Department of Nursing, Asia Eastern University of Science and Technology, New Taipei City, Taiwan.
J Clin Nurs. 2023 Aug;32(15-16):4638-4648. doi: 10.1111/jocn.16485. Epub 2022 Aug 8.
Fatigue is associated with multidimensional factors in heart failure patients. Investigating longitudinal changes in fatigue and its association in patients undergoing cardiac surgery is needed to create interventions for improving fatigue during recovery.
This study examined the trajectory of fatigue and its associated factors over time in patients undergoing cardiac surgery.
This longitudinal study enrolled 125 patients undergoing cardiac surgery in northern Taiwan. Patients completed questionnaires before surgery, at discharge, and at 1, 3 and 6 months post-discharge. Fatigue was measured using the General Fatigue Scale. Generalised estimating equation models were fitted to identify variables associated with fatigue over time. This study complied with the STROBE checklist.
The sample (mean age = 60.70 ± 10.42) was mostly male (68%). High fatigue was found in 73.6% of patients before cardiac surgery and significantly decreased over the six months after discharge. NYHA III/IV, lower haemoglobin level, more symptom distress, poor sleep quality, higher anxiety and depression and lower social and family support were significantly associated with an increase in fatigue levels over time. Compared with before discharge, decreases in sleep quality at 1, 3 and 6 months were significantly associated with an increase in fatigue levels (p < .001). The increases in social support (B = 0.20, p = .016) and family support (B = 0.37, p = .002) at 6 months were significantly associated with an increase in the fatigue scores.
Fatigue was common and associated with symptoms, sleep quality, emotion and social support in patients undergoing cardiac surgery. In addition to symptom management, improving sleep quality and social support are important to manage fatigue for the long-term care of patients undergoing cardiac surgery.
Patient education on symptom management, sleep hygiene and family support is suggested to improve fatigue in patients recovering from cardiac surgery.
心力衰竭患者的疲劳与多维因素有关。研究心脏手术后患者疲劳的纵向变化及其相关性，对于制定康复期间改善疲劳的干预措施是必要的。
本研究旨在探讨心脏手术后患者疲劳及其相关因素随时间的变化轨迹。
本纵向研究纳入了台湾北部 125 名接受心脏手术的患者。患者在手术前、出院时以及出院后 1、3 和 6 个月时完成了问卷调查。疲劳采用一般疲劳量表进行测量。使用广义估计方程模型来确定与随时间变化的疲劳相关的变量。本研究符合 STROBE 清单的要求。
样本（平均年龄=60.70±10.42）主要为男性（68%）。术前有 73.6%的患者出现高度疲劳，出院后 6 个月内显著下降。NYHA III/IV、较低的血红蛋白水平、更多的症状困扰、较差的睡眠质量、较高的焦虑和抑郁以及较低的社会和家庭支持与疲劳水平随时间的增加显著相关。与出院前相比，出院后 1、3 和 6 个月时睡眠质量的下降与疲劳水平的增加显著相关（p<0.001）。6 个月时社会支持（B=0.20，p=0.016）和家庭支持（B=0.37，p=0.002）的增加与疲劳评分的增加显著相关。
心脏手术后患者疲劳很常见，与症状、睡眠质量、情绪和社会支持有关。除了症状管理外，改善睡眠质量和社会支持对于心脏手术后患者的长期护理管理疲劳至关重要。
建议对心脏手术后康复的患者进行症状管理、睡眠卫生和家庭支持方面的教育，以改善疲劳。
