Charlotte-Anne WellsSenior Occupational Therapist

Craigavon Area Hospital

Fatigue Management

in Phase III

Cardiac Rehabilitation

FatigueFatigue

Frequent & distressing symptom (Brink et al, 2002)

Reported to be the most frequent symptom before Acute MI (McSweeney et al, 2003)

‘Vital Exhaustion’: unusual fatigue, increased irritability, feelings of demoralisation (Appels and Mulder, 1988; Shuitemaker et al 2004)

FatigueFatigue

Living with Incomprehensible Fatigue after Recent MI (Alsen et al, 2008. Advanced Journal of Nursing)

Description: ‘‘A different kind of

tiredness’ ‘Incomprehensible’ ‘Unpredictable’ ‘Not related to effort’

Effects: Daily functioning Ability to work Physical functioning Intellectual and

emotional function Social activity

Fatigue Management & Energy Conservation(Craigavon Area Hospital)

Fatigue Management & Energy Conservation(Craigavon Area Hospital)

Fatigue in relation to Activities of Daily Living, Work & Leisure

Activity Analysis Use of METS Activity Grading Use of Borg Scale in relation to Daily Activities Advice on Energy Conservation/Fatigue Management Psychological effect of Fatigue and MI

Audit AimsAudit Aims To ascertain the proportion of programme attendees who

felt that fatigue was a major symptom of their condition To establish how those individuals felt fatigue impacted

upon their daily functional ability To examine how useful individuals found the advice

given To establish what, if any, aspects of the session they

incorporated into daily life

To identify areas for improvement and development

MethodologyMethodology Study Design

Recruitment of Research Team

Sampling Size

Timescale

Data Collection

Demographics

ResultsResults

Percentage of patients who felt that Fatigue was a major symptom of their

condition

Percentage of patients who felt that Fatigue was a major symptom of their

condition

40%60%

Yes No

Areas of Daily Life affected by FatigueAreas of Daily Life affected by Fatigue

43%49%

36%

45%

21%

40%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

PersonalActivities ofDaily Living

Mobility DomesticChores

Leisure Work Not Applicable

N=20 N=23 N=17 N=21 N=10 N=19

Topics within the session which participants found useful

Topics within the session which participants found useful

68%

81%

49%57%

68%

51%

68%73%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

ActivityAnalysis

Grading Use of Mets Borg Scale FatigueManagement

Equipment/Home

Adaptations

PsychologicalImpact

InformationLealfet

N=25 N=30 N=18 N=21 N=25

N=19

N=25 N=27

How participants rated the session on Fatigue Management

How participants rated the session on Fatigue Management

60%

32%

8% 0%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Excellent Very Good Average Poor

N=22 N=12N=3 N=0

Topics within the session which participants introduced into daily life

Topics within the session which participants introduced into daily life

41%

57%

14% 19%

38%

8%

41%46%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

ActivityAnalysis

Grading Use of Mets Borg Scale FatigueManagement

Equipmenet/Home

Adaptations

PsychologicalImpact

InformationLeaflet

N=15 N=21 N=5 N=7 N=14 N=3 N=15 N=17

Qualitative FeedbackQualitative Feedback

‘Relevant’ ‘Interesting’‘It increased my confidence to complete my daily activities’

‘It enabled me to manage my condition with confidence’

‘My family was able to relate to the information provided’

‘It increased my confidence to complete my daily activities’

Study LimitationsStudy Limitations

Study is based on patient reporting alone – no objective measurement

Timeframe

Retrospective

RecommendationsRecommendations Further study

Larger sample size

The use of an objective measurement tool

Administer questionnaire or assessment tool within a set timeframe pre or post Phase III

…. and finally…. and finally

Thank YouThank You