Fatigue is a prominent complaint of persons with COPD. Fatigue is a distressing, multidimensional sensation that adversely affects quality of life. Few studies have examined factors that influence various dimensions of subjective fatigue in these individuals. The purpose of this study was to examine the emotional, behavioural, cognitive, and physical dimensions of fatigue and their relationships to dyspnea, mental health, sleep, and physiological factors in individuals with COPD enrolled in a pulmonary rehabilitation program.
A convenience sample of 42 pulmonary rehabilitation participants with COPD completed self-report questionnaires which measured: dimensions of fatigue using the Multidimensional Fatigue Inventory, anxiety and depression using the Hospital Anxiety and Depression Scale, and sleep quality using the Pittsburgh Sleep Quality Index. Data on other variables were abstracted from pulmonary rehabilitation program health records.
The majority of the participants (61.9% - 81.0%) experienced moderate levels of subjective fatigue across emotional, behavioural, cognitive and physical dimensions. Moderate to severe levels of physical fatigue were experienced by 95.3% of participants. Age was related to behavioural fatigue (ρ = 0.43, p < 0.01) and emotional fatigue (ρ = 0.31, p < 0.05). Anxiety was related to emotional fatigue (ρ = −0.47, p < 0.01). Fatigue was not associated with sex, supplemental oxygen use, smoking status, or MRC dyspnea scores. Nearly half (42.9%) the participants reported symptoms of anxiety, while almost one-quarter (21.4%) reported depressive symptoms.
Fatigue, particularly physical fatigue, was experienced by the overwhelming majority of participants in this study. Further research is needed: to determine the prevalence of fatigue, anxiety and depression using a representative sample of pulmonary rehabilitation participants; to identify how these factors are related to participation in and outcomes of pulmonary rehabilitation programs; and to compare fatigue, anxiety and depression between pulmonary rehabilitation participants and non-participants.
While dyspnea is often assessed in individuals with COPD, fatigue is often inadequately assessed and monitored. Pulmonary rehabilitation programs may incorporate measures of fatigue and interventions intended to alleviate fatigue into their curricula.
Cindy Wong, No Financial Disclosure Information; No Product/Research Disclosure Information