How fatigue is experienced and handled by female outpatients with inflammatory bowel disease

Anne Beck, Palle Bager, Peter Errboe Jensen, Jens F Dahlerup, Anne Beck, Palle Bager, Peter Errboe Jensen, Jens F Dahlerup

Abstract

Background. Fatigue is a significant aspect of everyday life for patients with inflammatory bowel disease (IBD), and it influences their health-related quality of life. Little is known about fatigue from the patient's perspective. Aim. To investigate how female IBD patients experience and handle fatigue. Methods. The study included 11 female outpatients. These patients were 40-59 years old and had IBD ≥ one year and a significantly increased fatigue score. Patients with severe active IBD, anaemia, comorbidity, or pregnancy were excluded. The included patients agreed to participate in a semistructured interview. The interviews were analysed using Malterud's principles of systematic text condensation. Results. The patients described physical and mental symptoms of fatigue that led to social-, physical-, and work-related limitations with emotional consequences. To handle fatigue, the patients used planning, priority, acceptance, exercise, and support. Two of the eleven patients used exercise on a regular basis. Surprisingly, some patients indicated that they did not need to talk with professionals about their fatigue unless a cure was available. Conclusion. Fatigue in IBD includes physical and mental symptoms that limit the patients' social-, physical-, and work-related lives. Despite this, some patients expressed that they had chosen to accept their fatigue.

Figures

Figure 1
Figure 1
Patient flow.
Figure 2
Figure 2
Experience of fatigue in IBD. The experience of fatigue begins with physical and mental symptoms, which leads to social-, physical-, and work-related limitations. These limitations may cause some emotional consequences like bad conscience. The emotional consequences are a part of the experience of fatigue.

References

    1. Pihl-Lesnovska K, Hjortswang H, Ek A-C, Frisman GH. Patients’ perspective of factors influencing quality of life while living with Crohn disease. Gastroenterology Nursing. 2010;33(1):37–44.
    1. Jelsness-Jørgensen L-P, Bernklev T, Henriksen M, Torp R, Moum BA. Chronic fatigue is associated with impaired health-related quality of life in inflammatory bowel disease. Alimentary Pharmacology and Therapeutics. 2011;33(1):106–114.
    1. Stjernman H, Tysk C, Almer S, Ström M, Hjortswang H. Worries and concerns in a large unselected cohort of patients with Crohn’s disease. Scandinavian Journal of Gastroenterology. 2010;45(6):696–706.
    1. Bager P, Befrits R, Lindgren S, et al. Fatigue in out-patients with inflammatory bowel disease is common and multifactorial. Alimentary Pharmacology & Therapeutics. 2012;35(1):133–141.
    1. van Langenberg DR, Gibson PR. Systematic review: fatigue in inflammatory bowel disease. Alimentary Pharmacology & Therapeutics. 2010;32(2):131–143.
    1. Hjollund NH, Andersen JH, Bech P. Assessment of fatigue in chronic disease: a bibliographic study of fatigue measurement scales. Health and Quality of Life Outcomes. 2007;5, article 12
    1. Jelsness-Jørgensen L-P, Bernklev T, Henriksen M, Torp R, Moum BA. Chronic fatigue is more prevalent in patients with inflammatory bowel disease than in healthy controls. Inflammatory Bowel Diseases. 2011;17(7):1564–1572.
    1. Banovic I, Gilibert D, Cosnes J. Crohn’s disease and fatigue: constancy and co-variations of activity of the disease, depression, anxiety and subjective quality of life. Psychology, Health and Medicine. 2010;15(4):394–405.
    1. Romberg-Camps MJL, Bol Y, Dagnelie PC, et al. Fatigue and health-related quality of life in inflammatory bowel disease: results from a population-based study in the Netherlands: the IBD-South Limburg cohort. Inflammatory Bowel Diseases. 2010;16(12):2137–2147.
    1. Schwarz R, Krauss O, Hinz A. Fatigue in the general population. Onkologie. 2003;26(2):140–144.
    1. Watt T, Groenvold M, Bjorner JB, Noerholm V, Rasmussen N-A, Bech P. Fatigue in the Danish general population. Influence of sociodemographic factors and disease. Journal of Epidemiology and Community Health. 2000;54(11):827–833.
    1. Mussell M, Böcker U, Nagel N, Singer MV. Predictors of disease-related concerns and other aspects of health-related quality of life in outpatients with inflammatory bowel disease. European Journal of Gastroenterology and Hepatology. 2004;16(12):1273–1280.
    1. Czuber-Dochan W, Ream E, Norton C. Review article: description and management of fatigue in inflammatory bowel disease. Alimentary Pharmacology & Therapeutics. 2013;37:505–516.
    1. Brown MM, Brown AA, Jason LA. Illness duration and coping style in chronic fatigue syndrome. Psychological Reports. 2010;106(2):383–393.
    1. Smets EMA, Garssen B, Bonke B, De Haes JCJM. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research. 1995;39(3):315–325.
    1. Kvale S, Brinkmann S. InterViews. Learing the Craft of Qualitative Research Interviewing. London, UK: SAGE; 2009.
    1. Sandelowski M. Focus on qualitative methods: sample size in qualitative research. Research in Nursing & Health. 1995;18(2):479–482.
    1. Repping-Wuts H, Uitterhoeve R, van Riel P, van Achterberg T. Fatigue as experienced by patients with rheumatoid arthritis (RA): a qualitative study. International Journal of Nursing Studies. 2008;45(7):995–1002.
    1. Addison R. A grounded hermeneutic editing approach. In: Miller W, Crabtree B, editors. Doing Qualitative Research. London, UK: SAGE; 1999.
    1. Malterud K. Systematic text condensation: a strategy for qualitative analysis. Scandinavian Journal of Public Health. 2012;40:795–805.
    1. Vogelaar L, Van’t Spijker A, Vogelaar T, et al. Solution focused therapy: a promising new tool in the management of fatigue in Crohn’s disease patients. Psychological interventions for the management of fatigue in Crohn’s disease. Journal of Crohn’s and Colitis. 2011;5(6):585–591.
    1. Banovic I, Gilibert D, Jebrane A, Cosnes J. Personality and fatigue perception in a sample of IBD outpatients in remission: a preliminary study. Journal of Crohn’s and Colitis. 2012;6:571–577.

Source: PubMed

3
Abonnere