Predicting fatigue in patients using home parenteral nutrition: a longitudinal study

Huisman-de Waal, Getty, Bazelmans, Ellen, van Achterberg, Theo, Jansen, Jan, Sauerwein, Hans, Wanten, Geert and Schoonhoven, Lisette (2011) Predicting fatigue in patients using home parenteral nutrition: a longitudinal study. International Journal of Behavioral Medicine, 18, (3), 268-276. (doi:10.1007/s12529-010-9116-7). (PMID:20862618).


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Background: Home parenteral nutrition (HPN) is a lifesaving therapy for patients with diseases that preclude adequate oral or enteral food intake. HPN has a large impact on daily life. Many patients suffer from fatigue and depression, and they experience limits in social activities. This all contributes to a lower quality of life.

Purpose: Fatigue is the most frequently mentioned problem in Dutch HPN patients. Therefore, we studied the prevalence, course and predictors of fatigue in these patients.

Methods: Patients completed questionnaires at baseline and follow-up (12 months later). Measurements included fatigue, depression, functional impairment, social support, self-efficacy, coping, anxiety and acceptance. Laboratory measures, including total bilirubin, creatinine, albumin and haemoglobin levels, were obtained from the medical records. Descriptive statistics, correlations and linear regression analysis were performed.

Results: The response rate was 71% (n=75). Sixty-five per cent of the patients were severely fatigued (n=49). Eighty-nine per cent experienced persistent fatigue. Baseline fatigue predicted 57% of the variance of fatigue at follow-up, and avoidance was responsible for 3% of the variance. No significant correlations between fatigue and laboratory measures were found. A cross-sectional analysis showed
that 46% of the variance of fatigue was explained by functional impairment, self-efficacy and depression.

Conclusion: Severe fatigue is a persistent problem for HPN
patients. Baseline fatigue was the strongest predictor of fatigue at follow-up. Functional impairment, self-efficacy and depression are strongly related to fatigue. Early recognition and treatment of fatigue are important.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1007/s12529-010-9116-7
ISSNs: 1070-5503 (print)
1532-7558 (electronic)
Keywords: home parenteral nutrition, fatigue, functional impairment, self-efficacy, depression
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Health Sciences
ePrint ID: 339201
Date :
Date Event
September 2011Published
Date Deposited: 25 May 2012 09:02
Last Modified: 31 Mar 2016 14:28

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