Problem-Solving Therapy to reduce chronic fatigue in cardiac arrest survivors

[摘要] Fatigue is prevalent in people with heart problems and negatively associated with physical and mental functions, and perceived performance and participation in activities of daily living. The two studies in this dissertation focused on chronic fatigue among post-cardiac arrest (CA) adults. The first study investigated fatigue-related problems in post-CA adults and energy conservation (EC) strategies used to resolve those problems. Using a qualitative descriptive design, it was found that CA survivors with moderate-to-severe fatigue, living in the community, more frequently reported problems in instrumental activities of daily living than basic activities of daily living. Also, the CA survivors used the EC strategy of 'plan ahead” most frequently followed by seven other EC strategies. The second study examined the effectiveness of the clinical intervention strategies (Maximizing Energy [MAX] intervention) on reducing the severity and impact of fatigue, and the impact on activities and participation. A pre-post experimental study design was used. By participating in MAX intervention sessions, CA survivors with chronic fatigue learned EC strategies while solving two fatigue-related problems. The results showed that the MAX intervention was effective in significantly reducing the impact of fatigue and general fatigue of CA survivors. Future studies should include larger samples with a comparison group and random allocation, examine the effectiveness of different numbers of intervention sessions and different time intervals between tests, and include measures that are more sensitive to changes in fatigue, perceived performance and participation in daily activities. Lastly, because of the low survival rate following a CA, and the strict eligibility criteria for chronic fatigue in our study, we recommend a multi-site study to increase the potential for reaching an adequate number of participants in a reasonable length of time.

[发布机构] the University of Pittsburgh