A Qualitative Exploration of Prodromal Myocardial Infarction Fatigue Experienced by Women.

AIMS AND OBJECTIVES The purpose of this study was to explore adult women's unique and shared experiences of prodromal myocardial infarction fatigue. BACKGROUND Fatigue is the most prevalent symptom experienced by women in the weeks and months before myocardial infarction. However, dimensions of this fatigue, such as timing, distress, intensity, quality, patterns, and associated characteristics have not been established through studies of this symptom. A lack of understanding of the characteristics of myocardial infarction fatigue and the context in which it occurs makes clinical decision-making difficult. DESIGN A qualitative, multiple case study guided by the Theory of Unpleasant Symptoms. METHODS Women were purposively enrolled from a large hospital in the Midwestern United States. Semi-structured, audio-recorded interviews were conducted during hospitalization and at two to three months post-discharge; women were also provided with a journal. A supplementary interview with family members and electronic health record review also assisted in data triangulation. Analysis was inductive and conducted within and across cases, using coding and categorization, counting, clustering, visual displays of data, and thematic development. The SRQR checklist was used in reporting the study. RESULTS Ten women, with a median age of 60, participated. Fatigue was described primarily using the terms tiredness and lack of energy, though some women described generalized weakness and cognitive fog. This fatigue was unusual and a notable change from baseline. Many women described significant difficulties performing activities of daily living due to fatigue. CONCLUSIONS The findings of this study will advance symptom science and an understanding of prodromal myocardial infarction fatigue. Future instrument development or selection of instruments for quantitative work will be aided by this study. RELEVANCE TO CLINICAL PRACTICE This study provides a clearer picture of prodromal myocardial infarction fatigue experienced by women, aiding health care professionals in understanding and identifying this symptom.