Patient perception of fatigue while undergoing long-term mechanical ventilation: Incidence and associated factors

OBJECTIVE: To describe a chronically critically ill population of patients receiving long-term ventilatory assistance, including patient perception of fatigue and the associated factors of nutritional status, depression, and sleep-rest. DESIGN: Prospective, descriptive correlational design. SETTING: Two tertiary care, university-affiliated medical centers. SUBJECTS: Twenty subjects who were undergoing mechanical ventilation for at least 7 days and who were in the process of weaning. RESULTS: Descriptive, correlational, and t test statistics were used in the data analysis. There was a 100% prevalence rate of fatigue, and with a 10-cm visual analogue scale, 45% of the subjects rated their fatigue as severe (greater than or equal to 6.0 cm) in intensity. The sample's mean serum albumin was 2.7 gm/dl, and mean hemoglobin was 10.1 gm/dl, but there were no statistically significant relationships between fatigue and nutritional status. Subjects' depression scores were in the moderate range, and they evaluated their sleep as fragmented and only moderately effective. Fatigue and depression were strongly correlated (r = 0.61; p = 0.004); there were no statistically significant relationships between fatigue and the sleep-rest scales. CONCLUSIONS: The descriptive findings suggest that patients receiving long-term ventilatory assistance are undernourished and experience fatigue, depressed mood state, and disruptions of their sleep-rest pat terns.