title: Fatigue two months after myocardial infarction and its relationships with other concurrent symptoms, sleep quality and coping strategies.
abstract: OBJECTIVE
  To explore fatigue levels two months after myocardial infarction and examine the associations with other concurrent symptoms, sleep quality and coping strategies.
  
  
  BACKGROUND
  Fatigue has been found to be the most frequent and bothersome symptom after myocardial infarction, influencing health-related quality of life negatively.
  
  
  METHODS
  The present study was explorative and cross-sectional. The focus was on fatigue two months postmyocardial infarction, complemented with a comparative analysis of fatigue dimension levels.
  
  
  METHODS
  The sample included 142 persons (mean age 63 years), treated for myocardial infarction, who responded to a questionnaire package measuring fatigue, depression, health complaints (symptoms), sleep quality and coping strategies.
  
  
  RESULTS
  The main results showed that a global fatigue score two months postmyocardial infarction was associated with concurrent symptoms, such as breathlessness and stress, and coping strategies such as change in values, intrusion and isolation. In comparisons of present fatigue dimension levels (general fatigue, physical fatigue, reduced activity and mental fatigue) two months postmyocardial infarction with baseline measurements (first week in hospital), the results showed that levels of fatigue dimensions had decreased. In comparisons with levels of fatigue four months postmyocardial infarction in a reference group, we found lower levels of fatigue two months postmyocardial infarction.
  
  
  CONCLUSIONS
  The present findings indicated that postmyocardial infarction fatigue is lowest two months postmyocardial infarction. This may thus be the right time to identify persons experiencing postmyocardial infarction fatigue, as timely fatigue relief support may prevent progression into a state of higher levels of fatigue.
  Measuring fatigue two months postmyocardial infarction would enable healthcare professionals to identify persons experiencing fatigue and to introduce fatigue relief support. Tailored rehabilitation support should include stress management and breathlessness relief support. If maladaptive use of the coping strategies isolation and intrusion is observed, these strategies could be discussed together with the patient.
authors.affiliation: Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.|Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.|Centre for Person-Centred Care, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Ulla
authors.identifier: http://orcid.org/0000-0003-0339-2671
authors.initials: U
authors.lastname: Fredriksson-Larsson
authors.affiliation: Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
authors.forename: Pia
authors.initials: P
authors.lastname: Alsén
authors.affiliation: AstraZeneca, Mölndal, Sweden.|Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Björn W
authors.initials: BW
authors.lastname: Karlson
authors.affiliation: Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.|Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.|Centre for Person-Centred Care, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Brink
mesh_terms: D000223:Adaptation, Psychological; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000451:nursing / Q000534:rehabilitation*; D011788:Quality of Life; D012890:Sleep; D011795:Surveys and Questionnaires
keywords: fatigue; myocardial infarction; regression analysis; symptom assessment