Factors Related to Fatigue and Physical Function in COPD: A Secondary Analysis Using National Survey Data

Fatigue in chronic obstructive pulmonary disease (COPD) is debilitating and associated with considerable morbidity. The aim of this study is to present a model based on the Theory of Unpleasant Symptoms of physiologic, psychologic, and situational factors with COPD-related fatigue and the relationship with physical functioning. This study used data collected from Wave 2 (2010-2011) of the National Social, Health, and Aging Project (NSHAP). A total of 518 adults with self-reported COPD were included in this study. Path analysis was used for hypothesis testing. Depression was the only psychologic factor found to have a direct relation to both fatigue (β = 0.158, p < .001) and physical function (β = −0.131, p = .001). Factors related to physical function included fatigue, depression, sleep, loneliness, and pain. Additionally, fatigue was indirectly associated with physical function via depression (β = −0.064, p = .012). These findings suggest avenues for future research on predictors of COPD-related fatigue in relation to physical functioning.

[1]  Chaithanya Avanthika,et al.  The Obesity Paradox in Chronic Heart Disease and Chronic Obstructive Pulmonary Disease , 2022, Cureus.

[2]  J. Carreira,et al.  Impact of anxiety and depression on the prognosis of copd exacerbations , 2022, BMC Pulmonary Medicine.

[3]  A. Bunevičius,et al.  Fatigue, Social Support, and Depression in Individuals With Coronary Artery Disease , 2021, Frontiers in Psychology.

[4]  H. Kuhn,et al.  A Proposal for a Unifying Set of Definitions of Fatigue , 2021, Frontiers in Psychology.

[5]  F. Martinez,et al.  Challenging the obesity paradox: extreme obesity and COPD mortality in the SUMMIT trial , 2021, ERJ Open Research.

[6]  A. Boonen,et al.  Does Including Pain, Fatigue, and Physical Function When Assessing Patients with Early Rheumatoid Arthritis Provide a Comprehensive Picture of Disease Burden? , 2020, The Journal of Rheumatology.

[7]  D. Christiani,et al.  Health Care Disparities Across the Urban-Rural Divide: A National Study of Individuals with COPD. , 2020, The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association.

[8]  L. Donini,et al.  Obesity or BMI Paradox? Beneath the Tip of the Iceberg , 2020, Frontiers in Nutrition.

[9]  Meilan K. Han,et al.  Goals of COPD treatment: Focus on symptoms and exacerbations. , 2020, Respiratory medicine.

[10]  Seoyoun Kim,et al.  Direct and Indirect Pathways From Social Support to Health? , 2019, The journals of gerontology. Series B, Psychological sciences and social sciences.

[11]  Katya L. Masconi,et al.  Biomarkers and clinical outcomes in COPD: a systematic review and meta-analysis , 2019, Thorax.

[12]  M. Sprangers,et al.  Fatigue is highly prevalent in patients with COPD and correlates poorly with the degree of airflow limitation , 2019, Therapeutic advances in respiratory disease.

[13]  K. Taber.  The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education , 2017, Research in Science Education.

[14]  M. Sprangers,et al.  Fatigue is Highly Prevalent in Patients with Asthma and Contributes to the Burden of Disease , 2018, Journal of clinical medicine.

[15]  M. Brusse-Keizer,et al.  COPD-related fatigue: Impact on daily life and treatment opportunities from the patient's perspective. , 2018, Respiratory medicine.

[16]  Seunghoon Lee,et al.  Association between sleep duration and stroke prevalence in Korean adults: a cross-sectional study , 2018, BMJ Open.

[17]  B. Riegel,et al.  A Systematic Review of Biological Mechanisms of Fatigue in Chronic Illness , 2018, Biological research for nursing.

[18]  Huong Q. Nguyen,et al.  Effect of symptoms on physical performance in COPD , 2018, Heart & lung : the journal of critical care.

[19]  A. F. Fratta Pasini,et al.  Body weight and mortality in COPD: focus on the obesity paradox , 2018, Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity.

[20]  So Ri Kim,et al.  Symptom Clusters and Quality of Life in Subjects With COPD , 2017, Respiratory Care.

[21]  Huong Q. Nguyen,et al.  Association between Social Support and Self‐Care Behaviors in Adults with Chronic Obstructive Pulmonary Disease , 2017, Annals of the American Thoracic Society.

[22]  Huong Q. Nguyen,et al.  Symptom profiles and inflammatory markers in moderate to severe COPD , 2016, BMC Pulmonary Medicine.

[23]  G. Verleden,et al.  Factors associated with experience of fatigue , and functional limitations due to fatigue in patients with stable COPD , 2016 .

[24]  Dave Singh,et al.  The Effect of Fatigue and Fatigue Intensity on Exercise Tolerance in Moderate COPD , 2016, Lung.

[25]  K. Schmitz,et al.  Association between Body Mass Index and Physical Function among Endometrial Cancer Survivors , 2016, PloS one.

[26]  J. Manjourides,et al.  Association of Ambient Air Pollution with Depressive and Anxiety Symptoms in Older Adults: Results from the NSHAP Study , 2016, Environmental health perspectives.

[27]  P. Barnes.  Sex Differences in Chronic Obstructive Pulmonary Disease Mechanisms. , 2016, American journal of respiratory and critical care medicine.

[28]  T. W. Effing,et al.  Social Support and Social Networks in COPD: A Scoping Review , 2015, COPD.

[29]  A. Lindberg,et al.  Physical activity and fatigue in chronic obstructive pulmonary disease - A population based study. , 2015, Respiratory medicine.

[30]  D. Brooks,et al.  Pain and its clinical associations in individuals with COPD: a systematic review. , 2015, Chest.

[31]  Lisa Skär,et al.  Fatigue Affects Health Status and Predicts Mortality Among Subjects with COPD: Report from the Population-Based OLIN COPD Study , 2015, COPD.

[32]  M. McClintock,et al.  Geriatric syndromes and functional status in NSHAP: rationale, measurement, and preliminary findings. , 2014, The journals of gerontology. Series B, Psychological sciences and social sciences.

[33]  R. Thisted,et al.  Assessment of sleep in the National Social Life, Health, and Aging Project. , 2014, The journals of gerontology. Series B, Psychological sciences and social sciences.

[34]  William Dale,et al.  Using and interpreting mental health measures in the National Social Life, Health, and Aging Project. , 2014, The journals of gerontology. Series B, Psychological sciences and social sciences.

[35]  B. Mendi,et al.  Assessment of relationship between self-care and fatigue and loneliness in haemodialysis patients. , 2014, Journal of clinical nursing.

[36]  Lisa Skär,et al.  Fatigue in chronic obstructive pulmonary disease: a qualitative study of people's experiences. , 2014, Scandinavian journal of caring sciences.

[37]  E. Kua,et al.  Life event stress and chronic obstructive pulmonary disease (COPD): associations with mental well-being and quality of life in a population-based study , 2012, BMJ Open.

[38]  J. Paddison,et al.  Fatigue in COPD: association with functional status and hospitalisations , 2012, European Respiratory Journal.

[39]  Courtney Crim,et al.  Persistent Systemic Inflammation is Associated with Poor Clinical Outcomes in COPD: A Novel Phenotype , 2012, PloS one.

[40]  Young Ae Kim,et al.  Web-based tailored education program for disease-free cancer survivors with cancer-related fatigue: a randomized controlled trial. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[41]  J. Molema,et al.  Course of normal and abnormal fatigue in patients with chronic obstructive pulmonary disease, and its relationship with domains of health status. , 2011, Patient education and counseling.

[42]  Tülay Fertelli,et al.  Fatigue and disability in elderly patients with chronic obstructive pulmonary disease (COPD). , 2011, Archives of gerontology and geriatrics.

[43]  Dave Singh,et al.  Biomarkers of systemic inflammation and depression and fatigue in moderate clinically stable COPD , 2011, Respiratory research.

[44]  D. Marciniuk,et al.  Fatigue in patients with COPD participating in a pulmonary rehabilitation program , 2010, International journal of chronic obstructive pulmonary disease.

[45]  Sharon Shiovitz-Ezra,et al.  The Role of Social Relationships in Predicting Loneliness: The National Social Life, Health, and Aging Project , 2010 .

[46]  E. Coups,et al.  Fatigue and functional impairment in early-stage non-small cell lung cancer survivors. , 2010, Journal of pain and symptom management.

[47]  Kenneth R Casey,et al.  Sleep disorders in chronic kidney disease. , 2010, Sleep medicine.

[48]  R. Garrod,et al.  Evaluation of psychological and physiological predictors of fatigue in patients with COPD , 2009, BMC pulmonary medicine.

[49]  J. Wedzicha,et al.  Determinants and impact of fatigue in patients with chronic obstructive pulmonary disease. , 2009, Respiratory medicine.

[50]  M. Kompier,et al.  “How Fatigued Do You Currently Feel?” Convergent and Discriminant Validity of a Single‐Item Fatigue Measure , 2007, Journal of occupational health.

[51]  A. Keshavarzian,et al.  The relevance of sleep abnormalities to chronic inflammatory conditions , 2007, Inflammation Research.

[52]  M. Kapella,et al.  Subjective Fatigue, Influencing Variables, and Consequences in Chronic Obstructive Pulmonary Disease , 2006, Nursing research.

[53]  J. Dimsdale,et al.  The association of obesity, cytokine levels, and depressive symptoms with diverse measures of fatigue in healthy subjects. , 2005, Archives of internal medicine.

[54]  Judith l. Reishtein.  Relationship between symptoms and functional performance in COPD. , 2005, Research in nursing & health.

[55]  John T. Cacioppo,et al.  A Short Scale for Measuring Loneliness in Large Surveys , 2004, Research on aging.

[56]  G. V. van Heck,et al.  Psychometric qualities of a brief self-rated fatigue measure: The Fatigue Assessment Scale. , 2003, Journal of psychosomatic research.

[57]  A. Mykletun,et al.  Hospital Anxiety and Depression (HAD) scale: Factor structure, item analyses and internal consistency in a large population , 2001, British Journal of Psychiatry.

[58]  Craig K. Enders,et al.  The Performance of the Full Information Maximum Likelihood Estimator in Multiple Regression Models with Missing Data , 2001 .

[59]  K. Breithaupt,et al.  Considerations for Measuring Functioning of the Elderly: IRM Dimensionality and Scaling Analysis , 2001, Health Services and Outcomes Research Methodology.

[60]  Z. Nahas,et al.  Functional impairment in COPD patients: the impact of anxiety and depression. , 2000, Psychosomatics.

[61]  K. Woo.  A pilot study to examine the relationships of dyspnoea, physical activity and fatigue in patients with chronic obstructive pulmonary disease. , 2000, Journal of clinical nursing.

[62]  F. Suppe,et al.  The middle-range theory of unpleasant symptoms: an update. , 1997, ANS. Advances in nursing science.

[63]  L. Berkman,et al.  Two Shorter Forms of the CES-D Depression Symptoms Index , 1993 .

[64]  T. Kamarck,et al.  A global measure of perceived stress. , 1983, Journal of health and social behavior.

[65]  L. Hawkley,et al.  National Social Life, Health, and Aging Project (NSHAP) , 2019, Encyclopedia of Gerontology and Population Aging.

[66]  Hee-Ju Kim,et al.  Measurement of fatigue: Comparison of the reliability and validity of single-item and short measures to a comprehensive measure. , 2017, International journal of nursing studies.

[67]  Sosun Kim,et al.  Correlates of fatigue in Koreans with chronic lung disease. , 2004, Heart & lung : the journal of critical care.

[68]  P. Bentler,et al.  Cutoff criteria for fit indexes in covariance structure analysis : Conventional criteria versus new alternatives , 1999 .

[69]  L. Radloff.  The CES-D Scale: A Self-Report Depression Scale for Research in the General Population — Source link , 2022 .