Subjective fatigue, influencing variables, and consequences in chronic obstructive pulmonary disease

Nurs Res. 2006 Jan-Feb;55(1):10-7. doi: 10.1097/00006199-200601000-00002.


Background: Fatigue is a common symptom of chronic obstructive pulmonary disease (COPD), but little is known about the specific nature of COPD-related fatigue and its impact on daily life.

Objectives: To (a) describe characteristics of fatigue in people with COPD and (b) test a theoretically and empirically supported model of the relationships among subjective fatigue, dyspnea, functional performance, anxious and depressed moods, and sleep quality in people with COPD.

Methods: A cross-sectional descriptive study was conducted with 130 people with moderate to severe COPD. Measures included the following: a Numerical Rating Scale (NRS) for frequency, intensity, and distress of fatigue and dyspnea; Fatigue Assessment Instrument (FAI); Chronic Respiratory Disease Questionnaire (CRQ); Profile of Mood States (POMS); Pittsburgh Sleep Quality Index (PSQI); Functional Performance Inventory (FPI); and spirometry. Path analysis was used to examine the relationships among variables.

Results: Participants reported moderate amounts of fatigue, which was described as situation-specific, had considerable consequences, and was responsive to rest and sleep. Dyspnea was slightly greater than fatigue, as measured by the NRSs (p <.001), and there was a strong relationship between fatigue and dyspnea (r =.74, p < .001). Dyspnea, depressed mood, and sleep quality accounted for 42% of the variance in subjective fatigue. Fatigue, dyspnea, airflow obstruction, and anxious mood accounted for 36% of the variance in functional performance.

Conclusions: Fatigue is an important problem that affects performance of daily activities in people with COPD. The relationships or interactions that exist among fatigue and other symptoms are complex.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Affect
  • Aged
  • Analysis of Variance
  • Anxiety / etiology
  • Attitude to Health*
  • Body Mass Index
  • Cross-Sectional Studies
  • Depression / etiology
  • Dyspnea / etiology
  • Fatigue / classification
  • Fatigue / etiology*
  • Fatigue / psychology*
  • Female
  • Forced Expiratory Volume
  • Humans
  • Male
  • Middle Aged
  • Models, Psychological
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Quality of Life
  • Risk Factors
  • Severity of Illness Index
  • Sleep Wake Disorders / etiology
  • Surveys and Questionnaires