N014. How fatigue is experienced and handled by female patients with inflammatory bowel disease (IBD)
A. Beck1, P. Bager1, P.E. Jensen2, 1Aarhus University Hospital, Department of Medicine V (Hepatology and Gastroenterology), Aarhus C, Denmark, 2VIA University College, Education of nurses, Aarhus, Denmark
Studies show that fatigue is a significant part of everyday life of IBD-patients, and that fatigue influences their health-related quality of life. Some studies seem to show that female patients experience a higher level of fatigue than men. In spite of the increased interest in fatigue as a symptom little is known about the patient's perspective. The aim of this study was to investigate how female IBD-patients experience and handle fatigue.
The study included 12 female outpatients, 40–59 years old, illness duration more than one year and a fatigue score (The Multidimensional Fatigue Inventory [MFI-20]). Patients with severe IBD, anaemia, comorbidity or pregnancy were excluded from participation. All included were willing to take part in a semi-structured interview. All interviews were analysed using Malterud's principle of text condensation.
A majority of the patients described physical fatigue involving heavy legs, tired eyes, pain or stiffness. The patients' description of mental fatigue was mainly expressed as concentration problems and irritation. These symptoms caused some social, physical and work-related limits, which lead to feelings like bad conscience, powerlessness, sadness, frustration and anger.
The patients used planning, priority, acceptance and support form their relatives to handle fatigue. Only two patients used exercise on regular basis to achieve more energy. As a surprise several patients told that they did not need to talk with professionals about fatigue, unless a cure was available.
Fatigue results in symptoms, which affect the patients' social, physical and work-related life. This means that fatigue is an important aspect of life of the IBD-patient, and furthermore fatigue and its limits are connected to negative thoughts and feelings. In spite of this, several patients expressed that they had chosen to accept fatigue.
The way that patients handle fatigue, reminds of how the general population handle tiredness. Nevertheless it is import to distinguish between fatigue and tiredness. It is possible that the patients are much more aware of the symptoms and possible actions, than the general population.
As already mentioned, only two patients used exercise. How exercise affects IBD-patients' energy level need to be investigated further.