Page 215 - Encyclopedia of Nursing Research

182 n FATIGuE

family members and to the family as a unit, measurement in the recently released
and how the environment influences their National Institutes of Health roadmap for
F health actions. Intervention research needs research initiatives. Because nursing is cen-
to examine explanatory processes to deter- trally interested in symptoms and symptom
mine how interventions work. Because the management, fatigue is of major concern for
family is the primary social agent in the pro- nurse researchers and clinicians alike.
motion of health and well-being, our knowl- The North American Nursing diagnosis
edge of the family and its relationship to the Association (NANdA) defines fatigue as “An
health of its individual members is central to overwhelming sustained sense of exhaus-
research related to health promotion and to tion and decreased capacity for physical and
families responding to risk information and mental work at usual level” (NANdA, 2003,
experiencing illness and disability. p. 74). Although a number of nurse research-
Because of limitations in the research ers have studied fatigue and offered vari-
of families, knowledge of the significance of ous proposals for categorizing fatigue, most
family to the health of the family and family accept the NANdA definition of fatigue. An
members has not translated to policy, prac- alternative view of fatigue as “the awareness
tice in health care systems, and the education of a decreased capacity for physical and/or
of health professionals. As a result, the fam- mental activity due to an imbalance in the
ily is not the context of care and the health availability, utilization, and/or restoration
care systems do not support the health of of resources needed to perform an activity”
families. The translation of research of fam- (Aaronson et al., 1999) has also been pro-
ilies requires interdisciplinary research and posed. This definition adds a generic under-
collaboration. standing of potential causes of fatigue that
may differ in different situations, to facilitate
Suzanne Feetham studying the mechanisms of fatigue in dif-
ferent clinical conditions. This addition also
allows for a clearer conception of fatigue as a
biobehavioral phenomenon.
Fatigue With increased recognition of the impor-
tance of studying symptoms within nurs-
ing, more work on fatigue has emerged.
Fatigue is a universal symptom associated Investigators and study participants have
with most acute and chronic illnesses. It also made distinctions between acute and chronic
is a common complaint among otherwise fatigue. These distinctions are similar to
healthy persons, and often is cited as one those put forth by Piper (1989), who identified
of the most prevalent presenting symptoms acute fatigue as protective, linked to a single
in primary care practices. defining fatigue, cause, of short duration with a rapid onset,
however, has challenged scientists for years. perceived as normal, generally occurring
No clear biological marker of fatigue has been in basically healthy persons with minimal
identified and fatigue remains a perplexing impact on the person, and usually relieved
symptom for all health care providers. by rest; whereas chronic fatigue is identi-
Not only was fatigue named one of the fied as being perceived as abnormal, having
top four symptoms for study by an expert no known function or purpose, occurring in
panel on symptom management convened by clinical populations, having many causes,
the National Institute of Nursing research in not particularly related to exertion, persist-
the early 1990s, but recently, fatigue has been ing over time, having an insidious onset, not
singled out as among the symptoms or health usually relieved by rest, and having a major
outcomes needing attention for standardized impact on the person.