Fatigue in Adults with Chronic Obstructive Pulmonary Disease Before and During a Pandemic
AdvisorKlinedinst, N. Jennifer
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AbstractBackground: Over half of the 11 million people living with chronic obstructive pulmonary disease (COPD) suffer from debilitating fatigue almost every day. There is limited evidence on known mechanisms of COPD-related fatigue and factors that influence fatigue. Purpose: The purposes of this dissertation were to 1) survey the findings of existing literature on correlates and underlying potential mechanisms of COPD-related fatigue and test these findings in a model of situational factors, psychologic and physiologic factors in adults with COPD-related fatigue and physical functioning and 2) explore the lived experience of COPD-related fatigue during the COVID-19 pandemic. Methods: Chapter 2 is a scoping review to identify relevant studies on potential mechanisms and influential factors of COPD-related fatigue based on the Theory of Unpleasant Symptoms. The second manuscript is a descriptive correlational study that presents a path model from a population-based study on the relationships between physiologic, psychologic, and situational factors with fatigue and physical function. The third manuscript is a qualitative research study using a phenomenological descriptive approach and collected data from adults living with COPD and fatigue during the COVID-19 pandemic with attention to the influence of social support and physical function. Results: In Chapter 2, a conceptual model of COPD-fatigue was established from the scoping review based on the TOUS of physiologic, psychologic and situational factors contributing to COPD fatigue. When testing the model, depression (0.181, p<0.001), smoking (0.541, p=0.019), and stress (0.073, p=0.038) all had significant direct effects on fatigue. Social support (0.967, p=.016) and sleep (0.577, p=0.010) impacted physical functioning, but not fatigue. In Chapter 4, three main themes were found from interviews pertaining to the experience of fatigue during the COVID-19 pandemic: experience of general fatigue from the COVID-19 pandemic, changes in response to pandemic, and psychologic and social mentality. Conclusion: These findings lay groundwork for research on influential factors of COPD-related fatigue and physical function. Interventions geared toward reducing depression and stress management may reduce COPD related fatigue. There remains a gap on physiologic mechanisms of COPD fatigue that should be addressed in future studies.
DescriptionUniversity of Maryland, Baltimore. Nursing. Ph.D. 2021
Pulmonary Disease, Chronic Obstructive
Signs and Symptoms, Respiratory
Correlation of Data