Are significant others able accurately to assess fatigue, exertion fatigue and types of fatigue in domiciliary heart patients?

Abstract

Although fatigue is recognized as a subjective and person‐related diagnosis both in patients and in healthy subjects, there have been no studies performed to show whether ‘significant others’ surrounding fatigued subjects are able to assess accurately the level of fatigue that exists in patients. The aim of this study is to investigate this issue.The following research questions are formulated: (i) To what degree do the assessments of fatigue and exertion fatigue given by significant others and patients agree? and (ii) To what degree do the assessments of types of fatigue given by significant others and patients agree?The method adopted employed a cross‐sectional design approach applied to domiciliary heart patients and their significant others. Data was gathered by questionnaire. Data collected from 64 selected patients and their significant others are used in the analyses. Measurement instruments used are the Dutch fatigue scale (DUFS), the Dutch exertion fatigue scale (DEFS), numerical rating scales for fatigue and exertion fatigue, types of fatigue and sociodemographic variables.The main conclusion of this study is that significant others are able to assess accurately patients' fatigue and exertion fatigue. At all three levels of measurement and analyses in this study — item‐level, scale‐level and assessment‐level — the paired absolute mean differences between patients and significant others for both the DUFS and DEFS are low. The measures of agreement —κ or Spearman's rank correlation coefficient and percentage agreement — are good and this degree of consensus increases from item‐level (DUFS & DEFS: moderate), scale‐level (DUFS & DEFS: substantial) to assessment‐level (DUFS: substantial; DEFS: almost perfect).Another conclusion of this study is that significant others are able to accurately estimate different types of fatigue. The measures of agreement among the indicators referring to the different types of fatigue ranged from moderate agreement (predominance and pattern) to substantial agreement (specificity and explicability) to almost perfect agreement (intensity).Furthermore, it may be concluded that both cohabiting significant others and noncohabitee family, friends and acquaintances may be seen as a potential and reliable human resource, providing professionals with fundamental information concerning patients' fatigue and exertion fatigue which may be used in their diagnostic process and treatment.