Fatigue One to Five Years after Lung Transplantation

PURPOSE: The knowledge is scarce regarding how recovery and well-being after lung transplantation is affected by various symptoms. Thus, little is known about self-management support for these recipients. Since fatigue is a symptom that severely impair well-being, the aim of this study was to explore associations between fatigue and influencing factors as perceived self-efficacy, social and psychological well-being, and recovery. METHODS: Cross-sectional, multi-center cohort study. Lung recipients (n=117) due for an annual follow-up one to five years after transplantation were screened with The Multidimensional Fatigue Inventory-20, Self-Efficacy for Managing Chronic Disease scale, Postoperative Recovery Profile questionnaire and the Organ Transplant Symptom and Well-being Instrument. RESULTS: Totally, 56% reported high general fatigue regardless of follow-up time. Regardless of time after transplantation patients reported high levels of fatigue. Lung recipients at the four-year follow-up reported most severe fatigue in all dimensions except for mental fatigue. There was no relationship between lung function (FEV1) and any of the five dimensions of fatigue. There was a weak relationship between mental fatigue and the grade of Bronchiolitis obliterans syndrome (rs-.202*). A strong negative correlation (range -.66- -.73; p<0.001) was found between four out of five dimensions of fatigue (general, physical fatigue, reduced activity and reduced motivation) and self-efficacy. A high level of fatigue was related to impaired self-efficacy. There was a strong relationship between all dimensions of fatigue and both mental and social well-being. Regardless of follow-up time, those reporting being fully or almost fully recovered were significantly less fatigued. CONCLUSION: A high level of fatigue is related to impaired self-efficacy causing a risk of impaired self-management ability and an increased demand for self-management support. Self-perceived recovery might be a matter of the lung recipient's experienced fatigue. Fatigue should be a preferred target of interventions in clinical practice due to its association to self-efficacy and recovery.