Fatigue and mental health among patients with heart failure in an outpatient setting

Abstract

Background: Heart failure is a health problem that occurs in the cardiovascular system which globally is the highest cause of death in the world. Heart Failure is a complex clinical syndrome in which the heart cannot pump blood to meet the body's blood circulation needs for tissue metabolism in certain conditions, due to structural or functional damage to the heart chambers. It is usually characterized by excessive blood volume, inadequate tissue perfusion, poor activity tolerance, and usually easily feels tired, orthopnea and edema. The emergence of various clinical symptoms in heart failure patients will cause nursing problems and interfere with basic human needs, one of which is fatigue. Heart failure sufferers have problems with the heart system which results in a lack of blood and oxygen supply to the brain and muscles, so sufferers often experience fatigue to the point of fainting.

Purpose: To determine the relationship between the level of fatigue and the mental health of heart failure patients.

Method: This type of quantitative research with a design using a cross sectional approach. Carried out at the heart clinic dr. Moewardi Surakarta, Central Java of the regional general hospital from October to December 2023. The population of heart failure sufferers in this study was 186 people, however by using a purposive sampling technique in sampling, a sample of 148 patients was obtained. The inclusion criteria in this study were patients aged >18 years, New York Heart Association (NYHA) class II and class III heart failure patients, while the exclusion criteria were heart failure patients who were unwilling or unable to take part in this study. The instruments used were the fatigue assessment scale (FAS) and depression anxiety and stress scale 21 (DASS-21) questionnaires. Data analysis used univariate and bivariate with the chi square test.

Results: The majority of respondents experienced mild fatigue with anxious conditions, 53 people (53.0%). Meanwhile, 47 patients (47.0%) who complained of severe fatigue showed anxiety, 24 people (85.7%), and 12 people (60.0%) felt stressed. The results of the analysis obtained a significant value with a p-value of 0.001 (<0.05) which indicates that H₀ was rejected. So there is a relationship between the level of fatigue and mental health conditions in heart failure sufferers.

Conclusion: There is a relationship between the level of fatigue and mental health in heart failure patients. The nursing implication that can be implemented is providing education about fatigue so that patients understand the impact it has on heart failure sufferers so that it does not cause mental health problems.